Pain associated with root canal treatment

• Published in: International endodontic journal Vol. 42; no. 7; pp. 614 - 620
• Main Authors: Segura-Egea, J. J., Cisneros-Cabello, R., Llamas-Carreras, J. M., Velasco-Ortega, E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2009
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Dental Pulp Diseases - physiopathology; Dental Pulp Diseases - therapy; Dental Pulp Necrosis - physiopathology; Dental Pulp Necrosis - therapy; Dentistry; endodontic pain; Female; Humans; irreversible pulpitis; Male; Mandible - pathology; Maxilla - pathology; Middle Aged; nonsurgical endodontic therapy; pain; Pain - classification; Pain Measurement; Periapical Diseases - physiopathology; Periapical Diseases - therapy; Periapical Periodontitis - physiopathology; Periapical Periodontitis - therapy; periapical status; pulpal status; Pulpitis - physiopathology; Pulpitis - therapy; Root Canal Therapy - methods; Sex Factors; Time Factors; Tooth - pathology; Young Adult
• ISSN: 0143-2885; 1365-2591
• DOI: 10.1111/j.1365-2591.2009.01562.x

Aim  To determine the pain experienced by patients during root canal treatment and to correlate with age and gender, pulpal diagnosis, previous periapical status, dental characteristics and length of treatment. Methodology  One hundred and seventy‐six patients (68 men and 108 women), with ages ranged from 6 to 83 years, were randomly recruited. Patients completed a 10‐cm visual analogue scale (VAS) that ranked the level of pain experienced during root canal treatment. Results  The mean pain level during root canal treatment was 1.2 ± 0.8 in a VAS between 0 and 10. Fifty‐four per cent of patients did not experience pain. There were no significant differences in relation to gender or age groups. Mandibular teeth had a significantly (P < 0.05) higher percentage incidence of pain in comparison with maxillary teeth. Pain was absent in 63% of anterior teeth compared with 44% in posterior ones (P < 0.01). Interventions shorter than 45 min resulted in a significantly higher percentage of pain absence (P < 0.05). Root canal treatment was significantly (P < 0.05) more painful in teeth with irreversible pulpitis and acute apical periodontitis compared to the group with necrotic pulps and chronic apical periodontitis (P = 0.049). Conclusions  Root canal treatment in teeth with irreversible pulpitis and acute apical periodontitis was more painful. Age, tooth type and length of the treatment were factors associated with increased risk for pain experienced during the procedure. Knowledge of pain levels endured by patients will allow dentists to decide when to use supplemental local anaesthesia.