Ability of Examiners to Estimate the Pain Experienced by Patients From Probing During Initial Periodontal Examination

BACKGROUND: The aims of the present study were to identify the level of pain experienced by patients from probing during periodontal examination, and to determine to what extent the examining periodontist and the dental assistant could estimate the degree of pain experienced by the patients. METHODS: For each of three periodontists, 20 patients referred for periodontal diagnosis and treatment were selected. The periodontist carried out his examination, which included probing at six sites per tooth. Following probing, the patients rated the pain using a visual analog scale (VAS). The periodontist and the dental assistant who helped out during the examination independently rated the pain level they perceived that each patient experienced, also using a VAS. RESULTS: Most patients showed low pain responses to probing. However, using an arbitrary threshold of VAS > or =40 mm to indicate significant pain, some patients had a painful experience. Differences were observed between the pain levels expressed by the three groups of patients. While two of the three periodontists were able to appraise the pain experienced by their patients, the third was not. CONCLUSIONS: It seems important that the periodontist at the first encounter with the patient should be sensitive to the discomfort the examination may entail. This may influence the patients' decision to accept the required treatment, and may also affect the patients' attitude to and co-operation with the subsequent treatment.