Pain in Pediatric Dentistry - a Grounded Theory Study on the Experiences of Dental Professionals and Students

Pain in Pediatric Dentistry - a Grounded Theory Study on the Experiences of Dental

This is a qualitative interview study, using Grounded Theory. The aim is to deepen our knowledge about how the dental team (dentists, dental hygienists, and dental assistants) and dental students perceive child patients' pain and how they perceive they are equipped to prevent and deal with child patients' pain and the child's response to pain during and after dental treatment.

Study Overview

• Status: Recruiting
• Conditions: Pain
• Intervention / Treatment: Behavioral: Interview

Detailed Description

BACKGROUND Pain in conjunction with dental treatment should be avoided, especially when treating children. Many dental procedures may result in procedural and/or postoperative pain. There is a well-documented relationship between perceived pain during dental treatment, and the development of dental fear and anxiety. This may lead to suffering for the patient, avoidance of dental care, and increasing treatment costs for the individual and society. Dental care professionals are responsible for providing as painless dental treatments as possible to their child patients. Earlier studies have pointed towards an underusage of local anesthetics when providing dental care to children. Though previous studies have not been able to fully answer why this is. Thus, the aim of this study is to gain knowledge into how dental professionals and students experience and relate to the child patient's experience of pain during and after dental treatment.

METHOD This is a qualitative study using Grounded Theory (GT). Dental students in their last two years of education and dental professionals (dentists, dental hygienists, and dental assistants), will be consecutively enrolled after signing an informed consent form.

In-depth interviews of approximately one hour each will be performed with the informants at a place of their convenience. Appropriate measures will be taken regarding public health recommendations in effect due to the Covid-19 pandemic.

In GT no sample size calculation is done. Participants will be included until saturation in data is reached, i.e. no new information can be obtained from further interviews. In GT this is often achieved after 10-15 interviews, but due to the scope of this study involving several different professionals and students it is likely the number of informants will be closer to 25. All interviews will be tape recorded, and without delay, the interviews will be transcribed verbatim. Data analyses and data collection will be done in tandem. The transcribed interviews will be analyzed, and codes identified. These codes will then be merged into different preliminary categories. In the following axial coding process, each category will be further developed by identifying common dimensions and characteristics (subcategories). Relations between data and categories is sought, and hereby a new whole is created. Selective coding will lead to data saturation and validation. Saturation can also be achieved by already retrieved data being re-coded.

KNOWLEDGE GAINS GT is a theory generating method. This is especially suitable for research areas where theories are scarce or lacking. A lot of research within the medical and dental field today, takes the perspective of the investigator, and far too seldom is the subjective experience of those directly affected (e.g. professionals and/or patients) heard. From this study we will gain new knowledge into dental professionals' and students' perception of the child patients' experiences of procedural and postoperative pain. These knowledge gains will be important for future research strategies related to pain. In the longer run the results can help lead to a better training of undergraduate students and professionals.

CHANGES TO ORIGINAL STUDY PLAN After the initial interviews were made, we saw that dental students had a pedagogical focus in their interviews. Therefore, we decided to split informants into two groups - dental students and dental professionals. Findings will be presented in two separate scientific papers, one for each group of participants. Interviews with dental students have been completed, while interviews with dental professionals are ongoing.

• Study Type: Observational
• Enrollment (Estimated): 35

Contacts and Locations

• Study Contact: Name: Rikard Roxner, DDS; Phone Number: +46 40 665 84 80; Email: rikard.roxner@mau.se
• Study Contact Backup: Name: Henrik Berlin, DDS; Phone Number: +46 40 665 84 88; Email: henrik.berlin@mau.se

Study Locations

• Sweden
  • Scania
    • Malmö, Scania, Sweden, 205 06
      • Recruiting
      • Malmo university
      • Contact: Rikard Roxner, MScDSc; Phone Number: +46 40 665 84 80; Email: rikard.roxnmer@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

4th and 5th year dental students, and dental professionals (dentists, dental hygienists, dental assistants)

Description

Inclusion Criteria:

• Dental students in their 4th or 5th year of training
• Dental professionals working with child patients on a regular basis

Exclusion Criteria:

• Do not understand Swedish language

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Dental students; Dental students in their two final years. No intervention.	Behavioral: Interview; Interview study using Grounded theory, to investigate dental professionals' and students' perception of child patient's experience and need for treatment regarding procedural and postoperative pain.
Dental professionals; Dental professionals aged 18-65, regularly working with children. No intervention.	Behavioral: Interview; Interview study using Grounded theory, to investigate dental professionals' and students' perception of child patient's experience and need for treatment regarding procedural and postoperative pain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain in pediatric dentistry, a Grounded theory study on the experiences of dental professionals and students.	By means of in-depth interviews and data analysis according to Grounded Theory, investigate dental professionals' and dental students' perceptions of child patients' experiences of pain related to dental treatment.	June, 2021

Collaborators and Investigators

• Sponsor: Malmö University
• Investigators: Study Chair: Gunilla Klingberg, Prof., Malmo university

Publications and helpful links

General Publications

• Berlin H, List T, Ridell K, Klingberg G. Dentists' attitudes towards acute pharmacological pain management in children and adolescents. Int J Paediatr Dent. 2018 Mar;28(2):152-160. doi: 10.1111/ipd.12316. Epub 2017 Jul 10.
• Murtomaa H, Milgrom P, Weinstein P, Vuopio T. Dentists' perceptions and management of pain experienced by children during treatment: a survey of groups of dentists in the USA and Finland. Int J Paediatr Dent. 1996 Mar;6(1):25-30. doi: 10.1111/j.1365-263x.1996.tb00204.x.
• Rasmussen JK, Frederiksen JA, Hallonsten AL, Poulsen S. Danish dentists' knowledge, attitudes and management of procedural dental pain in children: association with demographic characteristics, structural factors, perceived stress during the administration of local analgesia and their tolerance towards pain. Int J Paediatr Dent. 2005 May;15(3):159-68. doi: 10.1111/j.1365-263X.2005.00635.x.
• Charmaz, K. Grounded theory. In: Smith, J.A., Harre, R. & van Langenhove, L. (eds.) Rethinking methods in psychology. 2nd ed. London: Sage Publications, 1995; 27-49.
• Glaser, B. & Strauss, A. The discovery of grounded theory: strategies for qualitative research. New York: Aldine de Gruyter, 1967.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2020
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 30, 2026

Study Registration Dates

• First Submitted: November 9, 2020
• First Submitted That Met QC Criteria: November 20, 2020
• First Posted (Actual): November 25, 2020

Study Record Updates

• Last Update Posted (Actual): March 13, 2024
• Last Update Submitted That Met QC Criteria: March 12, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: FO 2020/529.

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No