Predictors of post-operative pain in diabetic patients with dental caries

Abstract

Background: Diabetic patients carry a higher caries burden and a distinct healing response, yet post-operative pain after treatment of dental caries is rarely organized around predictors specific to this population.

Objective: To synthesize evidence on the metabolic, disease-severity, procedural, and perioperative predictors of post-operative pain in diabetic patients treated for dental caries.

Methods: Narrative synthesis of case-control, cohort, systematic review, meta-analysis, and umbrella review evidence addressing diabetes, glycemic control, caries burden, and post-operative pain or healing outcomes.

Findings: Diabetic adults carry an adjusted DMFT approximately 4.5% higher than non-diabetic adults [4]; apical periodontitis and periapical healing are measurably worse in diabetic patients [9,10]; preoperative pain intensity and pulpal diagnosis remain the dominant predictors of post-operative pain irrespective of diabetes status [16,18]; glycemic control behaves as a graded modifier most clearly linked to caries burden and long-term healing [13,21]; and perioperative adjuncts raise implant survival from 86.5% to 95.6% in diabetic patients [19].

Conclusions: Post-operative pain in diabetic patients with dental caries is predicted by the same procedural and disease-severity factors as in non-diabetic patients, with glycemic control and diabetes-specific healing impairment layered on top; a predictor model for this population should combine all four domains rather than treating diabetes as a single undifferentiated risk flag.