Pain after periodontal scaling and root planing

Background. Although periodontal scaling and root planing, or SRP, is one o f the most common procedures used in dental practice, there is little infor mation available about the degree of postprocedural pain associated with it . The authors under-took this study to document the intensity and duration of pain after SRP with a view toward helping practitioners and their patien ts manage postprocedural discomfort. Methods. Using the Heft-Parker self-assessment pain scale, 52 adults with m oderate periodontitis evaluated their pain before and after SRP conducted w ith local anesthetic. Results. After SRP, 28 percent of all :patients reported faint-to-weak pain , 18 percent experienced weak-to-mild pain, 28 percent experienced mild-to- moderate pain, 8 percent had moderate-to-strong pain and 8 percent reported strong-to-intense pain. The average time to onset of maximum pain was appr oximately three hours after SRP, and the average duration of mild or greate r pain was about six hours. Upon awakening the morning alter SRP, subjects found that pain had returned to pre-SRP levels. Overall, 23 percent of all patients reported self-medicating with analgesics to relieve postprocedural pain. Women self-medicated earlier (P < .05) and more often than men (43 p ercent vs. 10 percent; P < .05). Conclusions. Patients experienced significant duration and magnitude of pai n after SRP. This pain peaked between two and eight hours after SRP, lasted about six hours, and returned to pre-SRP levels by the morning after the p rocedure. Almost 25 percent of all patients self-medicated to relieve pain after SRP, and women took analgesic medication earlier and more often than men. Clinical Implications. Practitioners should consider using appropriate anal gesic drugs to alleviate mild-to-moderate pain after SRP. On the basis of t his study, it would appear that an analgesic that has a peak effect two to eight hours after the completion of SRP would be the most appropriate medic ation. Moreover, it is unlikely that analgesic medication would be needed b y most patients beyond the day on which SRP was performed.