Electroencephalogram as an Objective Method for Recording Pain after Endodontic Noxious Stimuli

Introduction: This study evaluated the significance of brain wave activity, particularly theta waves, in detecting noxious endodontic stimuli and to determine their validity as an objective method for monitoring pain severity. Methods: The study included 300 patients with symptomatic irreversible pulpitis on 1 side of their jaws. Each participant wore a consumer-grade electroencephalogram (EEG) device, the EMOTIV EPOC X, for 10 minutes while seated in a dental chair. The control and inflamed teeth were evaluated to assess the patient's response to applied stimuli. Patients were asked to rate their pain intensity using a visual analog scale (VAS), while their theta wave brain activity was recorded using the EEG. Pain scores and EEG data were then collected and analyzed. Various comparisons were conducted using the signed-rank test, and correlations were assessed using Spearman's rank-order correlation coefficient. P values were adjusted for multiple comparisons using Bonferroni's correction, with the significance level set at P < .05 for all tests. Results: The results showed that in the inflamed side, theta wave activity (10.57 [6.76]) and VAS pain scores (7 [4]) were significantly higher (P < .001) than the control side (6.99 [4.87] and 1 [1.62], respectively). There was a moderate positive correlation between theta wave activity and VAS pain scores across all readings (0.3 < rs < 0.5, P < .001). Females had significantly higher theta band power readings than males on both sides (P < .05). However, females reported significantly higher pain scores than males only on the inflamed side (P < .001). Conclusions: This study illustrates the promising potential of monitoring theta brain wave activity as an objective method for assessing pain levels.