Comparative Evaluation of Pain Perception in Symptomatic Apical Periodontitis among Smokers and Non-Smokers Patients during Endodontic Treatment. A Clinical Prospective

Krishna P. Shetty1, *, Alexander M. Luke1, Musab Saeed1, Mathew Simy2, Satish S. Venkata3
1 Department of Clinical Sciences, College of Dentistry, Ajman University, United Arab Emirates
2 Department of Basic Medical and Dental Sciences, College of Dentistry, Ajman University, Surgical Science, United Arab Emirates
3 Department of Conservative Dentistry and Endodontics ,Navodaya Dental College , Karnataka 584102, India

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© 2021 Shetty et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Clinical Sciences, College of Dentistry, Ajman University, United Arab Emirates; Tel: +971588070392; E-mail:



The most common sequelae of events caused by the bacterial ingress into the tooth structures leading to pain is almost always treated by endodontic therapy, which establishes a correlation between pain and endodontics. There are many host modulatory factors that alter pain response. Smoking is one such factor that has a significant effect on human responses, immune responses, along with the risk of infection.


A total of 10 non-smokers and 10 smokers having symptomatic apical periodontitis undergoing root canal treatment were selected. The treatment was divided into four appointments, and the patients were asked to record the interappointment pain level on a VAS scale. The data obtained were analyzed using SPSS version 20 software, and the tests employed were independent sample t-test, post-hoc Bonferroni test.

Results and Discussion:

The interappointment pain levels during the endodontic treatment were found to be higher among smokers than non-smokers. Both the groups initially showed the perception of pain, but even at the end of the treatment, smokers were found to have pain. p-value </= 0.5 was considered significant.


It was concluded from the study that smokers have a higher level of pain perception when compared to non-smokers.

Keywords: Apical periodontitis, Endodontic pain, Non-smokers, Pain, Smokers, Bacterial Ingress.