ORIGINAL ARTICLE The relationship between resting arterial blood pressure and oral postsurgical pain Christophe Deschaumes & Laurent Devoize & Yannick Sudrat & Martine Baudet-Pommel & Christian Dualé & Radhouane Dallel Received: 24 June 2014 /Accepted: 4 November 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Objectives This prospective study examined the relationship between resting blood pressure (BP; primary outcome), de- mographic features of patients, anatomical characteristics of the extracted teeth, surgery variables (secondary outcomes), and acute postsurgical pain in patients undergoing tooth extraction. Materials and methods Standardized surgery was performed under local anesthesia. A composite numerical index, referred to as “postoperative pain/analgesia score” (PPAS), was built out of two intermediate ones, indicating (i) the degree of spontaneous pain reported by the patient (postoperative pain score) and (ii) the amount of analgesic drug intake (postoper- ative analgesia score). Results A total of 293 patients with complete data sets were included in the analysis. Univariate analysis reveals that the intensity of postoperative pain is related to age, history of hypertension and previous oral surgery, number of extracted teeth, duration of surgery, and extraction of the third molar. On the other hand, there is no relationship with gender, anxiety, and operation duration. Multivariate analysis reveals that the intensity of acute postoperative pain is only associated with the location (upper/lower jaw, P =0.004) and deepness of implantation of the extracted tooth (P <0.0001), and mean resting BP (P =0.031). Conclusions This large prospective study shows that patients with high resting BP had a lower oral postsurgical pain than those with low resting BP. This suggests that high resting BP is a protective factor against oral postsurgical pain. Clinical relevance The measurement of resting BP before surgery may be used in clinical practice to identify patients at risk of developing severe oral postsurgical pain. Keywords Blood pressure . Tooth extraction . Hypertension . Hypoalgesia . Prediction Introduction Multiple surgical procedures are performed daily in the oral cavity, such as endodontic treatment, tooth extractions, or periodontal surgery. Tooth extraction is one of the most com- mon oral surgical procedures performed in dentistry and in- variably gives rise to a number of postoperative complica- tions, almost always including pain [1]. Despite progresses in pain research, acute postoperative pain remains a significant clinical problem and is associated with a high risk of devel- oping chronic pain [2]. However, clinical studies have shown considerable indi- vidual variability in postoperative pain perception following standardized surgical procedures [3, 4]. In order to identify individuals with high risk of developing severe postoperative Electronic supplementary material The online version of this article (doi:10.1007/s00784-014-1356-5) contains supplementary material, which is available to authorized users. C. Deschaumes : L. Devoize : Y. Sudrat : M. Baudet-Pommel : C. Dualé : R. Dallel Clermont Université, Université d’Auvergne, Neuro-Dol, BP 10448, F-63000, Clermont-Ferrand and Inserm U1107, F-63001, Clermont-Ferrand, France C. Deschaumes : L. Devoize : Y. Sudrat : M. Baudet-Pommel : R. Dallel CHU Clermont-Ferrand, Service d’Odontologie, 63003 Clermont-Ferrand, France C. Dualé CHU Clermont-Ferrand, Inserm, CIC 50, 63003 Clermont-Ferrand, France R. Dallel (*) INSERM/UdA U1107, Neuro-Dol: Douleur Trigéminale et Migraine, Faculté de Chirurgie Dentaire, 2 rue de Braga, 63100 Clermont-Ferrand, France e-mail: radhouane.dallel@udamail.fr Clin Oral Invest DOI 10.1007/s00784-014-1356-5