Procedural pain in routine dental care for children: a part of the Swedish BITA study

M Ghanei, K Arnrup, A Robertson, M Ghanei, K Arnrup, A Robertson

Abstract

Aim: To investigate the frequency and reported intensity levels of dental treatment pain and discomfort in children, in conjunction with regular dental visits.

Methods: The study included 2363 children in four different age cohorts. Data was collected from structured interviews by dental personnel regarding pain experiences or discomfort after treatments, including analgesia, extractions, operative treatments and radiographic examinations.

Results: One-third of all treatment occasions were experienced as painful and/or causing discomfort. Treatment sessions including analgesia were assessed as painful in 49.7% of occasions, with injection being the most common given reason for pain. Extraction was painful in 62.4% of occasions, with injection as the main reason for pain. Operative treatments were assessed as painful in 38.8% of occasions, with drilling as the most common reason for pain and discomfort. Pain was reported in approximately 19% of all radiographic examinations.

Conclusions: Injection was the major reason for pain during treatment, including injection and extraction, while drilling was the most common cause of pain during restorative treatment. Dentists should try to minimise the experience of pain and discomfort by using all available measures to perform pain-free and effective dental injections.

Keywords: Children; Dental; Discomfort; Pain.

Conflict of interest statement

The authors declare that they have no conflict of interest.

References

    1. Allen KD, Kotil D, Larzelere RE, Hutfless S, Beiraghi S. Comparison of a computerized anaesthesia device with a traditional syringe in preschool children. Pediatr Dent. 2002;24(4):315–320.
    1. Aminabadi NA, Farahani RM, Oskouei SG. Site-specificity of pain sensitivity to intraoral anesthetic injections in children. J Oral Sci. 2009;51(2):239–243. doi: 10.2334/josnusd.51.239.
    1. Hain RD. Pain scales in children: a review. Palliat Med. 1997;11(5):341–350. doi: 10.1177/026921639701100503.
    1. Haukali G, Lundeberg S, Hogsbro Ostergaard BDH, Pain . Pain control. In: Koch G, Poulsen S, Espelid I, Haubeck D, editors. Paediactric dentistry—a clinical approach. UK: Wiley Blackwell; 2017. pp. 87–101.
    1. Jones CM, Heidmann J, Gerrish AC. Children’s ratings of dental injection and treatment pain, and the influence of the time taken to administer the injection. Int J Paediatr Dent. 1995;5(2):81–85. doi: 10.1111/j.1365-263X.1995.tb00169.x.
    1. Krekmanova L, Bergius M, Robertson A, et al. Everyday- and dental-pain experiences in healthy Swedish 8–19 year olds: an epidemiological study. Int J Paediatr Dent. 2009;19(6):438–447. doi: 10.1111/j.1365-263X.2009.01016.x.
    1. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008;137(3):473–477. doi: 10.1016/j.pain.2008.04.025.
    1. McGrath PA, Seifert CE, Speechley KN, et al. A new analogue scale for assessing children’s pain: an initial validation study. Pain. 1996;64(3):435–443. doi: 10.1016/0304-3959(95)00171-9.
    1. Meechan JG. Pain control in local analgesia. Eur Arch Paediatr Dent. 2009;10(2):71–76. doi: 10.1007/BF03321603.
    1. 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;6(1):25–30. doi: 10.1111/j.1365-263X.1996.tb00204.x.
    1. Nakai Y, Milgrom P, Mancl L, et al. Effectiveness of local anaesthesia in paediatric dental practice. J Am Dent Assoc. 2000;131(12):1699–1705. doi: 10.14219/jada.archive.2000.0115.
    1. Nakai Y, Hirakawa T, Milgrom P, et al. The Children’s Fear Survey Schedule-Dental Subscale in Japan. Community Dent Oral Epidemiol. 2005;33(3):196–204. doi: 10.1111/j.1600-0528.2005.00211.x.
    1. Naoumova J, Kjellberg H, Kurol J, Mohlin B. Pain, discomfort, and use of analgesics following the extraction of primary canines in children with palatally displaced canines. Int J Paediatr Dent. 2012;22(1):17–26. doi: 10.1111/j.1365-263X.2011.01152.x.
    1. Novaes TF, Matos R, Raggio DP, Braga MM, Mendes FM. Children’s discomfort in assessments using different methods for approximal caries detection. Braz Oral Res. 2012;26(2):93–99. doi: 10.1590/S1806-83242012000200002.
    1. Peretz B, Efrat J. Dental anxiety among young adolescent patients in Israel. Int J Paediatr Dent. 2000;10(2):126–132. doi: 10.1046/j.1365-263x.2000.00181.x.
    1. Pierro VS, Barcelos R, de Souza IP, Raymundo RJ. Paediatric bitewing film holder: preschoolers’ acceptance and radiographs’ diagnostic quality. Pediatr Dent. 2008;30(4):342–347.
    1. Pitts NB, Hamood SS, Longbottom C, Rimmer PA. The use of bitewing positioning devices in children’s dentistry. Dentomaxillofac Radiol. 1991;20(3):121–126. doi: 10.1259/dmfr.20.3.1807994.
    1. Ram D, Peretz B. Reactions of children to maxillary infiltration and mandibular block injections. Pediatr Dent. 2001;23(4):343–346.
    1. Ram D, Peretz B. Administering local anaesthesia to paediatric dental patients—current status and prospects for the future. Int J Paediatr Dent. 2002;12(2):80–89. doi: 10.1046/j.1365-263X.2002.00343.x.
    1. Ram D, Peretz B. The assessment of pain sensation during local anaesthesia using a computerized local anaesthesia (Wand) and a conventional syringe. J Dent Child (Chic) 2003;70(2):130–133.
    1. 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;15(3):159–168. doi: 10.1111/j.1365-263X.2005.00635.x.
    1. Ronneberg A, Strom K, Skaare AB, Willumsen T, Espelid I. Dentists’ self-perceived stress and difficulties when performing restorative treatment in children. Eur Arch Paediatr Dent. 2015;16(4):341–347. doi: 10.1007/s40368-014-0168-2.
    1. Versloot J, Veerkamp JS, Hoogstraten J. Assessment of pain by the child, dentist, and independent observers. Pediatr Dent. 2004;26(5):445–449.
    1. Versloot J, Veerkamp JS, Hoogstraten J. Children’s self-reported pain at the dentist. Pain. 2008;137(2):389–394. doi: 10.1016/j.pain.2007.09.025.
    1. Wondimu B, Dahllof G. Attitudes of Swedish dentists to pain and pain management during dental treatment of children and adolescents. Eur J Paediatr Dent. 2005;6(2):66–72.
    1. Young KD. Paediatric procedural pain. Ann Emerg Med. 2005;45(2):160–171. doi: 10.1016/j.annemergmed.2004.09.019.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel