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Effects of Gender and Acute Dental Pain on Thermal Pain Responses

Edwards, Robert R. M.A.; Fillingim, Roger B. Ph.D.; Yamauchi, Shizuko D.D.S., M.S.*; Sigurdsson, Asgeir D.D.S., M.S.*; Bunting, Shelley B.S.N.; Mohorn, Stephen G. D.D.S., M.S.*; Maixner, William D.D.S., Ph.D.*†


Objective: Considerable research suggests that females exhibit greater sensitivity to laboratory pain procedures than do males; however, whether the presence of acute clinical pain influences this sex difference in pain sensitivity has not been investigated. The present experiment investigated the effects of sex and acute dental pain on laboratory pain responses.

Design: Thermal pain onset and tolerance were determined in 46 dental patients (15 male, 31 female) experiencing pain due to acute irreversible pulpitis and in 33 healthy controls (13 male, 20 female). In addition, measures of mood and coping were obtained in all participants. All subjects participated in two experimental sessions. The first session took place immediately before the patients underwent endodontic treatment for relief of pulpal pain. The second session took place approximately 1-2 weeks later, when pulpitis patients were pain free after treatment. During each session, thermal pain onset and tolerance were assessed with a 1-cm2 contact thermode applied to the right volar forearm using an ascending method of limits.

Results: During both sessions, thermal pain onset and tolerance were lower in control females than in control males; however, male and female pulpitis patients did not differ in their thermal pain responses during either session. Pulpitis patients also showed greater affective distress than controls.

Conclusions: These data suggest that the sex difference in thermal pain sensitivity frequently reported in pain-free subjects appears to be absent in patients presenting with acute dental pain. However, this effect cannot be explained solely based on the presence of clinical pain because the effect on pain threshold and tolerance persisted into session 2, when pulpitis patients were pain free. Potential explanations for these results are discussed.

Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama; and *Department of Endodontics and †Dental Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.

Manuscript submitted September 9, 1998; first revision received April 24, 1999; accepted for publication June 26, 1999.

Address correspondence and reprint requests to Dr. Roger B. Fillingim, Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd., Birmingham, AL 35294-1170, U.S.A.

© 1999 Lippincott Williams & Wilkins, Inc.