Incidence and assessment of mechanical allodynia and its association with dental anxiety in endodontic pain: A clinical study

Abstract Context: Mechanical allodynia (MA) refers to pain elicited by normally nonpainful stimuli. Clinically healthy teeth may exhibit MA in relation to an endodontically diseased tooth. Aims: The study aimed to assess the prevalence of MA in healthy teeth ipsilateral, contralateral, and opposing teeth to an endodontically diseased tooth, and its association with patient anxiety. Settings and Design: A cross-sectional observational study evaluating patients presenting with endodontic pain. Subjects and Methods: A total of 150 patients diagnosed with symptomatic irreversible pulpitis or symptomatic apical periodontitis in permanent first molars were included. Pain on percussion in ipsilateral, contralateral, and opposing teeth was assessed using the visual analogue scale (VAS). Anxiety levels were measured using the Generalised Anxiety Disorder-7 scale. Statistical Analysis Used: Fisher’s exact test, Mann–Whitney U test, and Wilcoxon signed-rank test were applied. The level of significance was set at P ≤ 0.05. Results: MA was observed in 44% of ipsilateral and 10.7% of contralateral teeth, with no cases in the opposite arch ( P < 0.001). Patients with contralateral MA showed significantly higher anxiety levels compared to ipsilateral cases ( P < 0.001). VAS scores were significantly higher in the affected tooth than in the ipsilateral ( P < 0.001) and contralateral teeth ( P < 0.001). No significant associations were found with age or sex. Conclusions: MA may occur in healthy teeth adjacent to or contralateral to endodontically diseased teeth, likely due to central sensitization. Higher anxiety levels were associated with contralateral MA.