Anxiety, depression and stress as modulators of pain in dental care
Keywords:
depression, anxiety, psychological stress, pain perception, mental healthAbstract
Introduction: Emotional states can influence pain perception, especially in clinical settings such as dental care.
Objective: To examine the relationship between psycho-emotional states (depression, anxiety, and stress) and pain perception in dental patients.
Methods: An observational, cross-sectional, and prospective study was conducted in a dental clinic in Lima, Peru, with 185 patients aged 18 to 40 years. The DASS-21 questionnaire was applied to measure emotional states, and the Visual Analog Scale was used to evaluate pain.
Results: A positive correlation was found between anxiety (Rho = 0.35; p < 0.001) and stress (Rho = 0.48; p < 0.001) with pain perception. Depression showed no significant relationship (Rho = –0.003; p = 0.96). Ordinal logistic regression indicated that mild anxiety (OR = 8.81; 95% CI: 3.81–20.37) and moderate anxiety (OR = 2.22; 95% CI: 1.06–4.65), as well as mild (OR = 16.64; 95% CI: 7.15–38.70), moderate (OR = 2.97; 95% CI: 1.30–6.78), and severe stress (OR = 7.50; 95% CI: 1.68–33.36), were significantly associated with increased pain perception. Mild depression (OR = 0.40; 95% CI: 0.20–0.80; p = 0.01) and severe depression (OR = 0.08; 95% CI: 0.00–0.78; p = 0.03) were associated with lower pain perception.
Conclusions: Anxiety and stress were significantly associated with higher pain perception. These findings support the importance of early psychological interventions to optimize the quality of dental treatment experience.
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Copyright (c) 2025 Romina Moreno-Prieto, Víctor Moreno-Prieto, Juana Delgadillo-Avila, Carlos Temoche-Rosales, Carlos Campodónico-Reátegui
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