Postoperative pain after dental procedures: The National Dental Practice-Based Research Network observational study...

Managing postoperative dental pain is essential, but patient-reported data on pain and medication practices are scarce. The authors examined patient-reported pain, functional interference, and medication use after common dental procedures.

In this prospective observational cohort study, 2,674 adults in a multicenter US practice-based network reported pain intensity and interference via a mobile application. Outcomes were collected on days 0, 1, 3, 5, and 7 to assess trajectories across endodontics, periodontal surgery, oral surgery, and implant dentistry as well as multiple procedures within these 4 categories.

Among 2,674 participants (mean age, 49.8 years; 55.6% were female), mean (SD) pain intensity scores (numerical rating scale in which 0 represents no pain and 10 represents worst imaginable pain) decreased from 3.0 (3.5) on day 0 (preoperative), 2.2 (2.4) on day 1, and to 0.9 (1.5) on day 7. Patient-reported opioid use declined from 6.6% on day 1 to 1.8% on day 7. After adjusting for various factors, undergoing multiple procedures at 1 visit yielded the highest odds of moderate pain, with an adjusted odds ratio (aOR) of 4.2 (95% CI, 2.1 to 8.5; P < .01). Surgical periodontal procedures had the next highest odds of moderate pain with an aOR of 3.9 (95% CI, 1.9 to 8.2; P < .01). Multiple procedures were also associated with severe difficulty falling asleep (aOR, 4.6; 95% CI, 1.7 to 11.9; P < .01).

Postoperative pain and functional interference vary significantly according to procedure. Surgical tooth extractions and multiple procedures confer the highest risk of experiencing moderate through severe pain, which patients primarily managed with nonopioid analgesics.

These study findings can guide patient counseling on pain trajectories and help develop procedure-specific, nonopioid pain management protocols to improve care and promote opioid stewardship.