Date of Award
Spring 4-17-2026
Document Type
Thesis
Degree Name
Master of Science (MS)
Department
Dentistry
First Advisor
Vrisiis Kofina
Second Advisor
Arndt Guentsch
Third Advisor
Casey Wright
Fourth Advisor
Han Shengtong
Abstract
Objective: The purpose of this randomized clinical trial is to investigate the effects of preemptive analgesia on postoperative pain following extraction and ridge preservation and to evaluate the association between dental care-related fear and anxiety, health literacy, fear of pain, and pain catastrophizing with post-operative pain and swelling perception as well as Oral Health Impact Profile-14 (OHIP-14). Materials and Methods: Ibuprofen 600mg (test; n=9) or placebo (n=13) were randomly given one hour prior to extraction and ridge preservation. Preoperatively, patients completed the following questionnaires: Modified Dental Anxiety Scale (MDAS), Oral health-related quality of life (OHIP-14), Fear of Pain (FPQ-III), Pain Catastrophizing Scale (PCS), and Dental health literacy (REALD-30). Postoperatively, patients completed Visual Analogue Scale (VAS 0-100) for pain at hours 1, 2, 3 and days 1, 2, 3, 4, 5, 6, 7. Rescue medication (acetaminophen 500mg) was recorded. On days 1 and 7, patients rated their willingness to undergo the procedure again, if needed (VAS 0-100; 0=no willingness), their anticipated pain compared to actual pain and their intraoperative memory. Results: There were no statistically significant differences between the groups in mean MDAS scores (test: 3.1 ± 3.03; control: 3.85 ± 3.34), FPQ-III (test: 20.5 ± 5.13; control: 22.0 ± 3.12), PCS (test: 11.4 ± 9.03; control: 8.23 ± 5.54), OHIP-14 (test: 10.2 ± 9.18; control: 9.69 ± 8.90), or REALD-30 (test: 24.7 ± 2.75; control: 24.31 ± 4.09) (p > 0.05 for all). The test group experienced maximum pain on day 1 (6.56 ± 9.67), and the control group at hour 3 (21.15 ± 21.95). Pain was significantly different between groups at hour 2 (test: 3.67 ± 5.02 vs. placebo: 18.38 ± 19.75; p = 0.02), hour 3 (test: 1.33 ± 1.87 vs. placebo: 21.15 ± 21.95; p = 0.007), and day 6 (test: 0.11 ± 0.33 vs. placebo: 5.0 ± 7.38; p = 0.03). There was no significant difference between groups in rescue medication consumption (p > 0.05). Both test and placebo patients were willing to undergo the procedure again (92±5.7 vs 79±8.4 respectively; p=0.2). In the test group, 87.5% of patients reported that actual pain was less than anticipated, 12.5% reported it was similar, and none reported it was greater. In the control group, 70% reported less pain than anticipated, 20% reported similar pain, and 10% reported greater pain than anticipated. The difference in intraoperative pain memory between groups was statistically significant only on the first postoperative day (test: 7.22 ± 6.83; control: 21.23 ± 18.36; p = 0.02). MDAS scores were positively correlated with rescue medication consumption at hour 1 (ρ = 0.56, p = 0.04) in the control group only. Similarly, pain and swelling were positively correlated during the first three postoperative hours in the control group (Hour 1: ρ=0.81, p=0.00; Hour 2: ρ=0.71, p=0.00; Hour 3: ρ=0.63, p=0.02). Conclusion: Patients experience minimal pain following extraction and ridge preservation and are willing to undergo the procedure again, if needed. Preemptive ibuprofen significantly reduces pain on the day of the procedure.