Non surgical diagnosis and treatment involve scaling to remove the accumulated tartar, root planning to smooth the loosened gum tissues for preventing further tartar accumulation and probing the pocket depths to thoroughly clean the bacterial colonies in the sub-gingival layer, that is, the gaps between the root and the gum tissues.
This review attempts to provide a critical analysis of the paper presented by Daniel van Steenberghe, Peter Garmyn, Lut Geers, Elke Hendrickx, Marina Marechal, Karin Huizar, Ann Kristofferson, Karin Meyer-Rosberg, and Guy Vandenhoven on the basis of a multi-centered investigation in order to understand the extent of pain in fixed numbers of both first timers and recall patients during instrument based diagnosis and routine non-surgical treatment of the condition. The importance of the investigation not only lies in the common occurrence of the disease affecting a major part of the adult population in the United States of America, but also in its two-fold risk, including an imminent damage of the oral area and its association with much more severe physiologic conditions, like cardiac arrest, stroke, atherosclerosis and increased blood glucose levels. (Journal of American Dental Association, 2000) The study analyzed the findings obtained from a survey carried out on the experiences involving pain and discomfort of two different groups of patients during diagnosis and treatment with non-surgical periodontal instrumentation. The principal objective of the analysis was to run a trial test for establishing the hypothesis indicating the existence of discomfort during periodontal diagnosis based on observations from earlier rudimentary investigations. Another important aim of the study was to compare and contrast the discomforting experience for patients under instrumentation for diagnosis both in hospital environment and in clinics during private practice. The secondary objective of the investigation was to standardize and corroborate a set of earlier formulated survey questionnaires for assessing the past experience of patients with previous diagnostic sessions of scaling and pocket depth probing by periodontists that can be used for future assays on patient responses after administration of topical anesthetics during treatment.
A nested case controlled analysis was performed with the two groups of individuals, one composed of first timers for non-surgical treatment and diagnosis and the other being the recall patients who had earlier undergone primary SRP (Scaling and Root Planning) and probes for PD (Pocket Depth). The first timers who constituted the primary study group formed the basis of the investigation and were subjected to either PD or SRP or both. They were compared with recall patients constituting the comparison group, who were subjected to cohorts being exposed to either PD or SRP, thereby together constituting the control group. The best part of this longitudinal study population was the formation of the nested control group to minimize the recall bias, which is the misleading influence due to the memory of past treatments on the experiences of the individuals from the recall group. The longitudinal analysis was performed with both the respondents and the non respondents in the study and the