Journal article
Electronic health record associations in patients self-reporting to be difficult to anesthetize
Journal of dental anesthesia and pain medicine: JDAPM, Vol.25(2), pp.97-108
04/2025
DOI: 10.17245/jdapm.2025.25.2.97
PMCID: PMC11972930
PMID: 40201231
Abstract
Background
Patients who report to be difficult to anesthetize for dental procedures are commonly encountered. Determining their frequency and shared characteristics could improve understanding of pain management failures.
Methods
Categorical and continuous variables of 24 demographic, medical history, and dental history variables were compared in a deidentified cross-sectional study using electronic health records (EHR) of patients at the University of Iowa College of Dentistry. Individuals who self-reported to be difficult to anesthetize in their dental health history form were compared to those who reported no complications with local anesthesia. Descriptive, univariate regression, and multivariable regression statistical analyses were completed on the demographic, medical history, and dental history EHR variables.
Results
A total of 12,400 deidentified patient records met the inclusion criteria with a 11.4% (n = 1,411) prevalence of difficult to anesthetize self-reports. Eight categorical variables were found to have statistically significant (95% confidence interval [CI]) adjusted odds ratios (AOR) in the multivariable regression of difficult to anesthetize reporting patients: female gender (AOR = 1.61, 95% CI: 1.32-1.96, P < 0.001), dental fear (AOR = 3.60, 95% CI: 3.01-4.31, P < 0.001), mental health disorders (AOR = 1.21, 95% CI: 1.00-1.46, P < 0.045), problems with general anesthesia (AOR = 1.46, 95% CI: 1.11-1.89, P = 0.005), neurological/nerve disorders (AOR = 1.30, 95% CI: 1.05-1.60, P = 0.015), temporomandibular joint clicking/popping (AOR = 1.31, 95% CI: 1.08-1.60, P = 0.006), needle anxiety (AOR = 29.03, 95% CI: 23.80-35.52, P < 0.001), and history of root canal treatment (AOR 0.82, 95% CI: 0.68-0.99, P = 0.035).
Conclusion
A clinically relevant percentage of patients self-reported being difficult to anesthetize for dental procedures. The relationship between local anesthesia inadequacies and variables such as female gender, dental fear, mental health, and neurological disorders requires further investigation. The use of evidence-based local anesthesia approaches and communication practices is suggested to minimize pain experienced and subsequent fear of dental care.
Details
- Title: Subtitle
- Electronic health record associations in patients self-reporting to be difficult to anesthetize
- Creators
- Robert D. Bowers - University of IowaWei Shi - University of IowaChandler Pendleton - University of IowaShareef Dabdoub - Department of Periodontics and Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry, Iowa City, Iowa, USAJennifer Sukalski - Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USAOlivia C. Bartholomew - University of Iowa College of Dentistry, Iowa City, Iowa, USAChristopher T. Hogden - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of dental anesthesia and pain medicine: JDAPM, Vol.25(2), pp.97-108
- DOI
- 10.17245/jdapm.2025.25.2.97
- PMID
- 40201231
- PMCID
- PMC11972930
- NLM abbreviation
- J Dent Anesth Pain Med
- ISSN
- 2383-9309
- eISSN
- 2383-9317
- Publisher
- Korean Dental Soc Anesthesiology
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Preventive and Community Dentistry; Endodontics; Family Dentistry; Dental Research; Periodontics
- Record Identifier
- 9984803810902771
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