A survey of dental hygienists licensed and residing in Iowa was conducted in the fall of 1987. The response rate after two mailings was 596 of 705 (84.5%). Of the 596, the responses of those who provided clinical services for adults in Iowa (n = 421) were analyzed for information regarding pain control. The survey was designed to collect demographic information and to determine hygienists' use and perception of the need and desire for pain control measures. Nearly 70% of the practitioners reported that their patients needed anesthesia but did not receive it. The main reason given for not asking their dentist/employer to provide pain control measures was that time did not permit. The estimated numbers of patients who received pain control measures per month was low: a mode of 1 with a median of 1 to 2 for local anesthesia, and a mode of 0 and median of 2 for nitrous oxide analgesia. Investigators examined the strength of correlations between the independent variables of practice and hygienist characteristics, and the dependent variables of use and perception of the need and desire for pain control measures. Hygienists who provided selected periodontal services and those who worked in periodontal practices were more likely to ask the dentist to provide pain control measures. Local anesthesia was used more frequently by those hygienists who saw more patients with pockets equal to or greater than 4 mm. Use of nitrous oxide analgesia in practice was highly correlated with preparation in the use of nitrous.(ABSTRACT TRUNCATED AT 250 WORDS)