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Characteristics and impact of pain from root-filled teeth. A practice-based cross-sectional study comparing painful teeth with and without signs of inflammatory dental disease

  • Jakob Jonsson Sjögren1,2,*,
  • Thomas Kvist3
  • Thomas List4
  • Alf Eliasson1,5
  • EndoReCo
  • Maria Pigg2

1Dental Research Department, Public Dental Health Service, 701 16 Örebro, Sweden

2Department of Endodontics, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden

3Department of Endodontology, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden

4Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden

5School of Health and Medical Sciences, Örebro University, 701 82 Örebro, Sweden

DOI: 10.22514/jofph.2024.007 Vol.38,Issue 1,March 2024 pp.64-76

Submitted: 10 March 2023 Accepted: 30 January 2024

Published: 12 March 2024

*Corresponding Author(s): Jakob Jonsson Sjögren E-mail:

About author: EndoReCo: Endodontic Research Collaboration in Scandinavia, collab-orators: L. Bjørndal, V.S. Dawson, H. Fransson, F. Frisk, P. Jonasson, T. Kvist, M. Markvart, M. Pigg, E. Wigsten.


To compare pain characteristics, impact of pain and characteristics of patients with painful root-filled teeth with and without signs of inflammatory dental disease. This cross-sectional study was performed in the Public Dental Health services, Region Örebro County, Sweden. Adult patients with ≥1 root-filled tooth identified at their regular check-up were included and assigned to one of two groups; those with ≥1 sign of inflammatory dental disease (DD+) and those without any such sign (DD−). Patients/teeth were compared regarding pain characteristics (intensity, frequency, duration, quality and provoking factors), impact of pain (medication intake, impact on life) and patient characteristics as background factors (general health, other bodily and orofacial pain). Statistics included descriptive data (frequency tables) and group comparisons (Chi-square, Fisher’s Exact and Mann-Whitney U-tests). The DD+ group included 27 participants (30 teeth) and the DD− group 22 participants (23 teeth). On average, pain intensity was mild, the frequency most often recurrent, and the impact was low. Average pain duration since onset exceeded 2 years in both groups. The only observed between-group differences were average pain intensity; 3.1 (0–10 Numerical Rating Scale (NRS)) in DD− group compared to 1.6 for DD+ (p = 0.030), and tenderness to apical palpation; only reported in the DD+ group. The similarities in clinical presentation between the two groups underscore the difficulties in correctly distinguishing between pain of odontogenic and non-odontogenic origin in root-filled teeth with a standard clinical investigation. Additional diagnostic methods need to be investigated for their ability to differentiate between tooth pain or discomfort of different origins.


Dentistry/diagnosis; Dentistry/epidemiology; Endodontics; Facial pain; Pain; Root canal therapy

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Jakob Jonsson Sjögren,Thomas Kvist,Thomas List,Alf Eliasson,EndoReCo,Maria Pigg. Characteristics and impact of pain from root-filled teeth. A practice-based cross-sectional study comparing painful teeth with and without signs of inflammatory dental disease. Journal of Oral & Facial Pain and Headache. 2024. 38(1);64-76.


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