The effect of pain intensity levels and clinical symptoms on the treatment preferences of patients with endodontically involved teeth: A preliminary cross-sectional study

Purpose: This study aimed to evaluate the effect of pain intensity levels and clinical symptoms on the treatment preferences of patients with endodontically involved teeth in a local Turkish population. Subjects and Methods: A total of 30 patients with symptomatic teeth requiring non-surgical root canal treatment were included in the study. The patients’ demographic (age, gender, and education level) and diagnostic data (tooth type, pain intensity, response to percussion and palpation, presence of referred pain, and diagnosis) were analyzed. Data on the patients’ explicit preferences (requested treatment, whether they are willing to accept a proposed extraction, choice of treatment if an anterior tooth was involved, and choice of treatment if the pain was not severe) as well as previous root canal treatment experiences were also analyzed. Pain intensity levels were evaluated using the Visual Analog Scale. Results: Pain intensity levels had a significant effect on the treatment requested by the patient (p=0.001). Among the patients who requested extraction upon referral to the clinic, the rate of those who reported that they would not accept extraction if the pain was located in an anterior tooth was significantly lower than that of patients stating that they would refuse (p=0.039). The presence of referred pain also had a significant effect on the requested treatment (p=0.001). Conclusion: The intensity of pain and the presence of referred pain influence patients’ treatment preferences.

Keywords:

decision-making, dental pain, ethics informed consent, treatment preference,

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1. Lipton J, Ship JA, Larach-Robinson D. Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc. 1993;124:115.
2. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce, JAMA 2003;290:2443.
3. Khan AAl, Owatz CB, Schindler WG, Schwartz SA, Keiser K, Hargreaves KM. Measurement of mechanical allodynia and local anesthetic efficacy in patients with irreversible pulpitis and acute periradicular periodontitis. J Endod 2007;33:796–799.
4. Owatz CB1, Khan AA, Schindler WG, Schwartz SA, Keiser K, Hargreaves KM. The incidence of mechanical allodynia in patients with irreversible pulpitis. J Endod 2007;33:552–556.
5. Hargreaves KM. Pain mechanisms of the pulpodentin complex. In: Hargreaves KM, Goodis HE, eds. Seltzer and Bender’s Dental Pulp. Chicago: Quintessence Publishing Company; 2002:181.
6. Fristad I, Berggreen E. Hyperalgesia and allodynia. In: Kenneth MH, Louis HB, eds. Cohen’s Pathways of the Pulp. Missouri: Elsevier Publishing Company; 2016:550.
7. Latremoliere A, Woolf CJ. Central sensitization: A generator of pain hypersensitivity by central neural plasticity. J Pain 2009;10:895–926.
8. Woolf CJ, Salter MW. Neuronal plasticity: Increasing the gain in pain. Science 2000;288:1765–1769.
9. Woolf CJ, King AE. Subthreshold components of the cutaneous mechanoreceptive fields of dorsal horn neurons in the rat lumbar spinal cord. J Neurophysiol 1989;62:907–916.
10. Bender IB: Pulpal pain diagnosis: a review. J Endod 2000;26:175.
11. Güven T, Sert G. Advance directives in Turkey’s cultural context: Examining the potential benefits for the implementation of patient rights. Bioethics 2010;24:127–133.
12. Aydin E. Rights of patients in developing countries: The case of Turkey. J Med Ethics 2004;30:555–557.
13. Sert G, Güven T, Görkey S. Capacity to consent. In: Sert G, Güven T, Görkey S, Nys H, Alphen aan den Rijn NL, eds. International Encyclopaedia of Laws: Medical Law. The Netherlands: Kluwer Law International; 2014:69.
14. Bisbing SB. Competency and capacity: a primer. In: Sanbar SS, Gibofsky A, Firestone MH, et al., eds. Legal Medicine, 4th ed. St. Louis: Mosby; 1998: 32–43.
15. Leo RJ. Competency and the capacity to make treatment decisions: A primer for primary care physicians. Prim Care Companion J Clin Psychiatry. 1999;1:131–141.
16. Turk DC. Handbook of pain assessment. New York: Guilford Press; 2011.
17. D'Souza RS, Johnson RL, Bettini L, Schulte PJ, Burkle C. Room for Improvement: A Systematic Review and Meta-analysis on the Informed Consent Process for Emergency Surgery. Mayo Clin Proc 2019;94(9):1786-1798.
18. Hucho T, Levine JD. Signaling pathways in sensitization: Toward a nociceptor cell biology. Neuron 2007;55:365–376.
19. Klages U, et al. Psychosocial impact of dental aesthetics in adolescence: Validity and reliability of a questionnaire across age groups. Qual Life Res 2015;24:379–390.
20. Kiyak HA. Does orthodontic treatment affect patients’ quality of life? J Dent Educ 2008;72:886–894.
21. Pithon MM, Nascimento CC, Barbosa GC, Coqueiro RD. Do dental aesthetics have any influence on finding a job? Am J Orthod Dentofacial Orthop 2014;146:423–429.
22. Kirkevang LL, Wenzel A. Risk indicators for apical periodontitis. Community Dent Oral Epidemiol 2003;31, 59-67.
23. Pewa P, Garla BK, Dagli R, Bhateja GA, Solanki J. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs. J Contemp Dent Pract. 2015 Oct 1;16(10):829-33.
24. Cowan E, Klerman H, Ma J. Capacity to Consent to Research in Patients with Acute Pain: A Pilot Study. IRB 2015;37(3):1-6.
25. Pizzaro V, Ferrer M. The utilization of dental care services according to health insurance coverage in Catalonia Spain. Community Dent Oral Epidemiol 2009;37:78–84.
26. Ricci G, Ricci A, Ricci C. Save the natural tooth or place an implant? Three periodontal decisional criteria to perform a correct therapy. Int J Periodontics Restorative Dent 2011;31:29-37.
27. Moriarty O, McGuire BE, Fin DP. The effects of pain on cognitive function: A review of clinical and preclinical research. Progress in Neurobiology 2011;93:385-404.

ISSN: 2630-6158
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1967
Yayıncı: İstanbul Üniversitesi

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