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Background: Pain is considered a key symptom associated with possible impairment of oral-health-related quality of life and its assessment is important for the planning and evaluation of preventive and treatment effort. The tools for assessing pain must therefore be valid and consistent. The objective of this study was to assess dental patients' level of pain based on the clinical diagnosis of their dental condition and the correlation between two pain assessment scales, Visual analogue scale (VAS) and the Full Cup Test (FCT), for the assessment of pain among dental patients., Methods: A total of 185 patients presenting at the University of Benin Teaching Hospital dental outpatient clinics with various forms of orofacial pain were included in this study. The mean VAS scores and mean FCT scores for the different dental conditions were compared. Agreement between VAS and FCT was evaluated using the Intra-class correlation (ICC) coefficients and Cronbach alpha coefficient was also calculated to assess consistency of the two pain scales., Results: Majority i.e. 95.1, 96.2 and 100% who presented with acute pulpitis, acute apical periodontitis and pericoronitis respectively, presented with moderate to severe pain levels (p < 0.05). Only 25.9 and 4% who presented with chronic marginal gingivitis and chronic pulpitis respectively presented with no pain (p < 0.05). A large proportion (75%) of patients with no pain had single diagnosis while more than half (52.1%) of those who presented with severe pain had multiple diagnoses (p = 0.025). The mean VAS and FCT scores for acute pain were 6.1 ± 2.1 and 5.9 ± 2.4 respectively and for chronic pain 3.9 ± 2.7 and 3.7 ± 2.7 respectively (P = 0.001). The interclass correlation coefficient revealed that the mean VAS and FCT scores were statistically correlated and reliable with a Cronbach alpha coefficient of 0.85., Conclusion: It can be concluded that patients who presented with either acute or chronic dental conditions may experience moderate to severe level of pain, with patients with multiple diagnoses experiencing more severe pain, and there is a correlation between the VAS and FCT for pain assessment among dental patients.

Purpose: To assess the association between patients' pericoronitis pain symptoms and quality-of-life (QOL) outcomes for lifestyle and oral function., Patients and Methods: Subjects (American Society of Anesthesiologists health risk assessment level I or II) with mild symptoms of pericoronitis were enrolled in a study approved by the institutional review board and asked to complete a QOL instrument specifically for third molar problems covering lifestyle, oral function, and pain. Subjects assessed lifestyle and oral function using a 5-point Likert-type scale, ranging from "no trouble" (score, 1) to "lots of trouble" (score, 5), and worst and average pain using a 7-point Likert-type scale, ranging from "no pain" (score, 1) to "worst pain imaginable" (score, 7). Pain levels reported at enrollment were compared with QOL outcomes for lifestyle and oral function using Spearman correlation coefficients. Correlations of at least 0.6 were considered clinically quite important, and correlations of at least 0.4 were considered clinically important. Associations between these outcome measurements were considered statistically significant at a P value less than .05., Results: Most of the 113 subjects were Caucasian (51%), women (56%), 23 years old or younger (58%), and well educated (91% with at least some college). Mean pain levels ± standard deviation were low (worst pain, 3.3 ± 1.5; average pain, 2.4 ± 1.2). All pain outcomes were significantly associated with items in the lifestyle and oral function domains (P < .01). Clinically important correlations were seen between pain outcomes and daily routine, social life, eating a regular diet, chewing food, and talking (P < .0001)., Conclusions: Clinically important correlations existed between subjects' pericoronitis pain and lifestyle and oral function, associations not often considered by clinicians or policy makers., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: Our purpose was to assess the effect of third molar removal on the quality of life in subjects with symptoms of pericoronitis., Patients and Methods: Healthy subjects (American Society of Anesthesiologists Classes I and II), aged 18 to 35 years, with minor symptoms of pericoronitis affecting at least 1 mandibular third molar were recruited for an institutional review board-approved study. The exclusion criteria were major symptoms of pericoronitis, generalized periodontal disease, body mass index greater than 29 kg/m(2), and antibiotic or tobacco use. The data from patients undergoing surgery to remove all third molars with a follow-up examination after surgery at least 3 months later were included in these analyses. The clinical, demographic, and quality of life data were collected at enrollment and after surgery. At entry, the debris was removed from symptomatic third molar sites; no attempt was made to mechanically remove nonsheddable biofilm. The patients scheduled surgery electively with a recall examination at least 3 months after surgery., Results: The median age of the 60 subjects was 21.9 years (interquartile range 20.2 to 24.7). The median postoperative follow-up was 7.7 months (interquartile range 6.0 to 12.4). The proportion of patients reporting the worst pain as severe decreased from enrollment to after surgery from 32% to 3%. Those responding "none" for the worst pain increased from 10% to 78%. Fifteen percent of subjects reported the pain intensity as "nothing," "faint," or "very weak" at enrollment. This increased to 96% after surgery. One third of patients reported the unpleasantness of pain as "neutral," "slightly unpleasant," or "slightly annoying" at enrollment, which increased to 97% after surgery. Also, 22% and 18% of the patients reported "quite a bit" or "lots of difficulty" with eating desired foods and chewing foods at enrollment, respectively; only 1 patient reported this degree of difficulty at the follow-up examination. In contrast, 42% and 37% of the patients reported no difficulty with eating and chewing at enrollment, which had increased to 95% and 93% at the follow-up examination, respectively., Conclusions: Removal of the third molars positively influenced the quality of life outcomes in those with minor symptoms of pericoronitis., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The case report described here discusses gingivitis artefacta major, an oral presentation of self-injurious behaviour, in an adolescent. On presentation, the patient knew well the ramifications of her gum scratching behaviour, however, was unable to stop. At further presentations new lesions had appeared with further bone loss. The cause of her behaviour seemed to be of psychological origin and therefore no interventive dental treatment was possible until this issue was resolved. A more preventive approach was adopted in the meantime. Referral to appropriate services from the dental profession also proved to be challenging. In conclusion, gingivitis artefacta, although rarely seen to this extent, is extremely challenging to diagnose and treat fully in a dental setting.

Purpose: To assess the impact of symptomatic pericoronitis on health-related quality of life (HRQOL)., Patients and Methods: Healthy subjects with symptomatic pericoronitis were enrolled in an institutional review board-approved study. Each was given a third molar condition-specific HRQOL instrument to assess the impact of pericoronitis in the preceding week. Lifestyle and oral-function outcomes were assessed using a 5-point Likert-type scale, with anchors of "no trouble" (1) and "lots of trouble" (5). Pain outcomes were assessed using a 7-point scale anchored by "no pain" (1) and "worst pain imaginable" (7). Verbal descriptors for sensory perception and unpleasantness of pain were recorded on Gracely scales. The impact of symptomatic pericoronitis on overall health and well-being in the previous 3 months was recorded using the Oral Health Impact Profile (OHIP-14)., Results: The median age of 57 subjects was 23.1 years (interquartile range [IQR], 21.2 to 25.8 years). Forty-nine percent were female, 56% were Caucasian, 21% were Asian, and 16% were African American. Ninety-one percent had at least some college experience. Twenty-eight percent of subjects described their worst pain in the week before enrollment as severe (5-7/7), 40% as moderate (3-4/7), and 32% as none/little (1-2/7). Average pain in the previous week was described as severe (5-7/7) for 4% of subjects, as moderate (3-4/7) for 40%, and as none/little (1-2/7) for 56%. On the Gracely scales, 9% of subjects reported the sensory intensity of pain in the past week as "intense," "very intense," or "extremely intense." Subjects reported "quite a bit/lots" of difficulty (4-5/5) with oral function (23% with eating, 19% with chewing, and 6% with opening) and "quite a bit/lots" of difficulty (4-5/5) with lifestyle (sleeping, social life, and sports/hobby, all at 2%). The median OHIP-14 Severity score was 11/56 (IQR, 5-17). The most frequently reported OHIP-14 items in the 3 months before enrollment were in the pain dimensions. The median Severity score for pain items was 4/8 (IQR, 2-6)., Conclusion: Symptomatic pericoronitis can have adverse outcomes, compromising the quality of life and inflicting pain.

Purpose: In this study, we evaluated patients' perceptions of changes in oral health-related quality of life (OHQOL) over a 6-month period after third molar surgery., Patients and Methods: One hundred patients participated in this prospective study. Two specific OHQOL measures, the 14-item Oral Health Impact Profile (OHIP-14) and the 16-item UK Oral Health-Related Quality of Life measure (QHQoL-UK), were administered to the study group before surgery. Standardized surgical and analgesic protocols were used. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days and were contacted at 1, 3, and 6 months after surgery., Results: Both measures identified a significant deterioration in quality of life in the immediate postoperative period (P <.01). However, there was an improvement in OHQOL compared with preoperative status at 1 (P <.05), 3 (P <.05), and 6 (P <.01) months after surgery. Patients perceived physical, social, and psychologic changes in life quality after surgery. Previous pericoronitis was associated with changes in quality of life (P <.05)., Conclusion: The study concludes that third molar surgery is associated with changes in OHQOL. This has implications for understanding the value of third molar surgery from patients' perspectives and in assessing health gain.

A study of the attitudes of 102 arts and science undergraduate students was carried out to establish relative utility values, that is the participants own assessments, for possible outcomes of surgical intervention and non-intervention in lower third molar management. Using a standardised visual analogue scale, respondents were asked to rate 17 outcomes of treatment presented to them by means of short descriptions (vignettes). Ranking of mean utility values showed that post operative complications were considered to be a greater handicap than the sequelae of leaving third molars in situ. The respondents considered that the effects of irreversible lingual and inferior dental nerve damage reduced health to a major degree, and that normally encountered post operative complications such as moderate pain, swelling and trismus were a greater handicap than recurrent mild/moderate pericoronitis.

Visual analogue scales (VAS) of different lengths (5, 10, 15 and 20 cm) and with different end-phrases (troublesome, miserable, intense, unbearable and worst pain imaginable) were used to record pain in 50 male and 50 female patients with pulpitis or pericoronitis. All 100 patients successfully completed the questionnaire. High correlation was found between the scores on all the scales. Scales of length 10 or 15 cm had the smallest measurement error. The scale with the end-phrase 'worst pain imaginable' was found to be the best choice for comparing present pain or worst pain between different groups. Using this scale no significant difference was found between the scores of males and females or between those of patients with pulpitis and pericoronitis. This study suggests the use of 10 cm visual analogue scales with the end-phrase 'worst pain imaginable' as being the most suitable for measuring dental pain.