Patient-centered Outcomes of Root Canal Treatment: A Cohort Follow-up Study Javier Montero, PhD, DDS,* Beatriz Lorenzo, PhD, DDS,* Rocıo Barrios, PhD, DDS, † Alberto Albaladejo, PhD, DDS,* Jose Antonio Mir on Canelo, MD, ‡ and Antonio L opez-Valverde, PhD, MD* Abstract Introduction: This study aimed to evaluate the impact of pulpal pathology in terms of oral health–related qual- ity of life and to evaluate root canal treatment in terms of pain during and at 7 days after treatment. Methods: A consecutive sample of 250 adult patients requiring root canal treatment for a permanent tooth (incisors, canines, premolars, and molars) participated in this 1 week-follow-up study. The baseline impact regarding oral pain and well-being was recorded. After the root canal treatment had been performed, the pain and the comfort experienced during and 7 days after treatment were recorded on a 0–10 visual analog scale. Bivariate and multivariate analyses were performed to evaluate the modulating factors of pain. Results: At baseline, 41.2% of the patients reported a lot of pain, and the severity of the pain and the functional limitation were significantly greater among men compared with women. During the procedure, 62% of patients did not feel any pain, and 95% were relatively comfortable during the intervention. After 7 days, 60.4% reported some kind of post-treatment pain although on average this was very slight (1.5 1.6 on a 0–10 range). Intra- subject comparisons revealed that the pain decreased progressively from the preoperative phase up to the postoperative phase, the pain being more acute in pa- tients with vital teeth than those with necrotic pulps. Conclusions: The main impact on quality of life of pulpal pathology occurred in the pain and psychological discomfort dimensions. In more than 90% of patients undergoing root canal treatment, pain was totally or partially relieved after 7 days. (J Endod 2015;-:1–6) Key Words Dental pain, oral health-related quality of life, patient-centered outcomes, root canal treatment, self- assessment I n 1993, the World Health Organization defined health-related quality of life as ‘‘an in- dividual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’’ (1). This very broad concept encompasses the influence of social relations, physical health, the psychological-affective status of the individual, and the level of independence that health may exert in people’s self-assessment of their quality of life. The relationship between quality of life and oral health problems has been studied in depth, and many authors have related such problems to the use of prostheses (2), orthodontics (3), and periodontics (4). However, to date, only 4 research articles have attempted to relate quality of life to dental pulp–related problems (5–8), even though this odontologic speciality is for the treatment of infectious dental processes that are usually accompanied by pain. Moreover, dental pulp pain has a major impact on the oral health–related quality of life of the general population (9), and the primary reason for seeking dental attention (10). Both patients and dentists are concerned about the pain undergone before, dur- ing, and after root canal treatment. The clinical outcomes of root canal treatments have been widely studied; survival rates of about 90% after 10 years have been reported (11). Nevertheless, few studies (5–8) have addressed patients’ perceptions of this treatment (regarding pain or comfort) although clinicians are well aware that advanced caries lesions may cause discomfort, pain, and functional impairment. We hypothesized that root canal treatments may reduce patients’ pain in a short period of time (7 days). This study aimed to assess the impact of pulpal pathology in terms of oral health– related quality of life and to evaluate root canal treatment in terms of pain and comfort at 7 days after treatment. Materials and Methods Based on the premise that root canal treatment is able to reduce dental pain levels in a short period of time, we performed a prospective clinical study in a consecutive sample of 250 adult patients requiring root canal treatment for at least 1 permanent tooth (incisors, canines, premolars, and molars). All interventions were performed by a dentist specialized in root canal treatment (BL) at 3 dental clinics in the city of Sal- amanca, Spain. The study protocol was judged favorably by the Bioethics Committee of the University of Salamanca, and all patients provided informed consent to participate in the study. First, the sociodemographic data of the patients were collected (age, sex, profes- sional activity, brushing frequency, and the reason for visiting the dentist); afterward, the clinical data (pain produced by the tooth, teeth to be treated, the need for prior medication to alleviate pain, the presence of different symptoms such as difficulty in From the *Department of Surgery, Faculty of Medicine and ‡ Department of Preventive Medicine, University of Salamanca, Salamanca, Spain; and † Department of Stomatology, Dental School, University of Granada, Granada, Spain. Address requests for reprints to Dr Javier Montero, Facultad de Medicina y Odontologıa, Departamento de Cirugıa, C/Alfonso X el Sabio S/N CP 37007, Salamanca, Spain. E-mail address: javimont@usal.es 0099-2399/$ - see front matter Copyright ª 2015 American Association of Endodontists. http://dx.doi.org/10.1016/j.joen.2015.06.003 Clinical Research JOE — Volume -, Number -, - 2015 Patient-centered Outcomes of Root Canal Treatment 1