Anxiety and pain related to mandibular block injections: comparison of self-reported measures and physiological response

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov;124(5):456-463. doi: 10.1016/j.oooo.2017.08.021. Epub 2017 Sep 6.


Objective: The aim of this study was to determine whether patients with a pain score ≥7 (high pain group) after a mandibular block injection had a higher physiologic response compared with patients with scores <7 (low pain group).

Study design: Before oral surgery, patients (n = 66) filled out questionnaires to measure anxiety and expected pain. The questionnaires also assessed patients' experiences with dental injections and dental anxiety, as well as their emotional state and intensity of anxiety. Before, during, and after the injection, physiologic responses were measured by using Nexus-10. Patients were then asked about the pain and anxiety they had experienced.

Results: The mean score for pain experienced was 3.45 (standard deviation 2.17) on an 11-point rating scale. Eight patients (12.1%) experienced high injection pain. There was a significant increase in mean sweat secretion and a significant decrease in mean respiration between the relaxing phase and the injection phase. There was a significant positive relationship between experienced anxiety and mean heart rate during the injection phase. No significant difference in physiologic response was found between patients who experienced high pain and those who experienced low pain.

Conclusions: Reported pain was not associated with the physiologic response of patients receiving mandibular block injections.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dental Anxiety / etiology*
  • Dental Anxiety / psychology*
  • Facial Pain / etiology*
  • Facial Pain / psychology*
  • Female
  • Humans
  • Male
  • Mandible
  • Middle Aged
  • Nerve Block / adverse effects*
  • Nerve Block / psychology*
  • Pain Measurement
  • Risk Factors
  • Surveys and Questionnaires