Little is known about how patients experience their root-filled teeth. This cross-sectional practice-based study aimed to investigate aspects of pain and discomfort associated with root-filled teeth in adult patients visiting the Swedish public dental service. An additional aim was to explore differences between pain due to persistent/recurrent dental disease and tooth pain of possible non-odontogenic origin.
In connection with their annual check-up, all patients from the age of 20 years who had a root-filled tooth were invited to participate. Participants answered questionnaires about their general health, chronic bodily pain, TMD symptoms, and any current pain or discomfort from the root-filled tooth. The tooth was also assessed clinically and radiographically by their general dentist.
The study included 23 clinics in Örebro County, contributing 550 patients with 1256 root-filled teeth. The observed prevalence of pain or discomfort was 9.6% on patient level and 4.9 % on tooth level. On average the pain was of mild intensity and had low impact on daily life, but had been present for >2 years. Only about half of the painful teeth had clinical or radiographic signs indicative of an infectious dental pain origin. Patient- and pain-related factors were very similar regardless of whether signs of dental disease were present or absent, the only difference being that patients with painful teeth without signs of dental disease on average reported higher pain intensity.
In summary, about 1 patient in 10 can be expected to experience some form of symptom from their root filled tooth. The origin of pain is often persistent or recurrent infection of the root canal, but likely to be non-odontogenic in about half of the patients. The pain presentation is very similar, which suggests that unless clear signs of pathology are identified, further diagnostics should be undertaken to identify the true pain cause before any intervention is performed.
The material is currently being used further
- in a case-control study comparing patients with and without pain from their root-filled tooth, aiming to identify patient-level predictors of pain, and
- as baseline in a follow-up study examining to what degree the teeth with either symptoms or clinical/radiographic signs of disease received further treatment within 6 years.
The study was performed within the Scandinavian Endodontic Research Collaboration (EndoReCo), and received additional financial support from the Dental Research Department of the Public Dental Health Service, Region Örebro County, Sweden.
Maria Pigg, University of Malmӧ
Jonsson Sjögren J, Kvist T, Eliasson A, EndoReCo, Pigg M. The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice-based study. (2019) International Endodontic Journal, 52, 1264-1273.
Jonsson Sjögren J, Kvist T, List T, Eliasson A, EndoReCo, Pigg M. 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. (submitted for publication, 2023)