Intra-oral quantitative cold sensory test as a predictor of postoperative pain after restorative dental treatment

Background: Postoperative pain affects roughly 40% of the population and poses a substantial concern for both dentists and patients. Its potential to induce severe discomfort can have repercussions, potentially fostering negative behaviors like dental anxiety and neglect. Addressing and managing this aspect is pivotal in ensuring a positive post-treatment experience and long-term oral health.

This study aims to tackle this issue by establishing a framework to identify patients at a heightened risk of experiencing post-operative pain by using IQST (Intra-oral Quantitative Sensory Testing).

Materials & Methods: A total of 66 dental patients (27 women, 39 men; average age 36) underwent preoperative assessments with a detailed questionnaire covering dental anxiety (DAS) and general depression/anxiety (PHQ-4). They also took an IQS test involving applying a cold swab to the oral mucosa. Follow-up assessments were conducted at 6-, 24-, and 48-hours post-operation to evaluate pain levels and medication use. Inclusion criteria were adults over 18 with Class 1 or Class 5 tooth lesions. Excluded were those with extensive caries near pulp, central nervous system conditions, prior analgesic use, or medication affecting the nervous system. Collected patient data: gender, age, income, DMFT, treated jaw, anesthesia type/amount, DAS & PHQ4 scores.

Results: Throughout our study, a noteworthy trend emerged regarding pain perception between the sexes. Male participants consistently reported higher levels of pain compared to their female counterparts across all three recall points. This observation suggests a potential sex difference in pain experience following dental procedures. Furthermore, analyzing pain scores for the entire participant group, irrespective of sex revealed a consistent pattern. Pain levels peaked at the 6-hour mark post-operation, indicating a period of heightened discomfort immediately after the dental procedure. However, there was a discernible decrease in reported pain levels at the 24 and 48-hour marks, indicating a gradual alleviation of discomfort over time.

Conclusion: Intra-oral cold stimulation reactions hold the potential for predicting postoperative dental pain (PDP) following restorative procedures. Identifying high-risk patients enables tailored treatment approaches, such as selective prescription of analgesics, thereby optimizing medication use. Further studies are necessary to enhance our understanding of pain behavior. These studies should aim to include larger samples of patients and additionally encompass those undergoing more complex and invasive dental procedures. Expanding research in this area could provide valuable insights into refining pain management strategies within dental practice.