Levels of pain assessment tools for pediatric dental patients: a narrative review
Keywords:Pain assessment, Self-reporting pain assessment, Behavioural pain assessment, Physiological pain assessment
Pain is defined as an unpleasant sensory and emotional experience associated with actual and potential tissue damage. Pain perception in children causes a number of changes in their emotional state. It can lead to emotions like fear, anxiety, sadness and might have an impact on day-to-day activities. Due to the lack of cognitive development young children are unable to express their pain verbally. Pain assessment can be carried out by using various approaches, such as self-reporting pain assessment tools, behavioural pain assessment tools and by assessment of various physiologic parameters. The process of pain evaluation for a child is strenuous as they have limited cognitive sophistication to describe their painful experiences during any disease process. Out of all the scales discussed, Wong-Bakers facial pain rating scale (WB-FPS) is considered the best as it is simple to use for the operator and can be easily reproduced and can be used in children as young as 3 years of age.
Shindova M, Belcheva A. Pain assessment methods among pediatric patients in medical and dental research. Med Biol Studies Clin Studies Social Med Health Care. 2016;6(1):16-23.
Kahsay H. Assessment and treatment of pain in pediatric patients. Current Pediatric Res. 2017;21(1):148-157.
Dhillon MK. Use of Emoji in Pain Level Assessment in Pediatric Dental Patients. Virginia Commonwealth University Richmond, Virginia. 2019.
Jain A, Yeluri R, Munshi AK. Measurement and assessment of pain in children-a review. J Clin Pediatr Dentistry. 2012;37(2):125-36.
Colares V, Franca C, Ferreira A, Amorim Filho HA, Oliveira MC. Dental anxiety and dental pain in 5-to 12-year-old children in Recife, Brazil. Euro Arch Paediatr Dentistry. 2013;14(1):15-9.
Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM. Psychological aspects of persistent pain: Current state of the science, invited comentary. J Pain. 2004;5:195-211.
Young KD. Pediatric procedural pain. Ann Emergency Med. 2005;45:160-71.
Braš, M.; Đorđevi´c, V.; Gregurek, R.; Bulaji´c, M. Neurobiological and clinical relationship between psychiatric disorders and chronic pain. Psychiatr. Danube 2010, 22, 221–226.
Sikorová L, Rajmová L. Pain coping strategies in pediatric dental care. Cent Eur J Nurs Midwifery. 2015;6:327-35.
Diatchenko L, Slade GD, Nackley AG, Bhalang K, Sigurdsson A, Belfer I et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet. 2005;14:135-43.
Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: A literature review. Arch Intern Med. 2003;163:2433-45.
Beesdo K, Hoyer J, Jacobi F, Low NCP, Hofler M, Wittchen HU. Association between generalized anxiety levels and pain in a community sample: Evidence for diagnostic specificity. J. Anxiety Disord. 2009;23:684-93.
Knook LM, Konijnenberg AY, Van Der Hoeven J, Kimpen JL, Buitelaar JK, Van Engeland H et al. Psychiatric disorders in children and adolescents presenting with unexplained chronic pain: What is the prevalence and clinical relevancy? Eur Child Adolesc Psychiatr. 2011;20:39-48.
International Association for the Study of Pain. IASP definition of pain. IASP Newsletter. 2001;2:2.
McGrath PJ, Walco GA, Turk DC, Dworkin RH, Brown MT, Davidson K et al. Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations. J Pain. 2008;9(9):771-83.
American Pain Society. Assessment and management of children with chronic pain: A position statement from the American pain society. Available at: http://americanpainsociety.org/uploads/get-involved/ pediatric-chronic-painstatement.pdf. Accessed on 25 March, 2021.
Brown JC, Klein EJ, Lewis CW. Emergency department analgesia for fracture pain. Ann Emerg Med. 2003;42(2):197Y205.
Phillips DM. JCAHO pain management standards are unveiled. JAMA. 2000;284:428Y429.
Hester NO, Barcus CS. Assessment and management of pain in children. Pediatrics Nursing Update 1986;1(14):1-8.
Ball J, Bindler R. Pain assessment and management. In: Ball J, Bindler R, editors. Pediatric nursing: Caring for children. Norwalk: Appleton and Lange. 1995.
Stanford EA, Chambers CT, Craig KD. The role of developmental factors in predicting young children's use of a self-report scale for pain. Pain. 2006;120(1-2):16-23.
Perrott DA, Goodenough B, Champion GD. Children’s ratings of the intensity and unpleasantness of post-operative pain using facial expression scales. Euro J Pain. 2004;8(2):119-27.
Chan AY, Ge M, Harrop E, Johnson M, Oulton K, Skene SS et al. Pain assessment tools in paediatric palliative care: A systematic review of psychometric properties and recommendations for clinical practice. Palliative Med. 2021;02692163211049309.
Pincus T, Bergman M, Sokka T, Roth J, Swearingen C, Yazici Y. Visual analog scales in formats other than a 10-centimeter horizontal line to assess pain and other clinical data. J Rheumatol. 2008;35(8):1550-8.
Thirion J, O’Riordan MA, Stormorken A. Revisiting the Pieces of Hurt pain assessment tool-do the pieces matter. Pediatr Pain Lett. 2015;17(1):1-4.
Brand K, Thorpe B. Pain assessment in children. Anaesthesia Intensive Care Med. 2016;17(6):270-3.
Manworren RC, Hynan LS. Clinical validation of FLACC: preverbal patient pain scale. Pediatric Nurs. 2003;29(2):140.