Pain Perception after Periodontal Therapies


pain perception
periodontal therapy
visual analog scale


Background: Pain perception is a complex sensory experience which is perceived by different individuals in different manners. The pain perceived by the patient after periodontal surgery may vary based on different parameters.

Aim: This observational study was conducted to evaluate the perception of pain after periodontal therapies.

Materials and Methods: A total of 63 surgeries were carried out in 50 patients and the surgeries were divided into three categories: open flap debridement, resective and regenerative surgeries, and periodontal plastic surgeries. The pain experienced by the patient was recorded on the visual analog scale that ranged from 0 to 10.

Results: The mean VAS score for different periodontal surgeries was 2.49. The study showed highest mean VAS in open flap debridement (2.74) followed by periodontal plastic surgery (2.5) and the lowest in resective and regenerative procedures (2.13). Among various variables such as age, sex, periodontal dressing, arch, amount of local anaesthesia and time duration, the data showed statistical difference between VAS score and sex (p = 0.04) and between VAS score and amount of local anaesthesia (p = 0.012).

Conclusion: The study showed there is low pain perception after different periodontal surgeries as measured by VAS. Proper understanding of the variables that affect pain is important as they may produce emotional responses that could influence compliance and the therapy result. Inadvertent use of large dose of anaesthetics beforehand assuming high anticipation of pain should be discouraged as the increase in volume relates to increased pain. .

Keywords: Anxiety; pain perception; periodontal therapy; visual analog scale.



The International Association for the Study of Pain (IASP). Pain 1979;6:250.

Eli I, Baht R, Kozlovsky A, Simon H. Effect of gender on acute pain prediction and memory in periodontal surgery. Eur Jour Oral Sci. 2000;108:99-103.

Curtis JW Jr, McLain JB, Hutchinson RA. The incidence and severity of complications and pain following periodontal surgery. J Periodontol. 1985;56(10):597-601.

Eli I, Schwartz-Arad D, Baht R, Ben-Tuvim H. Effect of anxiety on the experience of pain in implant insertion. Clin Oral Implants Res. 2003;14:115-8.

Mei CC, Lee FY, Yeh HC. Assessment of pain perception following periodontal and implant surgeries. J Clin Periodontol. 2016;43(12):1151-9.

Matthews DC, McCulloch CA. Evaluating patient perceptions as short-term outcomes of periodontal treatment: a comparison of surgical and non-surgical therapy. J Periodontol. 1993;64:990-7.

Hashem AA, Claffey NM, O’Connell B. Pain and anxiety following the placement of dental implants. Int J Oral Maxillofac Implant. 2006; 21:943-50.

Al-Khabbaz AK, Griffin TJ, Al-Shammari KF. Assessment of pain associated with the surgical placement of dental implants. J Periodontol. 2007;78:239-46.

Fardal O, McCulloch CA. Impact of anxiety on pain perception associated with periodontal and implant surgery in a private practice. J Periodontol. 2012;83:1079-85.

Tan WC, Krishnaswamy G, Ong MMA, Lang NP. Patient-reported outcome measures after routine periodontal and implant surgical procedures. J Clin Periodontol. 2014;41: 618-24.

Al-Hamdan K. Pain perception following different periodontal procedures. Pak Oral Dental J. 2009;29:63-8.

Urban T, Wenzel A. Discomfort experienced after immediate implant placement associated with three different regenerative techniques. Clin Oral Implants Res. 2010;21:1271-7.

Canakci CF, Varol Canakci V. Pain experienced by patients undergoing different periodontal therapies. J Am Dent Assoc. 2007;138:1563-73.

Beaudette JR, Fritz PC, Sullivan PJ, Piccini A, Ward WE. Investigation of factors that influence pain experienced and the use of pain medication following periodontal surgery. J Clin Periodontol. 2018;45:578–85.

Fardal Q, Johannessen AC, Linden G. Patient perception of periodontal therapy completed in a periodontal practice. J Periodontal. 2002;73:1060-6.

Lopez A, Nart J, Santos A, Alcazar J, Freixa O. Assessment of morbidity after periodontal resective surgery. J Periodontol. 2011;82:1563-9.

Dal Pra DJ, Strahan JD. A clinical evaluation of the benefits of a course of oral penicillin following periodontal surgery. Aust Dent J. 1972;17:219-21.

Jones TM, Cassingham RJ. Comparison of healing following periodontal surgery with and without dressings in humans. J Periodontol. 1979;50:387-93.

Sanchez-Siles M, Torres-Diez LC, Camacho-Alonso F, Salazar-Sanchez N, Ballester Ferrandis JF. High volume local anesthesia as a postoperative factor of pain and swelling in dental implants. Clin Implant Dent R. 2014;16:429-34.

Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol. 2006;77:2070-9.