Pain among children with Severe-Early-Childhood-Caries: A Pilot Study

Pain among children with Severe-Early-Childhood-Caries: A Pilot Study

Objectives: Severe-Early Childhood Caries (S-ECC) is a rampant form of decay among children <72 months of age. Little information about preschool dental pain currently exists. This pilot study was undertaken to create and validate a tool to measure pain experienced by preschoolers with S-ECC.

Methods: Comprehensive review of both the pediatric pain and pediatric dental literatures was conducted, generating a list of potential items to assess pain that were included in a pilot questionnaire for parents. The tool was designed to elicit parents' judgments of their child's behaviors over a single day. S-ECC was defined according to established criteria and children and parents/caregivers were recruited from community and private practice clinics.

Results: To date 13 children have been enrolled (53.9% males; mean age of 49.1 ± 14.2 months). 61.5% respondents were mothers. 76.9% of responders indicated they had sometimes or often noticed their child having a toothache. Variables appearing to have higher positive response rate to behaviors or signs of dental pain in the preceding 24 hours included ‘Child did not finish eating something he usually does' (30.8%), ‘Child pointed to her face/teeth/mouth while eating' (30.8%), ‘Child bit into food with back teeth instead of front teeth' (38.5%), ‘Child had difficulty biting hard on food' (38.5%), ‘Child chewed food only on one side or avoided a side' (30.8%), ‘Child was more withdraw/shy/quiet' (30.8%), ‘Child was more irritable/agitated/grouchy' (38.5), and ‘Child was seeking comfort or wanted to be held more that usual' (30.8%).

Conclusion: Many children with S-ECC have noticeable pain detectable by their parents/caregivers. This pilot will help lay the foundation for studies examining the basic validity and reliability of a new Preschool-Dental-Pain-Scale (PDPS). It may ultimately provide a tool allowing pediatric and general dentists to appropriately triage young children for dental surgery.

Funding: CIHR Studentship – Musculoskeletal Health Research