Dr. Dunsky raises an important issue relative to the management of postprocedural pain after periodontal scaling and root planing.
It is certainly reasonable to expect that the use of long-acting local anesthetics may be effective in alleviating such pain. However, it is important to recognize that unless the onset, duration and magnitude of pain are assessed, it may not be possible to appropriately design or test intervention strategies to reduce postprocedural discomfort.
The purpose of our study was not to test or compare various methods of alleviating postprocedural pain. Rather, our purpose was to clearly define the time of the onset, magnitude and duration of pain following these commonly used periodontal procedures. Once such parameters are established, appropriate pain management strategies can be designed and tested.
Certainly, the use of long-acting anesthetics with an extended duration that includes the time at which maximum discomfort occurs would be one strategy for reducing postprocedural discomfort.
As Dr. Dunsky points out, a double-blind comparison of various local anesthetics might yield information that would affect the choice of anesthetics for scaling and root planing. Other studies that compare preoperative and/or postoperative use of appropriate analgesic agents might also yield helpful information relative to this issue.
