Pain and Immunologic Response to Root Canal Treatment and Subsequent Health Outcomes : Psychosomatic Medicine

Journal Logo

Original Articles

Pain and Immunologic Response to Root Canal Treatment and Subsequent Health Outcomes

Logan, Henrietta L. PhD; Lutgendorf, Susan PhD; Kirchner, H. Lester PhD; Rivera, Eric M. DDS, MS, and; Lubaroff, David PhD

Author Information
Psychosomatic Medicine 63(3):p 453-462, May 2001.



This study examined the effects of pain and stress associated with a dental procedure, root canal treatment (RCT), on natural killer cell cytotoxicity (NKCC) and the subsequent development of symptoms of upper respiratory illness during the following month.


Patients (N = 33) were recruited from those scheduled for RCT appointments. Subjects for a non-RCT comparison group (N = 14) were also recruited from dental clinic patients. Peripheral blood was drawn by use of an indwelling catheter three times: just before RCT, 30 minutes after injection of a local anesthetic, and 30 minutes after RCT (a parallel time course was followed for the comparison group.) Blood was assayed for cortisol and NKCC. Subjects completed a health diary in the month after RCT.


Patients showed a significant increase in NKCC between baseline and RCT and a significant decrease from RCT to after RCT, whereas the comparison group did not. The NKCC following the RCT was negatively correlated with the pain level during RCT (r = −0.48, p < .01) and pain levels 2 and 6 hours after RCT (r = −0.43, p < .05;r = −0.44 p < .05, respectively). The patient group reported significantly more illness episodes 2 weeks after RCT than the comparison group (Wilcoxon rank sum = 4.78, p = .03). Discriminant function analysis correctly classified 88% of the subjects into the illness category using predictor variables of post-RCT NKCC, stress, and pain levels during RCT (F (3,21) = 8.23, p < .001).


Transitory changes in NKCC associated with pain and stress may be implicated in the development of infectious disease episodes after an acute stressful event.

Copyright © 2001 by American Psychosomatic Society

You can read the full text of this article if you:

Access through Ovid