Association between preoperative anxiety, intraoperative discomfort, and postoperative pain across different dental extraction types: a prospective observational study

Abstract

BACKGROUND This study investigated the association among preoperative dental anxiety, intraoperative discomfort, and postoperative pain perception across various types of dental extractions, ranging from simple to complex procedures. METHODS A prospective observational clinical trial was conducted in 573 patients who underwent dental extractions. Preoperative anxiety was assessed by using a self-reported verbal scale. Intraoperative discomfort was measured using the Self-Perception Questionnaire for Dentoalveolar Oral Surgery. Postoperative pain was assessed on the seventh day using a verbal categorical rating scale. RESULTS Preoperative anxiety levels were significantly higher in patients who underwent mandibular third molar extraction. Intraoperative discomfort was significantly influenced by surgical technical complexity, surgical duration, and preoperative anxiety. Mediation analysis revealed that anxiety indirectly influenced postoperative pain through intraoperative discomfort with no direct effect. The analysis confirmed the interplay between anxiety, surgical factors, intraoperative discomfort, and patient demographics in shaping the surgical experience. CONCLUSIONS The findings indicate that Anxiety did not directly predict postoperative pain in most surgical groups; however, it appeared to contribute to increased intraoperative discomfort, which subsequently elevated postoperative pain levels.