Pain with Pericoronitis Affects Quality of Life

Magraw, Caitlin

Purpose: Clinicians most often associate pericoronitis affecting 3^rd molars with pain. Because pain results from an individual’s immune inflammatory response to anaerobic bacteria colonized in non-sheddable biofilm on symptomatic 3^rd molars, pericoronitis is better termed “symptomatic periodontal inflammatory disease”. However, symptoms from inflammation usually involve more than pain alone. The purpose of this study is to assess the association between subjects’ pericoronitis pain symptoms and quality of life outcomes for Oral function and Lifestyle.

Materials and Methods: Subjects (ASA I, II) with mild symptoms of pericoronitis were enrolled in an IRB approved study and asked to complete a Quality of Life (QOL) instrument specifically for 3^rd molar problems covering Oral function, Lifestyle, and Pain. Subjects assessed Oral function and Lifestyle using 5-point Likert-type scales, ranging from “no trouble” (score 1/5) to “lots of trouble” (score 5/5) and worst and average pain using 7-point Likert-type scales ranging from “no pain” (score 1/7) to “worst pain imaginable”(score 7/7). Pain levels were compared to QOL outcomes for Lifestyle and Oral function with Spearman correlation coefficients. The Oral Health Impact Profile (OHIP-14) instrument was used to evaluate pericoronitis symptoms over a three-month interval prior to enrollment. Pain severity and physical pain were compared to the other OHIP-14 subscales reflecting overall health and well-being using Spearman correlation coefficients. Correlations at least 0.6 were considered clinically quite important, and correlations at least 0.4 were considered clinically important. Associations between these outcome measures were considered significant at P<0.05.

Results: Most of the 113 subjects were Caucasian 51%, female 56%, and 23 years old or younger 58%. Mean pain levels were low; worst pain 3.3 SD+1.5, and average pain 2.4 SD+1.2. All pain outcomes were significantly associated with the items in the Oral function and Lifestyle domains, P<0.01. Clinically important correlations were seen for pain outcomes and daily routine, social life, eating a regular diet, and chewing food. Pain severity and physical pain were significantly associated with the other dimensions in the OHIP-14 profile, P<0.001. Clinically important correlations were seen for OHIP-14 pain outcomes and functional limitation, physical disability, psychological disability, psychological discomfort, and social disability.

Conclusions: Clinically important correlations existed between subjects’ pericoronitis pain, and Oral function and Lifestyle, associations not often considered by clinicians, policy makers, or the public. The persistence of these correlations over a three-month interval highlights the chronic, episodic nature of pericoronitis.

Funding Sources: Oral & Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, and the UNC Department of Oral and Maxillofacial Surgery.

Registered Clinical Trials.gov Identifier: NCT 01882270.

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