Patients who experience greater levels of anxiety during dental visits display greater needs to take painkillers after tooth extractions, according to researchers at CEU Cardenal Herrera University (UCH) of Valencia and the University of Valencia.
During their study, the researchers analyzed the levels of anxiety that patients feel before the extraction as well as several physiological parameters to establish their correlation with the greater need for subsequent pain relief treatment.
The researchers used the Corah dental anxiety scale, one of the most commonly used on an international level, on 185 patients before undergoing an extraction. These patients filled out a questionnaire in the waiting room to ascertain their anxiety level prior to the procedure based on a scale of non-existent, moderate, high, or severe.
Also, the researchers assessed blood pressure and heart rate before and after the extraction. Other variables included age, sex, prior painkiller intake, the type of local anesthetic used, and duration of the extraction.
Following the procedure, each patient received a form to note whether they had to take medication for the pain, such as 650 mg of paracetamol of 400 mg of ibuprofen, and how long they had to take the medication.
The researchers followed the patients for 15 months to prove the relationship between the levels of anxiety expressed by the patients and their heart rates and blood pressure before and after the dental intervention.
The study also confirmed that patients with higher levels of anxiety leaned more towards ibuprofen as an anti-inflammatory to decrease the pain. Patients with low or no anxiety tended to take paracetamol or no painkillers.
According to researcher Javier Fernández Aguilar, professor of odontology at CEU UCH, “the fear and anxiety of patients who go to a dental clinic are part of day to day life. It is believed that, in western countries, one in seven patients has high anxiety levels when going to the dentist.”
Also, he said, “In the most extreme cases, this anxiety is considered a phobia. We have now confirmed that this emotional state of anxiety, at its highest levels, has direct effects on the physiological state of the patient and also on the treatment required afterwards to deal with the pain.”
The study shows that patients with high and severe levels of anxiety are the ones who took the most painkillers after the tooth extraction, especially during the first 24 hours following the intervention, the researchers said.
“These results lead us to believe that if we can decrease the level of anxiety of a patient before a tooth extraction, we can also decrease or erase the consumption of painkillers, especially anti-inflammatories such as ibuprofen, with the subsequent benefits that this has for the overall health,” said Fernández Aguilar.
“Furthermore, 650-mg doses of paracetamol and 400-mg doses of ibuprofen were selected with the goal of achieving the greatest pain-killing benefit with the lowest dosage possible. This is very important for the long-term health of the patients,” he continued.