Hassan Mohamed A, Bogle Gary, Quishenbery Mary, Stephens Denise, Riggs Matt, Egelberg Jan
Department of Periodontology, School of Dentistry, Loma Linda University, Loma Linda, CA 92354, USA.
J Periodontol. 2005 Jun;76(6):980-4. doi: 10.1902/jop.2005.76.6.980.
The aim of the present study, performed during periodontal recall visits, was to compare the levels of pain experienced by patients during periodontal probing using probes with tip diameters of either 0.40 mm or 0.63 mm.
Three groups of 20 adult patients were examined by three different therapists. Diagonal maxillary/mandibular quadrants were probed with a 0.40 mm and a 0.63 mm probe, respectively. At the completion of probing of each quadrant, the patients were asked to describe their pain using a visual analog scale (VAS).
Most patients showed low VAS pain scores for both probes. However, using an arbitrary threshold of VAS > or =40 mm to indicate significant pain, some patients had a painful experience. Lower median pain responses following probing with the 0.63 mm probe compared to the 0.40 mm probe were observed for patients of therapist 1, and for the quartile of all 60 patients that showed the highest VAS scores. For therapist 2 and 3 groups, no differences were found. The pain levels expressed by the three groups of patients varied, confirming results of our previous studies, which also observed differences in patients' pain experiences following probing by different therapists.
The ability to deliver dental care with a minimum of patient discomfort would seem to be an essential part of the skills of individual clinicians. We would like to suggest that dental therapists periodically evaluate this part of their skill by asking patients to express their pain experiences following various procedures using VAS scales.
本研究在牙周复查期间进行,目的是比较使用尖端直径为0.40毫米或0.63毫米的探针进行牙周探测时患者所经历的疼痛程度。
三组各20名成年患者由三名不同的治疗师进行检查。分别用0.40毫米和0.63毫米的探针探测上颌/下颌对角象限。在每个象限探测完成后,要求患者使用视觉模拟量表(VAS)描述他们的疼痛。
大多数患者对两种探针的VAS疼痛评分都较低。然而,使用VAS≥40毫米的任意阈值来表示明显疼痛时,一些患者有疼痛体验。对于治疗师1的患者以及所有60名患者中VAS评分最高的四分位数患者,与0.40毫米探针相比,使用0.63毫米探针探测后的中位疼痛反应更低。对于治疗师2和3组,未发现差异。三组患者表达的疼痛程度各不相同,证实了我们之前研究的结果,该研究也观察到不同治疗师探测后患者疼痛体验存在差异。
以最小化患者不适的方式提供牙科护理的能力似乎是个体临床医生技能的重要组成部分。我们建议牙科治疗师通过要求患者使用VAS量表表达他们在各种操作后的疼痛体验,定期评估他们这部分技能。