Research in Focus
Talking to Patients About Pain: One PEARL Practitioner-Investigator's Experience

Dr. James Keenan

The PEARL Network's Study of Analgesic Use and Effectiveness addresses the value of different analgesics by determining the degree of pain that a dentist perceives a procedure will produce, his or her prescription or recommendation to control the pain, and the patient's perception of how well the medication has controlled pain. Nearly 2,000 subjects have enrolled in the study to date. In the following article, Dr. James Keenan discusses how his participation in the analgesics study has helped him communicate more effectively about pain management with his patients.

A surprising number of patients do not understand their dentist's instructions on managing postoperative pain, a recent review of interim data from the PEARL Network's Study of Analgesic Use and Effectiveness has found. Importantly, participation in the analgesics study can help dentists communicate more effectively with patients about pain management. So says Dr. James Keenan, who has enrolled 125 subjects from his Queens, New York, practice in the analgesics study since November 2008.

"I've become more aware of patients' pain management needs as a result of my work on the analgesics study," says Dr. Keenan. "My patients' responses to questions about postoperative pain have given me a great deal of feedback about their experience with discomfort or pain following root canals, extractions, and other operative procedures; their willingness to follow my instructions for taking pain medication; whether they filled an analgesics prescription or used over-the-counter drugs; and the amount and length of time spent taking pain medication.

"Now, if a patient asks me how much pain he or she should expect to feel postoperatively, I can describe what most patients under similar circumstances have experienced and can recommend a treatment regimen knowing that other patients in similar situations have reported doing well with the same medication.

"The information from the analgesics study has enhanced my ability to assess individual thresholds for pain, and has enabled me to establish a baseline for pain that may require prescription-strength analgesics.

"The bottom line is that participating in this study can facilitate information-sharing about pain management and analgesics, which, in turn, helps me make dental treatment as efficient and painless as possible."

In 2005, NYUCD received a $26.7 million award from the NIDCR to establish a regional practice-based network, the PEARL (Practitioners Engaged in Applied Research and Learning) Network.