Psychological factors associated with pain in patients undergoing endodontic procedures: a scoping review protocol
Creators: name: SADR, ATIEH
name: Gholamrezaei, Ali
name: Ashton-James, Claire
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: ALI GHOLAMREZAI
subject: Claire Ashton-James

description: Root canal therapy is necessary when dental caries are left untreated, causing infection, inflammation, and pain. It is estimated that 49% of dental visits are related to endodontic treatment, with the prevalence of endodontic procedures increasing with age and the cumulative effects of mastication and carious exposure (1). It is common for patients to report mild to moderate pain during or immediately after endodontic treatment (2), and it is estimated that 5-10% of individuals will experience persisting pain after endodontic procedures (3,4). Inadequate pain management during endodontic procedures is concerning. Those who experience inadequate pain management during an endodontic procedure may develop dental anxiety or phobia, leading to an avoidance of subsequent oral health care treatments (5,6). It has been reported that patients often avoid endodontic treatment, or leave dental caries untreated for long periods of time due to fear of pain during or after the endodontic treatment (7). Untreated deep caries and can result in loss of teeth, negatively impacting health and quality of life (8,9,10). Hence, it is important to identify optimal pain management strategies for endodontic procedures (11,12). Providing adequate deep root nerve anaesthesia is challenging, particularly in the presence of additional root disease-related inflammation and infection. However, patients may still experience pain when local anaesthesia is successful. Pain is defined as “an emotional or unpleasant physical experience or feeling related to an existing or probable tissue injury or a feeling described in case of such damage” (13). Hence, nociception is neither necessary nor sufficient to cause pain (i.e., it is an experience or feeling which can be elicited by imagined or anticipated tissue damage). Accordingly, local anaesthetics - which work by blocking nociceptive input – are not always sufficient to manage the experience of pain during dental procedures. Optimal pain management is biopsychosocial, meaning that it addresses not only the biological contributors to pain, but also the psychological and social contributors. Evidence for the efficacy and acceptability of psychological interventions for acute and chronic pain management has proliferated over the past 25 years (14). However, psychological approaches to pain management in dentistry are scarce. In order to identify or develop psychological interventions to modulate pain associated with endodontic procedures, the current research investigates the scope of evidence for psychological predictors of pain experienced prior to, during, and after endodontic procedures. “CONFIDENTIAL This document is confidential and the property of the Pain Management Research Institute, Faculty of Medicine &amp; Health, The University of Sydney. No part of it may be transmitted, reproduced, published, or used without prior written authorisation from first Author by possible permission of the institution.”