Anxiety and pain during dental injections

J Dent. 2009 Sep;37(9):700-4. doi: 10.1016/j.jdent.2009.05.023. Epub 2009 May 27.


Objectives: The aim of this study was to study the relationship between anxiety and pain felt during a dental injection in a sample of 'normal' patients about to undergo 'invasive' dental treatment.

Methods: Duration and intensity of pain during a dental injection were measured within a sample of 247 patients. In addition, data on dental anxiety, fear of dental pain, type of treatment, amount of anesthetic fluid, injection location and the use of surface anesthesia were also collected.

Results: Anxious patients felt more pain and of longer duration than less anxious patients. 28% of variance on the duration of pain felt could be accounted for by fear of dental pain, the use of surface anesthesia and gender. For the intensity of pain felt, 22% of variance could be accounted for by anxiety felt for the injection and dental anxiety.

Conclusions: Pain felt during dental injections is dependent on dental anxiety, fear of dental pain, fear for the injection, gender and amount of injection fluid (rather than the use of surface anesthesia). In other words, some patients are expected to feel elevated levels of pain during dental injection and would benefit from extra attention and care from the dentist.

MeSH terms

  • Anesthetics, Local / administration & dosage*
  • Dental Anxiety / complications*
  • Facial Pain / etiology*
  • Female
  • Humans
  • Injections / adverse effects
  • Injections / psychology*
  • Male
  • Manifest Anxiety Scale
  • Middle Aged
  • Pain Measurement
  • Regression Analysis
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires


  • Anesthetics, Local