Predicting Pain After Tooth Extraction With Easy-to-Collect Preoperative Variables

To examine the determinants of acute pain following tooth extraction, within a set of factors belonging to different domains: biometry, dental nosology and anatomy, psychology toward pain and surgery, and surgical procedure.

Participants were recruited in two centres in France and Lebanon. A 'simple extraction' (161 patients) and a 'wisdom teeth/tooth' group (at least mandibular) (115 patients) were studied separately. Postoperative pain and total analgesic drug intake (over 5 days) were both expressed as a composite score. Both scores were ranked within each surgery group, and their sum was the primary outcome, which was analysed by multivariable linear mixed models after a factor selection.

In the simple extraction group, the primary outcome was predicted positively by preoperative fearfulness (defined by a composite of various phobias) and preoperative dental pain, and negatively by age (≥ 60) and a previous tooth extraction. In the wisdom teeth/tooth group, it was predicted positively by preoperative fearfulness and pain catastrophising, and negatively by a local inflammatory context and preoperative dental pain.

Whereas postoperative pain was constantly favoured by psychological distress, age and other dental factors had different influences on postoperative pain depending on the type of extraction.

ClinicalTrials.gov identifier: NCT05405088.