Pain is the sensation created by the body when it detects damaging stimuli. It is a reaction within the nervous system that is interpreted by the brain. The severity of the pain perceived will depend on the type and duration of stimuli, as well as the individual response – everyone experiences pain differently and to a different extent, making it a highly subjective and a difficult field for scientific analysis and comparison.
The science
The physiology of pain involves a number of complex pathways and multiple interrelated processes that affect the neuronal, endocrine, and inflammatory systems in the body.[i] In most cases, nociceptors in the skin, muscles, or organs detect damage, inflammation, or other stimuli, transmitting signals through the nervous system to the brain, which determines the response.
Pain is often referred to as acute or chronic. The former describes pain that is experienced only temporarily, often not lasting longer than a few months and resolving upon healing of the injury. Chronic pain is more persistent and can be felt by individuals for prolonged periods of time. Neither one of these alone indicate the severity of pain or the danger posed by the injury or disease causing the discomfort.[ii]
To facilitate a standard approach to assessment and diagnosis, pain can be further classified according to aetiology, pathophysiology, anatomical location, intensity, or duration.[iii] Pain can also be categorised as nociceptive, triggered by physical damage to the non-neural tissue; neuropathic, arising as a result of a lesion or disease affecting the somatosensory system; or nociplastic pain, which is commonly used for those experiencing unexplained or unclassified pain.[iv]
To feel or not to feel
Further complicating the assessment, classification, and comparison of pain between individuals is the subjectivity with which pain is reported. As such, two people in a similar situation will rarely report the same level of discomfort.
This is, at least partly, because several neurological aspects influence how pain is perceived. For example, there is evidence that not knowing what to expect can actually increase the intensity of pain experienced.[v] The study postulated that the brain uses a probabilistic modelling technique that predicts required reactions to set stimuli, and sets expectations. In the absence of the data needed to make these calculations, the brain errs on the side of caution by signalling greater discomfort than may actually be occurring.
The literature also shows that cognitive and emotional control of pain can influence how it is experienced.[vi] Focusing on the pain increases its perceived unpleasantness, as does a negative emotional state. Distraction techniques may also be useful in reducing the pain reflex, although further research is needed in this field to determine the exact mechanisms at play.
Pain management in the dental setting
All of this is important because the duration and severity of pain experienced during dental treatment can substantially influence a patient’s oral health-related quality of life.[vii] Reducing the amount of physical and emotional discomfort they feel with each visit is also important for enhancing their overall treatment journey.
How this is achieved may differ between practices, practitioners, and patients. Distraction techniques, for example, may be useful for implementing alongside dental treatment for patients who are nervous about an upcoming procedure. Music therapy has been shown to lower stress and anxiety prior to dental care, in both adult and child patients.[viii] There is also initial evidence that indicates listening to music they enjoy can significantly affect a person’s pain threshold, improving the pain-related response.[ix]
A positive attitude and warm demeanour by the clinician may also impact the patient’s perception of pain during dental procedures – once again, this is especially true for anxious individuals.[x] It can also help to clearly communicate the proposed treatment procedure and expected outcomes, allowing patients to visualise the process so they know what to expect.
It is just as important that clinical steps are taken to reduce pain and discomfort before, during, and after treatment. In addition to minimally invasive techniques and preventive strategies, clinicians must be prepared to help patients address sudden toothache or dental pain even before they are able to visit the practice. Recommending a topical local anaesthetic that is proven to deliver safe, fast and effective pain relief is important in these crucial moments. Orajel® Dental Gel[xi] is an ideal solution, containing 10% benzocaine to deliver rapid pain relief[xii] in just 2 minutes.[xiii] Patients simply apply the gel to any painful area in the mouth to benefit from rapid relief. For those with a high perceived level of pain, the Orajel® Extra Strength[xiv] solution contains 20% benzocaine and affords even more powerful relief.
Enhancing the patient experience
Pain is a complex and highly subjective experience that has a significant impact on a person’s daily life. Understanding how to help patients manage any pain relating to the mouth is an important aspect of the modern dental professional’s remit.
For essential information, and to see the full range of Orajel products, please visit https://www.orajelhcp.co.uk/
Author: Sumera Bashir Medical Affairs & Scientific Engagement Lead
[i] Liu S, Kelliher L. Physiology of pain—a narrative review on the pain pathway and its application in the pain management. DMR Vol 5, December 2022. https://dmr.amegroups.org/article/view/8443
[ii] Wirral University Teaching Hospital. NSH Foundation Trust. https://www.wuth.nhs.uk/our-departments/a-z-of-departments/wirral-chronic-pain-service/the-difference-between-chronic-and-acute-pain/ [Accessed February 2026]
[iii] Pain basics. Classification of Pain. Change Pain. https://www.change-pain.co.uk/hcp-homepage/pain-basics/classification-of-pain [Accessed February 2026]
[iv] Cao, B., Xu, Q., Shi, Y. et al. Pathology of pain and its implications for therapeutic interventions. Sig Transduct Target Ther 9, 155 (2024). https://doi.org/10.1038/s41392-024-01845-w
[v] Ehmsen, J. F., et al. (2025). Thermosensory predictive coding underpins an illusion of pain. Science Advances. doi.org/10.1126/sciadv.adq0261.
[vi] Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013 Jul;14(7):502-11. doi: 10.1038/nrn3516. Epub 2013 May 30. PMID: 23719569; PMCID: PMC4465351.
[vii] Caldas W, Bonin FA, Vianna CP, Shimizu RH, Trojan LC. Influence of pain duration and severity on oral health-related quality of life and patient satisfaction during adult treatment with clear aligners. Prog Orthod. 2024 Apr 29;25(1):18. doi: 10.1186/s40510-024-00514-6. PMID: 38679672; PMCID: PMC11056347.
[viii] López-Valverde N, López-Valverde A, Macedo de Sousa B, Blanco Rueda JA. Efficacy of music therapy on stress and anxiety prior to dental treatment: a systematic review and meta-analysis of randomized clinical trials. Front Psychiatry. 2024 Feb 23;15:1352817. doi: 10.3389/fpsyt.2024.1352817. PMID: 38463434; PMCID: PMC10920280.
[ix] Antioch I, Furuta T, Uchikawa R, Okumura M, Otogoto J, Kondo E, Sogawa N, Ciobica A, Tomida M. Favorite Music Mediates Pain-related Responses in the Anterior Cingulate Cortex and Skin Pain Thresholds. J Pain Res. 2020 Oct 29;13:2729-2737. doi: 10.2147/JPR.S276274. PMID: 33154663; PMCID: PMC7605953.
[x] Tang B, Ting J, Brown R, Nathan S, Ashton-James C, Sadr A, Gholamrezaei A. Is there an association between clinician behavioural factors, and the experience of pain in a dental setting? A Scoping Review. medRxiv 2023.06.18.23291577; doi: https://doi.org/10.1101/2023.06.18.23291577
[xi] Orajel Dental Gel. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1230/smpc
[xii] Lee, H-S. Recent advances in topical anesthesia. J Dent Anesth Pain Med. 2016;16(4):237–244.
[xiii] Hersh, EV, et al. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothache. J Am Dent Assoc. 2013;144(5):517–526.
[xiv] Orajel Extra Strength. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1231/smpc
