Women Expect, Tolerate More Pain at Dentist

A new study suggests women have more anxiety when they go to the dentist, but that expectation of pain results in a higher pain threshold than male patients.

A study of 100 dental patients, undergoing orthodontic and required extractions of teeth (Nos. 34 or 44) found “statistically significant” gender differences between men and women according to “Assessment of Relationship between Pain and Anxiety Following Dental Extraction—A Prospective Study” and appearing in a recent issue of “Scientific Research.”

Lead author Shalender Sharma—department of oral and maxillofacial surgery, SGT Dental College, Gurgaon, India—evaluated 56 females and 44 males to find women experienced higher thresholds of pain because they expected it. While “being seated in a dental chair” provoked dental pain and anxiety in women, “uncertainty about proper numbness before extraction” provoked this response in men. Researchers—who excluded patients with medical or psychological disorders that impact pain, anxiety medication, acute periodontal pain, pulpitis, abscess or other acute infections—uncovered no statistical age-related differences among the participants who ranged in age from 18 to 30.

The same dental assistant and maxillofacial surgeon performed all procedures on patients who sat in the same dental chair to receive inferior alveolar, lingual and mental nerve block. All participants gave written, informed consent in Hindi after tooth extraction.

A visual analog scale and questionnaire assessed pain and anxiety after extraction, resulting in a mean VAS group score of 16.23 plus/minus 1.28. “There was a statistically significant correlation between VAS and total anxiety score. When VAS was evaluated for each question, there was a significant correlation except for questions Nos. 4, 8, and 9 in males,” reports the study, conducted at the department of oral and maxillofacial surgery between October 2013 and 2014 in compliance with the Institutional Review Board/Human Subjects Research Committee. These questions dealt with the experience of going to the dentist and receiving anesthesia.

The study calls dental anxiety—also known as dental phobia, odontophobia, dentophobia, or dental fear—“a state of apprehension that something dreadful is going to happen in relation to dental treatment.” Dental anxiety varies between 4% and 20% worldwide, states the study, which notes that nearly 6% of respondents to a Canadian survey reported being “very afraid or terrified” of dental visits and nearly 10% “somewhat afraid.”

The International Association for the Study of Pain defines “pain” as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” Forty percent of the population suffer from this multi-faceted emotional and sensory experience—associated with and exaggerated by previous experience, expected stress, clinical situation and anxiety, it adds.