Prevalence of and factors affecting postpreparation pain in patients undergoing two-visit root canal treatment

Aim This longitudinal, prospective study (i) investigated the prevalence of postpreparation pain during root canal treatment and (ii) evaluated the influence of factors affecting the pain experience. Methodology Twenty practitioners, comprising general dental practitioners, MSc graduates and endodontists, participated in this study. The patient sample (n = 272) was derived from consecutive patients attending the practitioners' surgeries for a two-visit root canal treatment on a single tooth. Demographic, medical history, preoperative and intraoperative data as well as pain experience on days 1 and 2 after root canal preparation were recorded. Intensity of pain experienced was recorded on a visual analogue scale (VAS) of 0-5. The data were analysed using logistic regression models. Results The prevalence of postpreparation pain within 48 h after treatment was 64.7% (n = 176), but less than 10% of patients experienced severe pain (VAS 4 or 5) on either day 1 or day 2. The presence of preoperative pain (OR = 2.841, P < 0.001), tooth type (OR = 2.008, P = 0.009), systemic steroid therapy for other medical reasons (OR = 0.181, P = 0.023) and preoperative swelling (OR = 2.433, P = 0.040) were the only factors to significantly influence postpreparation pain experience. Conclusions The prevalence of postpreparation pain was high, and the important prognostic determinants were presence of preoperative pain, tooth type, systemic steroid therapy and preoperative swelling.