Association Between Preoperative Anxiety And Postoperative Pain Following Third-Molar Surgery: A Prospective Observational Study.

Abstract

Background: Postoperative pain following mandibular third-molar surgery varies considerably between individuals despite comparable surgical procedures. Preoperative dental anxiety may contribute to this variability. Aim: To evaluate the association between preoperative dental anxiety and postoperative pain following surgical removal of impacted mandibular third molars. Materials and Methods: This prospective observational study included 80 adults undergoing surgical removal of a unilateral impacted mandibular third molar under local anesthesia. Preoperative anxiety was assessed using the Modified Dental Anxiety Scale (MDAS). Postoperative pain was measured using a 0–10 visual analogue scale (VAS) at 6, 24, 48, and 72 hours. Surgical characteristics and analgesic consumption were recorded. Correlation and multivariable regression analyses were used to evaluate the association between anxiety and postoperative pain. Results: The mean MDAS score was 12.4 ± 4.2. Mean VAS scores decreased from 5.8 ± 1.7 at 6 hours to 2.1 ± 1.3 at 72 hours (P<0.001). MDAS demonstrated positive correlations with pain at 6 hours (r=0.46, P<0.001), 24 hours (r=0.51, P<0.001), 48 hours (r=0.34, P=0.002), and 72 hours (r=0.25, P=0.026). Patients with severe anxiety had greater analgesic consumption than those with lower anxiety (P=0.003). Preoperative MDAS remained independently associated with 24-hour pain after adjustment for demographic and operative variables (P<0.001). Conclusion: Greater preoperative dental anxiety was associated with increased early postoperative pain following mandibular third-molar surgery. Preoperative anxiety screening may assist in identifying patients at risk of greater postoperative discomfort.