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Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

  • Raocharernporn, Somchart (Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University) ;
  • Boonsiriseth, Kiatanant (Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University) ;
  • Khanijou, Manop (Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University) ;
  • Wongsirichat, Natthamet (Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University)
  • Received : 2017.01.20
  • Accepted : 2017.04.09
  • Published : 2017.06.30

Abstract

Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

Keywords

References

  1. Gatchel RJ, Ingersoll BD, Bowman L, Robertson MC, Walker C. The prevalence of dental fear and avoidance: a recent survey study. J Am Dent Assoc 1983; 107: 609-10. https://doi.org/10.14219/jada.archive.1983.0285
  2. Kaufman E, Epstein JB, Naveh E, Gorsky M, Gross A, Cohen G. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesth Prog 2005; 52: 122-7. https://doi.org/10.2344/0003-3006(2005)52[122:ASP]2.0.CO;2
  3. Nusstein J, Steinkruger G, Reader A, Beck M, Weaver J. The effects of a 2-stage injection technique on inferior alveolar nerve block injection pain. Anesth Prog 2006; 53: 126-30. https://doi.org/10.2344/0003-3006(2006)53[126:TEOASI]2.0.CO;2
  4. Liau FL, Kok SH, Lee JJ, Kuo RC, Hwang CR, Yang PJ, et al. Cardiovascular influence of dental anxiety during local anesthesia for tooth extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105: 16-26. Epub 2007 Jul 25. https://doi.org/10.1016/j.tripleo.2007.03.015
  5. Jensen MP, Chen C, Brugger AM. Interpretation of Visual Analog Scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 2003; 4: 407-14. https://doi.org/10.1016/S1526-5900(03)00716-8
  6. Luyk NH, Beck FM, Weaver JM. A visual analogue scale in the assessment of dental anxiety. Anesth Prog 1988; 35: 121-3.
  7. Okawa K, Ichinohe T, Kaneko Y. Anxiety may enhance pain during dental treatment. Bull Tokyo Dent Coll 2005; 46: 51-8. https://doi.org/10.2209/tdcpublication.46.51
  8. Locker D, Shapiro D, Liddell A. Negative dental experiences and their relationship to dental anxiety. Community Dental Health 1996; 13: 86-92.
  9. Edmunds R, Buchanan H. Cognitive vulnerability and the aetiology and maintenance of dental anxiety. Community Dent Oral Epidemiol 2011; 40: 17-25.
  10. Kleinknecht RA, Thornlike RM, McGlynn FD, Harkavy J. Factor analysis of the dental fear survey with crossvalidation. J Am Dent Assoc 1984; 108: 59-61. https://doi.org/10.14219/jada.archive.1984.0193
  11. Steven R, Rolf AP, David MG, Richard JM. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behavior Res Ther 1986; 24: 1-8. https://doi.org/10.1016/0005-7967(86)90143-9
  12. Klages U, Ulusoy O, Kianifard S, Wehrbein H. Dental trait anxiety and pain sensitivity as predictors of expected and experienced pain in stressful dental procedures. Eur J Oral Sci 2004; 112: 477-83. https://doi.org/10.1111/j.1600-0722.2004.00167.x
  13. Kim YK, Kim SM, Myoung H. Musical intervention reduces patients' anxiety in surgical extraction of an impacted mandibular third molar. J Oral Maxillofac Surg 2011; 69: 1036-45. https://doi.org/10.1016/j.joms.2010.02.045
  14. Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L. Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized controlled trials. Ambul Pediatr 2008; 8: 117-28. https://doi.org/10.1016/j.ambp.2007.12.005
  15. Mobilio N, Gremigni P, Pramstraller M, Vecchiatini R, Calura G, Catapano S. Explaining pain after lower third molar extraction by preoperative pain assessment. J Oral Maxillofac Surg 2011; 69: 2731-8. https://doi.org/10.1016/j.joms.2011.05.023
  16. Baum C, Huber C, Schneider R, Lautenbacher S. Prediction of experimental pain sensitivity by attention to pain-related stimuli in healthy individuals. Percept Mot Skills 2011; 112: 926-46. https://doi.org/10.2466/02.09.22.PMS.112.3.926-946
  17. Alemany-Martinez A, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Hemodynamic changes during the surgical removal of lower third molars. J Oral Maxillofac Surg 2008; 66: 453-61. https://doi.org/10.1016/j.joms.2007.06.634
  18. Rivat C, Becker C, Blugeot A, Zeau B, Mauborgne A, Pohl M, et al. Chronic stress induces transient spinal neuroinflammation, triggering sensory hypersensitivity and long-lasting anxiety-induced hyperalgesia. Pain 2010; 150: 358-68. https://doi.org/10.1016/j.pain.2010.05.031
  19. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg 1998; 86: 102-6.
  20. Frabetti L, Checchi L, Finelli K. Cardiovascular effects of local anesthesia with epinephrine in periodontal treatment. Quintessence Int 1992; 23: 19-24.
  21. de Morais HH, de Santana Santos T, da Costa Araujo FA, de Freitas Xavier RL, Vajgel A, de Holanda Vasconcellos RJ. Hemodynamic changes comparing 2% lidocaine and 4% articaine with epinephrine 1: 100,000 in lower third molar surgery. J Craniofac Surg 2012; 23: 1204-11. https://doi.org/10.1097/SCS.0b013e31824f66a0
  22. Ping B, Kiattavorncharoen S, Saengsirinavin C, Im P, Durward C, Wongsirichat N. The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery. J Dent Anesth Pain Med 2015; 15: 69-76. https://doi.org/10.17245/jdapm.2015.15.2.69
  23. Lasemi E, Sezavar M, Habibi L, Hemmat S, Sarkarat F, Nematollahi Z. Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: Effects on the vital signs and onset, and duration of anesthesia. J Dent Anesth Pain Med 2015; 15: 201-5. https://doi.org/10.17245/jdapm.2015.15.4.201
  24. Ping B, Kiattavorncharoen S, Durward C, Im P, Saengsirinavin C, Wongsirichat N. Hemodynamic changes associated with a novel concentration of lidocaine HCl for impacted lower third molar surgery. J Dent Anesth Pain Med. 2015; 15: 121-8. https://doi.org/10.17245/jdapm.2015.15.3.121
  25. Kammerer PW, Palarie V, Daublander M, Bicer C, Shabazfar N, Brullmann D, et al. Comparison of 4% articaine with epinephrine (1:100,000) and without epinephrine in inferior alveolar block for tooth extraction: double-blind randomized clinical trial of anesthetic efficacy. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113: 495-9. https://doi.org/10.1016/j.tripleo.2011.04.037
  26. de Holanda Vasconcellos RJ, do Egito Vasconcelos BC, Genu, PR. Influence of local anesthethics with adrenalina 1:100.000 in basic vital constants during third molar surgery. Med Oral Patol Oral Cir Bucal 2008; 13: E431-7.
  27. Carrera I, Mestre R, Berini L, Gay-Escoda C. Alterations in monitored vita constants induced by various local anesthetics in combination with different vasoconstrictors in the surgical removal of lower third molars. Bull Group Int Rech Sci Stomatol Odontol 2000; 42: 1-10.
  28. Fernieini EM, Bennett JD, Silverman DG, Halaszynski TM. Hemodynamic assessment of local anesthetic administration by laser Doppler flowmetry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 526-30. https://doi.org/10.1067/moe.2001.114382