Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth: A prospective observational study

Tze-Fang Wang, Ya-Ting Wu, Chien-Fu Tseng, Chyuan Chou, Tze-Fang Wang, Ya-Ting Wu, Chien-Fu Tseng, Chyuan Chou

Abstract

The aim of the study is to identify associations between dental anxiety and postoperative pain in patients undergoing extraction of horizontally impacted wisdom teeth.A total of 119 volunteers provided demographic data, and completed questionnaires, the State-Trait Anxiety Inventory (STAI), Chinese Index of Dental Anxiety and Fear (C-IDAF)-4C, and the Numeric Rating Scale (NRS) for pain.Mean SAI, TAI, and C-IDAF-4C scores were 42.5 ± 8.7, 46.4 ± 10.9, and 16.9 ± 7.2, respectively. Mean postoperative pain level score was 3.0 ± 1.8 (range: 0.3-8.4). SAI scores increased as preoperative pain levels increased (β = 1.30, 95% confidence interval [CI]: 0.62-1.98, P < .001); females had higher SAI scores than males (5.34; 95% CI: 1.74-8.95, P = .004). Multivariable analysis revealed that females, bad exodontic experience, and higher predicted pain levels were associated with higher IDAF-4C scores. SAI scores (γ = 0.611, P < .001) and TAI scores (γ = 0.305, P < .001) increased as C-IDAF-4C scores increased. Higher C-IDAF-4C scores and longer operative time were significantly associated with higher levels of postoperative pain.Specific factors are associated with anxiety and stress, and postoperative pain in patients undergoing wisdom teeth extraction. Addressing these factors preoperatively may reduce stress and anxiety, and lead to more favorable treatment outcomes.

Conflict of interest statement

The authors declare that there are no conflicts of interest related to this study.

Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

References

    1. Kazancioglu HO, Tek M, Ezirganli S, et al. Does watching a video on third molar surgery increase patients’ anxiety level? Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:272–7.
    1. Sirin Y, Humphris G, Sencan S, et al. What is the most fearful intervention in ambulatory oral surgery? Analysis of an outpatient clinic. Int J Oral Maxillofac Surg 2012;41:1284–90.
    1. Santosh P. Impacted mandibular third molars: review of literature and a proposal of a combined clinical and radiological classification. Ann Med Health Sci Res 2015;5:229–34.
    1. Singh V, Alex K, Pradhan R, et al. Techniques in the removal of impacted mandibular third molar: a comparative study. Eur J Gen Dent 2013;2:25–30.
    1. Aznar-Arasa L, Figueiredo R, Valmaseda-Castellon E, et al. Patient anxiety and surgical difficulty in impacted lower third molar extractions: a prospective cohort study. Int J Oral Maxillofac Surg 2014;43:1131–6.
    1. Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty. J Oral Maxillofac Surg 2004;62:1363–71.
    1. Zuniga JR. Guidelines for anxiety control and pain management in oral and maxillofacial surgery. J Oral Maxillofac Surg 2000;58(suppl 2):4–7.
    1. Lago-Mendez L, Diniz-Freitas M, Senra-Rivera C, et al. Relationships between surgical difficulty and postoperative pain in lower third molar extractions. J Oral Maxillofac Surg 2007;65:979–83.
    1. Dao J, Zhang J, Song G, et al. Effect of preoperative anxiety level on postoperative pain sensation in patients receiving implant denture for partial edentulism. Nan Fang Yi Ke Da Xue Xue Bao 2014;34:528–31. [in Chinese].
    1. Spielberger CD, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.
    1. Kazancioglu HO, Dahhan AS, Acar AH. How could multimedia information about dental implant surgery effects patients’ anxiety level? Med Oral Patol Oral Cir Bucal 2017;22:e102–7.
    1. Yildirim TT, Dundar S, Bozoglan A, et al. Is there a relation between dental anxiety, fear and general psychological status? PeerJ 2017;5:e2978.
    1. Kneeland ET, Dovidio JF, Joormann J, et al. Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science. Clin Psychol Rev 2016;45:81–8.
    1. American Society of Anesthesiologists (ASA). ASA physical status classification system. 2014. Available at: . Accessed June 30, 2016.
    1. Pell GJ. Impacted mandibular third molars: classification and modified techniques for removal. Dental Dig 1933;39:330–8.
    1. Chung SC. Revision of the State-Trait Anxiety inventory. Testing Yearbook of the Chinese Association of Psychological Testing 1984;31: (chinese version). Accessed November 14, 2014.
    1. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 2003;3:310–6.
    1. Lin CS, Wu SY, Yi CA. Association between anxiety and pain in dental treatment. J Dent Res 2017;96:153–62.
    1. Kyle BN, McNeil DW, Weaver B, et al. Recall of dental pain and anxiety in a cohort of oral surgery patients. J Dent Res 2016;95:629–34.
    1. Eli I, Schwartz-Arad D, Bartal Y. Anxiety and ability to recognize clinical information in dentistry. J Dent Res 2008;87:65–8.
    1. Stouthard MEA, Hoogstraten GJ. Assessment of dental anxiety: a facet approach. Anxiety Stress Coping 1993;6:89–105.
    1. Armfield JM. Development and psychometric evaluation of the Index of Dental Anxiety and Fear (IDAF-4C+). Psychol Assess 2010;22:279–87.
    1. Moerman N, van Dam FS, Muller MJ, et al. The Amsterdam Preoperative Anxiety and Information Scale (APAIS). Anesth Analg 1996;82:445–51.
    1. Nishimori M, Moerman N, Fukuhara S, et al. Translation and validation of the Amsterdam preoperative anxiety and information scale (APAIS) for use in Japan. Qual Life Res 2002;11:361–4.
    1. Torres-Lagares D, Recio-Lora C, Castillo-Dali G, et al. Influence of state anxiety and trate anxiety in postoperative in oral surgery. Med Oral Patol Oral Cir Bucal 2014;19:e403–8.
    1. Locker D, Liddell A, Shapiro D. Diagnostic categories of dental anxiety: a population-based study. Behav Res Ther 1999;37:25–37.
    1. Muglali M, Komerik N. Factors related to patients’ anxiety before and after oral surgery. J Oral Maxillofac Surg 2008;66:870–7.
    1. Brignardello-Petersen R. Previous bad experience, propensity to anxiety, and pain expectations may be associated with fear and anxiety when undergoing tooth extractions. J Am Dent Assoc 2017;148:e4.
    1. Heyman RE, Slep AM, White-Ajmani M, et al. Dental fear and avoidance in treatment seekers at a large, urban dental clinic. Oral Health Prev Dent 2016;14:315–20.
    1. de Santana-Santos T, de Souza-Santos aA, Martins-Filho PR, et al. Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables. Med Oral Patol Oral Cir Bucal 2013;18:e65–70.
    1. Gopalraju P, Lalitha RM, Prasad K, et al. Comparative study of intravenous Tramadol vs. Ketorolac for preventing postoperative pain after third molar surgery-a prospective randomized study. J Cranio Maxillofac Surg 2014;42:629–33.
    1. Desai A, Patel R, Desai K, et al. Comparison of two incision designs for surgical removal of impacted mandibular third molar: A randomized comparative clinical study. Contemp Clin Dent 2014;5:170–4.

Source: PubMed

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