Characteristics and impact of pain from root-filled teeth. A practice-based cross-sectional study comparing painful teeth with and without signs of inflammatory dental disease.

Abstract

To compare pain characteristics, impact of pain and characteristics of patients with painful root-filled teeth with and without signs of inflammatory dental disease. This cross-sectional study was performed in the Public Dental Health services, Region Örebro County, Sweden. Adult patients with ≥1 root-filled tooth identified at their regular check-up were included and assigned to one of two groups; those with ≥1 sign of inflammatory dental disease (DD+) and those without any such sign (DD-). Patients/teeth were compared regarding pain characteristics (intensity, frequency, duration, quality and provoking factors), impact of pain (medication intake, impact on life) and patient characteristics as background factors (general health, other bodily and orofacial pain). Statistics included descriptive data (frequency tables) and group comparisons (Chi-square, Fisher's Exact and Mann-Whitney U-tests). The DD+ group included 27 participants (30 teeth) and the DD- group 22 participants (23 teeth). On average, pain intensity was mild, the frequency most often recurrent, and the impact was low. Average pain duration since onset exceeded 2 years in both groups. The only observed between-group differences were average pain intensity; 3.1 (0-10 Numerical Rating Scale (NRS)) in DD- group compared to 1.6 for DD+ (p = 0.030), and tenderness to apical palpation; only reported in the DD+ group. The similarities in clinical presentation between the two groups underscore the difficulties in correctly distinguishing between pain of odontogenic and non-odontogenic origin in root-filled teeth with a standard clinical investigation. Additional diagnostic methods need to be investigated for their ability to differentiate between tooth pain or discomfort of different origins.