Clinical and Patient-Related Factors Influencing Postoperative Pain and Oral Health-Related Quality of Life After Emergency Endodontic Treatment: A Prospective Observational Study

J Dent. 2026 Jun 9:106825. doi: 10.1016/j.jdent.2026.106825. Online ahead of print.

ABSTRACT

OBJECTIVES: This prospective study aimed (i) to evaluate postoperative pain intensity and Oral Health-Related Quality of Life (OHRQoL) following emergency endodontic treatment, and (ii) to identify clinical- and patient-related factors associated with pain and changes in OHRQoL.

METHODS: Patients presenting with moderate to severe endodontic pain (Numerical Rating Scale, NRS ≥ 4) were enrolled. After recording baseline NRS and Oral Health Impact Profile-14 (OHIP-14) scores, participants underwent access opening followed by no, partial, or complete root canal debridement. Pain intensity and OHRQoL were reassessed at 1, 2, and 7 days postoperatively. These outcomes across time intervals were analyzed using Friedman test. Linear regression analysis was performed to identify factors associated with pain and changes in OHRQoL. (p < 0.05).

RESULTS: A total of 110 patients were enrolled, of whom 96 completed the study. Postoperative pain and OHRQoL improved significantly over time (p < 0.001), with the greatest pain reduction occurring within 24 hours. Pain reduction and OHRQoL improvement were positively correlated (r = 0.645, p < 0.001). Preoperative pain severity significantly predicted higher postoperative pain levels (p < 0.05). Greater OHRQoL improvement was significantly associated with severe preoperative pain and complete root canal debridement (p < 0.05).

CONCLUSIONS: Emergency endodontic treatment significantly reduced postoperative pain and improved OHRQoL within one week. Pain reduction was strongly associated with OHRQoL improvement. Preoperative pain severity was a significant determinant of postoperative pain intensity and was also associated with changes in OHRQoL. Complete root canal debridement contributed to better quality of life.

CLINICAL SIGNIFICANCE: Emergency endodontic treatment rapidly reduces postoperative pain and improves oral health-related quality of life within one week. Greater pain reduction is closely linked to better OHRQoL outcomes. Preoperative pain severity predicts postoperative recovery, while thorough root canal debridement contributes to more favorable patient-reported quality-of-life improvements.

PMID:42263928 | DOI:10.1016/j.jdent.2026.106825