Optimizing Acute Post-Operative Dental Pain Management Using New Health Information Technology

Pain has been deemed the fifth vital sign and many describe it as an adverse event. The
adequate management of pain is the bane of the dental profession and its continuous
assessment is crucial to minimizing patients' pain experiences. Due to the duration of action
of most commonly-used local anesthetic agents, dental patients are unable to predict their
pain following dental procedures until many hours later, when the participants have already
returned home and dental offices are closed. This has led to an over-reliance on
pre-emptively prescribed opioids by dental providers because the participants have no means
to actively track their patients' pain after hours. Innovative mobile applications and
connected health technologies that allow real-time tracking of patients' symptoms, functional
status and quality of life, provide healthcare professionals with data that were previously
unavailable, and have fostered patient engagement, shared decision-making and adherence to
treatment plans. The investigators propose an innovative solution to optimize the quality of
dental pain monitoring and management by implementing mobile phone technology to monitor
patients' pain during the critical acute post-operative phase. The hypothesis is that by
actively tracking these symptoms using mobile phones, the investigators modify analgesic
prescriptions), thereby eliminating needless suffering, reducing the occurrence and/or
severity of post-op complications, and enhancing the overall care experience. The
investigators' ultimate goal is to achieve the quadruple aim: improve patient experience,
improve patient outcomes, improve physician experience and reduce per capita costs. The
investigators will test this hypothesis using a cluster-randomized experimental study design
with: (1) an intervention arm where patients receive push notifications through text messages
on their mobile phones (FollowApp.Care) at designated time intervals on Days 1, 3, 5 and 7;
and (2) a control arm where patients receive the usual care. This project will be conducted
at two dental institutions: Willamette Dental Group (WDG) and University of California San
Francisco (UCSF). In Aim 1 the investigators will customize the design features of the
existing FollowApp.Care at two dental institutions (Willamette Dental Group and University of
California San Francisco) and assess its capacity to accurately capture patient-reported
outcomes. In Aim 2 the investigators evaluate the impact of using FollowApp.Care on patient
post-op experiences and oral health outcomes. And in Aim 3, the investigators evaluate
provider acceptance of FollowApp.Care and its impact on provider performance. By collecting
patient reported outcomes in a timely and usable way, the investigators expect to help
dentists enhance their practice performance and reduce the burden of unnecessary opioid
prescriptions on society.

Inclusion Criteria:

- Patients who have undergone periodontal procedures.

- Patients who have undergone endodontic procedures.

- Patients who have undergone oral surgery procedures.

Exclusion Criteria:

- 3rd year pre-doctoral students

- 4th year pre-doctoral students

- dental hygiene students