Perception of non-surgical periodontal treatment with or without local anesthesia

Abstract

Objective: Patients might refuse the offer of local anesthesia (LA) administration prior to dental treatment. This study investigates subjective discomfort perception during non-surgical mechanical periodontal therapy delivered with or without prior administration of LA.

Method:

Sixty mild-to-moderate chronic periodontitis patients were randomly enrolled to non-surgical therapy with or without LA administration. Patients were free to comply or not with the allocated treatment arrangement. Visual analogue scales (VAS) of discomfort perception at various stages of the treatment, plus overall satisfaction were recorded.

Result:

A total of 31 patients undergoing non-surgical periodontal therapy not receiving (LA-) and 29 subjects receiving (LA+) LA were studied. All patients had experienced periodontal debridement before. Compared to LA- subjects, LA+ individuals perceived less discomfort during treatment and reported less dental anxiety. Prior unpleasant periodontal experience was identified to be associated with lower perceived overall treatment satisfaction (P = 0.047). Overall, debridement discomfort was associated with not receiving LA, non-compliance with the pain control regimen allocated, greater gingival inflammation and higher percentage sites with probing pocket depths ≥5 mm (P < 0.05).

Conclusion:

Gingival inflammation, periodontal pocketing and not receiving LA, appeared to be associated with more perceived discomfort by mild-to-moderate periodontitis patients undergoing non-surgical periodontal treatment. Clinicians should be aware that subjects who refuse LA could have with higher dental anxiety and therefore may require various pain control strategies for comfort during non-surgical periodontal therapy, which if not employed in turn could lead to lower periodontal treatment satisfaction. This abstract is based on research that was funded entirely or partially by an outside source: Research Grants Council of the Hong Kong Special Administrative Region, China, HKU 772110M