Longitudinal Analysis of Acute and Sub-acute Pain Following Dental Surgery: Trajectories and Predictive Factors

J Pain. 2026 Mar 31:106273. doi: 10.1016/j.jpain.2026.106273. Online ahead of print.

ABSTRACT

Dental surgeries are among the most common outpatient procedures, yet the temporal aspects of pain resolution and the relation to longer term pain outcomes remains poorly understood. Furthermore, the risk factors for long lasting pain after common dental surgeries remain largely unknown. This prospective cohort study identified subgroups of individual pain trajectories of acute (7-day) post-operative pain after root-end resection surgery and their associated risk factors. Ninety-three patients were included in this study. Latent class mixed modeling identified seventy-nine patients (85%) in the resolving pain group, while fourteen (15%) patients were in the non-resolving pain group. Multivariate logistic regression model revealed that higher pain catastrophizing scale (PCS) score (odds ratio: 1.11, 95% CI: 1.05-1.20), chronic bodily pain (odds ratio: 7.56, 95% CI: 1.35-63.89) and pre-operative pain at the surgical site (odds ratio: 5.95, 95% CI: 1.08-42.64) associate with an increased likelihood of having non-resolving acute pain (p<0.05). Validity of the trajectory groups was supported by the observation that the frequency of pain with neuropathic characteristics at 1 week and the frequency of ongoing pain at 1 month were higher in patients with non-resolving pain trajectories. Finally, it was found that the presence of perioperative pain and the anatomical location of the tooth were significant predictors of ongoing pain at 1 month (sub-acute pain). This study sheds light on crucial determinants of delayed pain resolution following a common dental surgery, which provides insight for future efforts at the management and prevention of prolonged post-surgical dental pain.

PERSPECTIVE: Recognizing acute post-operative pain trajectories with non-resolving patterns, individual risk factors, and neuropathic qualities can identify patients needing tailored pain management strategies after routine dental surgery to prevent prolonged acute and subacute post-surgical pain.

PMID:41933816 | DOI:10.1016/j.jpain.2026.106273