Intra-loperative pain perception in tooth extraction - possible causes

Objectives: To elicit the perception of pain in patients undergoing dental extraction under local anaesthesia and also to identify factors that might contribute to this experience despite the administration of local anaesthesia. Setting: Ile-Ife, Southwestern Nigeria. Participants: 122 randomly selected single-tooth extraction patients. Methods: Informed consent was obtained from patients who subsequently completed a questionnaire on the Corah Dental Anxiety Scale prior to treatment. Details documented for each patient included the demographics, history of previous tooth extraction and the status of the operator. The extraction was timed from the application of instrument until tooth delivery. Immediately after extractions, patients were asked to indicate on a Visual Analogue Scale (VAS) scores graded 0-10, the level of pain perceived during extraction. The data were subjected to simple descriptive and statistical analysis using SPSS for Windows 11.0. Results: Positive correlations were found between the VAS and the anxiety scores, the attending surgeons' status, patients' anxiety score and the duration of surgery. A significant difference was found between the anxiety and the VAS scores in the different occupational groups. Conclusions: These results suggest that the status of the attending surgeon may affect the level of anxiety in patients undergoing tooth extractions prior to surgery. While patient's occupational group and duration of surgery could contribute to patient's intra-operative pain perception despite the administration of local anaesthesia.