Is it Anxiety or Pain Experienced by Patients during Scaling?

Objectives: Dental fear and dental anxiety are strong negative feelings associated with dental treatment. Pain is determined by the intensity of nociceptive stimulation and depended on psychological factors such as the emotional and motivational state of human. This study was conducted for facilitating the recognition of the patients who are likely to experience pain during routine periodontal care.

Methods: One hundred-thirteen patients (mean age 35.59±9.28) were evaluated following scaling. Patients′ pain levels followed by treatment were assessed with horizontal visual analog scale (VAS), subsequently, patients completed an anxiety questionnaire (DAS) which was consisted of dental fear survey questions (DFQ) and Corah′ dental anxiety scale questions (DAQ). Gender, age, education levels, smoking, income, marital status, calculus index and decayed, missing and filled teeth index (DMFT) were recorded.

Results: Using arbitrary thresholds of pain VAS≥40 mm, 14% of the patients experienced pain during scaling. While there were no significant correlation between pain experienced by patients and DAS, there was a very weak correlation for DFQ 2. There was a significant difference between women and men in both DFQ (P<0.01) and DAQ (P<0.001). DFQ and DAQ scores were higher for women (7.96±3.17; 7.25±2.77) than men (6.29±2.78; 5.59±2.44). However, both were only statistically different for women (P < 0.05) and higher for the group with 29-39 ages (8.21±3.27; P<0.001) when comparing different age groups. However, there was no difference between age groups for VAS. There were no significant differences between patients′ pain perception and other evaluated parameters except smoking (P>0.05). It was found that nonsmokers had significantly higher pain perception than smokers (P<0.05).

Conclusion: The present study showed the most patients experienced limited pain during scaling. Contrary to previous reports, recognition of patients who are likely to experience pain during scaling does not seem possible with neither DAS nor DFQ 2. However, these patients are likely to be female, nonsmokers; their ages are around between 29 and 39 years old. The therapist should consider these indicators for successful interactions with patients and treatment results.