Objective: The “third molar model” is a superb surgical scientific prototype for investigating factors which influence acute pain particularly in a healthy young sample, devoid of premorbid conditions that typically confound research studies in pain. Understanding mechanisms of acute pain may lend insight into pre-emptive care for invasive procedures and improved acute post-operative care. Little is known about these factors individually much less collectively. This study sought to test the validity of a model to predict acute post-operative pain and outcome. The domains included: baseline pre-operative pain measures; psychological factors; acute pain ratings; genetic markers; pharmacokinetic/pharmacodynamic (PK/PD) measures.

Methods: Participants included 71 healthy young adults (mean age = 23) who underwent oral surgery as well as extensive pre-operative and post-operative assessments and assay collection.

Results: The most salient factors within each domain were tested independently and then tested collectively as a full model using the most significant predictors from each domain. The overall model was far more predictive than individual domains ( R ² range over 3 post-operative days = 0.59–0.73). The strength of certain predictors varied in acute post-operative phase, suggesting important influences on biological processes (i.e. pain, inflammation) that might change over time and alter recovery.

Conclusions: These findings may prove significant in acute pain management and perhaps identify important risk factors for development of future chronic pain. This study was comprised of healthy young adults with short-term acute pain, offering a “clean sample” from which to draw potential pathways of clinical relevance along the pain continuum especially in the acute pain phase.

Conflict of interest: None declared.