The relationship between resting arterial blood pressure and oral postsurgical pain (2025)

The relationship between resting arterial blood pressure and acute postoperative pain in endodontic patients

Journal of orofacial pain, 2012

To evaluate the relationship between preoperative resting arterial blood pressure and postoperative pain in patients undergoing nonsurgical root canal therapy. Written informed consent was obtained from normotensive patients seeking treatment for teeth with a preoperative diagnosis of pulpal necrosis and periradicular periodontitis. Preoperative resting blood pressure was recorded, and nonsurgical root canal therapy was initiated using a standardized protocol. Patients recorded their pre- and postoperative pain intensity on a 100-mm visual analog scale (VAS) for 7 days after the procedure. A linear regression model to predict postoperative VAS intensity used preoperative pain and blood pressure values as covariates. Pearson correlations were calculated to assess the relationship between the measures of preoperative blood pressure and both pre- and postoperative pain. After controlling for preoperative pain, significant correlations were observed between preoperative systolic blood p...

Analysis of blood pressure during tooth extraction

2014

Introduction: Surgical procedures have a history of dental pain, apprehension and fear reported by patients. Because of these reasons, they trigger a series ...

Impacted lower third molars: Can preoperative salivary pH influence postoperative pain?

National Journal of Maxillofacial Surgery, 2010

Pain as a frequent occurrence after dental procedures concerns patients and has an adverse impact on patient satisfaction. [1] Third molar post extraction pain (PEP) is one of the most common models successfully used in recent years for assessing the analgesic efficacy of pain-killing drugs. [2,3] Pain is a subjective experience influenced by many factors such as patient age, cultural and educational level, past experiences, pain threshold and tolerance which makes its objective assessment difficult. Despite these limitations, a visual analog scale (VAS) is universally considered to be the most appropriate instrument for pain measurement and is the most widely used means for scoring postoperative painand specifically that caused by the surgical extraction of the lower third molar. [4-6] The literature has it that many factors are related to PEP (such as patient age, surgical parameters, number of sutures, degree of impaction, etc.). Some have strong supporting evidence Confirming their relationship while some are still mired in controversy. Most of the literature focuses little attention on the patient and surgical factors that influence third molar PEP. [7] However, one of the most important factors regulating oral health is saliva. [8] For diagnostic and prognostic purposes, routine dental practice should therefore

EVALUATION OF ANXIETY AND BLOOD PRESSURE IN PATIENTS UNDERGOING MINOR ORAL SURGERY (Atena Editora)

EVALUATION OF ANXIETY AND BLOOD PRESSURE IN PATIENTS UNDERGOING MINOR ORAL SURGERY (Atena Editora), 2023

The dental environment generates fear and anxiety for many individuals. These feelings can be observed by behavioral and physiological changes, such as altered blood pressure, tachycardia, changes in temperature, pulse and respiratory rate. The objective of this study was to verify if there is variation in blood pressure (BP) of normorreactive patients submitted to surgical procedures in the Update on Minor Oral Surgery course at ``Universidade Vale do Itajaí``- Univali, before and after the anesthetic act, and to relate the values blood pressure levels with patients' anxiety. Cross-sectional clinical study through primary data collection. Eighty-five patients participated, who answered a Corah Anxiety Scale questionnaire. Subsequently, blood pressure was measured before the anesthetic act and immediately after it. After the measurements, the data were tabulated and related to the Corah Anxiety Scale, in order to determine whether there was a relationship between anxiety levels and the variation in blood pressure values. It was observed that the mean BP was 122/84 before and 127/80 after the anesthetic act. As for anxiety, 57.6% were calm, 24.7% a little tense, 13% tense and 4.7% very anxious. It was concluded that there was no significant difference in blood pressure before and after the anesthetic procedure, nor was there any relationship between pressure values and patient anxiety.

Effect of Dental Anxiety on Blood Pressure of Patients Undergoing Dental Extractions Under Local Anesthesia

2017

Dental treatment especially surgical treatments like tooth extractions are usually considered by patients as a fearful procedure due to the sight of instruments and blood and the expected pain during and after the procedure. The fear and anxiety may raise the blood pressure which may further complicate the operative and postoperative phases. The study was aimed at finding a relationship between Dental anxiety and Blood Pressure fluctuations in patients undergoing dental extractions under local anesthesia. A total of 196 participants were included in the study after getting the written consent signed. Dental anxiety was measured by a Modified Corah’s Dental Anxiety Scale. Blood pressure measurements were done at five different points during patients’ visit for dental extraction and were standardized according to the JNC (Joint National Committee)-8 guidelines for Hypertension. The local anesthetic solution used was Lidocaine 2% with 1:100,000 adrenaline in a 1.8 mL cartridge. The res...

Predicting Pain After Tooth Extraction: Pain Prediction Index

Journal of oral & facial pain and headache, 2018

To identify relevant variables that may predict pain after routine extraction of erupted teeth, to construct a Pain Prediction Index (PPI) based on these variables, and to verify how these variables are related by using valid structural equation modeling (ie, path analysis). This study was designed as an observational prospective study for postoperative memory of pain after dental extraction of erupted teeth. Data from a total of 781 surgical procedures related to dental extractions were included. Pain was self-reported by the patients and was evaluated by a verbal category scale (VCS) on the seventh postoperative day. The database was searched for predictive variables that were significantly (P < .05) associated with postoperative pain. Pain was scored by patients as none in 65.4% of cases (511); light in 22.9% (179); moderate in 11% (86); and severe in 0.6% (5). Seven predictive variables were strongly related to postoperative pain: gender (female); age (younger than 33); numbe...

Update on the Use of Analgesics in Oral Surgery

Romanian Journal of Oral Rehabilitation, 2020

Hemodynamic variations and anxiety during the surgical extraction of impacted lower third molars

Journal of Clinical and Experimental Dentistry

Background: The surgical removal of an impacted third molar can cause patient anxiety. Such anxiety and the use of vasoconstrictor drugs and local anesthetics in turn can induce hemodynamic variations during the operation. A study is made of the variations in hemodynamic parameters (systolic and diastolic blood pressure and heart rate) and their correlation to patient gender and anxiety during surgical removal of an impacted lower third molar. Material and Methods: A prospective study was carried out in the Oral Surgery Unit of a university clinic, with the inclusion of 125 patients (mean age 24.9 years). Anesthesia was administered in the form of 4% articaine and adrenalin 1:200,000 for surgical removal of the impacted lower third molars. Results: Women experienced greater anxiety than men. Systolic blood pressure showed few changes-the maximum and minimum values being recorded at the time of incision and upon suturing, respectively. Diastolic blood pressure in turn showed maximum and minimum values before the start of surgery and during extraction, respectively, while heart rate proved maximum during incision and minimum upon suturing. The differences in systolic and diastolic blood pressure, and heart rate, between men and women, and between patients with and without anxiety, failed to reach statistical significance. Conclusions: The fact that these were young patients could contribute to explain the absence of significant hemodynamic changes in our study.

Evaluation of changes in blood pressure in patients submitted to dental surgical procedures

2021

The present study aimed to evaluate the occurrence of significant changes in systemic blood pressure (SBP) during surgical-dental procedures. A prospective study was performed with a sample of 135 randomly selected individuals who underwent surgical procedures at the Bucomaxillofacial Surgery Clinic of the Dentistry School of the ESFA (ES) between the second half of 2017 and April 2018. After consent, sociodemographic, lifestyle data, weight and height were obtained through a questionnaire, weighing and measurement, respectively. BP measurements were performed at three moments: preoperative (BP1), intraoperative (BP2) and postoperative (BP3) using a mercury column sphygmomanometer and stethoscope. Values ​​<120/80 mmHg were used as normal values. When BP1 and BP2 were compared, 63.0% remained within normal values ​​and 22.2% reached the stage of hypertension. In the comparison of BP1 and BP3, 66.7% remained normal, and only 7.4% reached the stage of hypertension. When BP2 and BP3...

Analysis of the acute postoperative pain experience following oral surgery: Identification of ‘unaffected’, ‘disabled’ and ‘depressed, anxious and disabled’ patient clusters

Acute Pain, 2006

Background: Pain is defined as both a sensory and an emotional experience. Acute postoperative tooth extraction pain is assessed and treated as a physiological (sensory) pain while chronic pain is a biopsychosocial problem. The purpose of this study was to assess whether psychological and social changes occur in the acute pain state. Methods: A biopsychosocial pain questionnaire was completed by 438 subjects (165 males, 273 females) with acute postoperative pain at 24 hours following the surgical extraction of teeth and compared with 273 subjects (78 males, 195 females) with chronic orofacial pain. Statistical methods used a k-means cluster analysis. Results: Three clusters were identified in the acute pain group: 'unaffected', 'disabled' and 'depressed, anxious and disabled'. Psychosocial effects showed 24.8 per cent feeling 'distress/suffering' and 15.1 per cent 'sad and depressed'. Females reported higher pain intensity and more distress, depression and inadequate medication for pain relief (p<0.001). Distress and depression were associated with higher pain intensity. The developed questionnaire had tested reliability (test-retest r=0.89) and estimated validity. Conclusion: Cluster analysis showed constituent groups with a range of psychosocial effects in acute postoperative dental extraction pain and is associated with an increase in pain intensity.

Evaluation of Pain and Anxiety Levels of Tooth Extraction

International Journal of Academic Medicine and Pharmacy

The anxiety observed in patients before and during dental treatments is defined as a complex behavior pattern related to physiological activation against internal or external stimuli. Anxiety formation is common before dental treatments, especially before tooth extraction. In this study, we were aimed to evaluate the anxiety, preoperative / postoperative pain levels and the relationship of various variables (age, smoking, etc.) with tooth extraction, which is one of the most basic procedures of oral and maxillofacial surgery. During the study process, 982 patients applied, 312 patients were identified according to the inclusion criteria, and the study was conducted with 210 patients who volunteered to participate in the study. There were significant differences between the groups in terms of marital status, educational status, history of previous tooth extraction and tooth brushing frequency (p <0.05). The level of anxiety increases towards posterior teeth (mean: 37.38 ± 7.40 for anterior teeth, mean: 44.40 ± 10.43 for molar teeth with complications). When the VAS scores were examined, the pain increased significantly from the anterior teeth to the posterior teeth (r: 0.568, p <0.05). There were statistically significant differences in terms of Penn State Worry Questionnaire (PSWQ) total scores when the groups that had tooth extraction were compared. Although smoking causes an increase in the incidence of alveolar osteitis, it has been observed that it causes less pain (low VAS score) in patients who undergo tooth extraction.

Common risk factors for postoperative pain following the extraction of wisdom teeth

The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies. KEYWORDS: Extraction; Pain; Risk factors; Third molar

Analytical parameters and vital signs in patients subjected to dental extraction

Journal of clinical and experimental dentistry, 2017

Dental consultation may provoke stress to the patient, especially when a dental surgery is going to be performed, stressful situations can cause a reaction in the sympathetic nervous system that could lead to cardiovascular alterations. Blood pressure and cardiac frequency are used often as an indirect measurement and this parameters combined can serve as good indicators of stress. Objective: Analyze the changes in vital signs and analytical parameters induced by a dental extraction. 24 healthy patients who required a simple dental extraction underwent to a blood test and motorization of their pre- and post-extraction vital signs before, at 2 and 48 hours after the procedure. Data analysis was performed by means of repeated measures one way ANOVA followed by multiple comparisons Bonferroni&#39;s Post-hoc test. The evaluated patients were 13 women and 11 men with an average age of 35.1. Thirteen patients (54.17% of the sample) were smokers and five were regular drinkers (20.8%). No s...

Does Body Mass Index and Position of Impacted Lower Third Molar Affect the Postoperative Pain Intensity? A B

The main objective of this study was to determine to which extent body mass index and position of impacted lower third molar was affecting the pain intensity in the first seven postoperative days. The study was conducted following the extraction of the lower third molar in 108 patients. Depending on the type of information given to each particular patient, the patients were divided in two groups: the test group where patients were given detailed standard written and verbal instructions and the control group which received only standard written instructions about treatment after surgery. Using canonical discriminant analysis we investigated the influence of body mass index and the position of impacted lower third molar on postoperative pain intensity in two groups of patients. Results of this study showed that the body mass index or the tooth position did not have influence on intensity of postoperative pain. The body mass index and the position of impacted lower third molar do not affect the postoperative pain intensity.

Preemptive analgesia in third molar surgery: A randomized clinical trial comparing two multimodal associations

Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial, 2022

Objective: This study aimed to verify the effect of preemptive administration of dexamethasone 8 mg co-administered with paracetamol 1 g compared with dexamethasone 8 mg co-administered with nimesulide 100 mg in surgeries for extracting third molars. Methods: A prospective, randomized, triple-blind clinical trial was conducted, allocating patients into two groups by the split-mouth method: Group 1 received dexamethasone and paracetamol, and Group 2 received dexamethasone and nimesulide. Each patient underwent two surgeries on different occasions, evaluating the parameters: pain, number of consumed rescue analgesics, time to the first rescue analgesic consumption, edema, trismus, and patient satisfaction. Results: Similar results were found in pain, trismus, number of rescue analgesics ingested, time until ingesting the first rescue analgesic, and overall assessment variables. However, Group 1 showed better results regarding edema, with a statistically significant difference in the 4...

Evaluation of systolic and diastolic blood pressure, pulse rate and SPO2 levels pre and post dental extraction under local anesthesia

IP Innovative Publication Pvt. Ltd., 2018

Aim: To evaluate the changes in blood pressure, pulse rate and SpO2 pre during and post extraction procedure under local anesthesia. Materials and Method:A total of 150 patients were included in the study. Pulse oximeter was placed to evaluate the parameters and changes were investigated before administering local anesthesia, during anesthesia, during extraction procedure and post extraction. Data was tabulated and statistical analysis was done using 20 SPSS software. Results:Almost of the patients has increase in the systolic blood pressure and pulse rate during administration of local anesthesia and during extraction procedure. Very minimal change was observed in diastolic blood pressure and SpO2 levels. Conclusion:Significant changes are noted in changes in systolic blood pressure and pulse rate pre administration of local anesthesia, during administration of local anesthesia, during extraction, and post extraction procedure. Diastolic blood pressure and SpO2 has no significant differences. Keywords:Blood pressure, Pulse rate, SpO2, Dental extraction, Local anesthesia

Does Body Mass Index and Position of Impacted Lower Third Molar Affect the Postoperative Pain Intensity

The main objective of this study was to determine to which extent body mass index and position of impacted lower third molar was affecting the pain intensity in the first seven postoperative days. The study was conducted following the extraction of the lower third molar in 108 patients. Depending on the type of information given to each particular patient, the patients were divided in two groups: the test group where patients were given detailed standard written and verbal instructions and the control group which received only standard written instructions about treatment after surgery. Using canonical discriminant analysis we investigated the influence of body mass index and the position of impacted lower third molar on postoperative pain intensity in two groups of patients. Results of this study showed that the body mass index or the tooth position did not have influence on intensity of postoperative pain. The body mass index and the position of impacted lower third molar do not affect the postoperative pain intensity.

Pain Levels after Third Molar Surgical Removal: An Evaluation of Predictive Variables

The Journal of Contemporary Dental Practice, 2011

Aim: The aim of this prospective study was to evaluate the pain course after surgical removal of third molars. Materials and methods: The sample consisted of 100 consecutive patients. Pain intensity was assessed by means of a visual analog scale (VAS). Results: At day 1, moderate and severe pain were observed predominantly in patients who had surgery in the mandible (p < 0.001) and for patients younger than 24 years (p = 0.009), while more patients who weekly consumed mate tea (Ilex paraguariensis) showed pain classified as none or light (p = 0.017). At day 2, the profile of pain moderate/severe was more prevalent for patients who had surgery in the mandible (p < 0.001) with the report of difficult surgery (p = 0.042) and with odontotomy performed (p = 0.033). In the third postoperative day, severe/moderate pain was associated with surgery in the mandible (p < 0.001) and with odontotomy (p = 0.021) and ostectomy (p = 0.028) performed, with report of long and difficult procedure (p = 0.023), surgeries which last more than sixty minutes (p < 0.026), and for those patients who developed postoperative inflammatory complications (p < 0.001). Conclusion: Higher pain complains could be expected for patients who have long and difficult mandibular third molar surgery characterized by odontotomy and ostectomy. Clinical significance: Pain after third molar surgery is a common sequele. It is indispensable for the dentists to be apt in handling and preventing it as far as possible and know possible variables that may influence or increase these pain levels. It can be a clinical advantage. Better understanding the pain characteristics may guide the dentist through preoperative decisions.

Post-operative pain and use of analgesic agents following various dental procedures

PubMed, 2006

Purpose: To evaluate the incidence and duration of post-operative pain and the use of analgesic agents in adults with regard to gender, type of injection, dental procedure performed, and tooth history. Methods: Frequency and duration of post-operative pain and use of analgesic agents were examined in 255 patients, aged 18-42 years, who received routine dental treatment, including amalgam and composite restorations, root canal treatment (instrumentation), root canal filling (obturation), posts, and extractions. Teeth were anesthetized by either local infiltration (for maxillary teeth) or inferior alveolar nerve block (for mandibular teeth). Information regarding post-operative pain and use of analgesic agents was obtained though a phone call, 24 hours after treatment. Results: The overall incidence of post-operative pain was 40.4% (103 patients) of whom 36.9% (38 patients) reported a low level of pain. Pain-relieving medication was used by 32% of the patients who reported post-operative pain (12.9% of the population). Incidence and severity of post-operative pain were significantly correlated with specific dental treatment: the highest after root canal filling (52.8%, 21% reported a low level of pain) and lowest after restorations (36.1%, 42.4% reported a low level of pain). Post-operative pain was reported more often by females (52.2%) than males (33.7%) (P= 0.012). Incidence of post-operative pain was not correlated with depth and extension of the restoration performed. However, the severity of post-operative pain as indicated by analgesic usage was more frequent following deep restorations (over 3 mm).

Assessment of Relationship between Pain and Anxiety Following Dental Extraction—A Prospective Study

Pain Studies and Treatment, 2015

Objective-Anxiety and expected dental pain are the main reasons for avoiding any dental treatment by general population. In this study, we aimed to evaluate the various factors which can increase the anxiety and its association with pain perception of patients following dental extraction. Material and Methods-We had included 100 patients in our study who were undergoing orthodontic treatment and required extraction of either 34 or 44. Pain and anxiety levels after extraction were assessed with a visual analog scale (VAS) and an anxiety questionnaire consisting of eleven questions. Results-The mean VAS score for the entire study group was 16.23 ± 1.28 with statistically significant differences between genders, and was high in females and no statistically significant differences between different age groups. The mean anxiety score was 10.64 ± 3.12. This was significantly higher in women (P = 0.005), but there was no statistically significant differences between different age groups. There was a statistically significant correlation between VAS and total anxiety score (P < 0.001) as well as each question, except for question number 4, 8 and 9 in men. Conclusion-Although most patients had experienced limited pain, there was a significant gender difference in pain and anxiety level. They were anxious because they expected pain, women being more anxious than men. The most provoking factor for anxiety and pain while going for extraction in females was "being seated in dental chair", while in men the most provoking factor was "uncertainty about proper numbness before extraction".