Children's pain history reported by parents and children attending a UK teaching hospital's dental emergency clinic

Abstract

Background: The 2013 UK Children's Dental Health Survey found that 37% of five‐year‐olds and more than half (55%) of eight year‐olds had a dental problem that had caused pain in the previous six months. This study focused on children who had experienced a dental problem, which led them to attend an emergency dental clinic in September to December 2018. Aim: To assess the pain history reported by children and parents attending children's dental emergency clinic (CDEC) in a UK teaching dental hospital. Design: This service evaluation used a structured questionnaire completed by the parents/carers of children aged 0‐15 years before their emergency appointment. The questionnaire recorded the reason for attendance, the pain duration and a child‐reported current pain rating for children aged 4 years and older, using the Wong‐Baker FACES pain rating scale. The parents also rated their children's dental pain on a scale of 0‐10. Clinicians provided a clinical diagnosis, following assessment and investigations. Data was analysed using SPSS. Results: One‐hundred and thirty‐six questionnaires were completed by parents (response rate: 39%). The mean age was 7.4 years (SD = 3.6); 58% of the children were boys. The most commonly represented ethnicities were Caucasian (37%) and Asian (37%). Sixty‐seven percent of children reported dental pain; 27% reported swelling; and 16% reported dental trauma. There was a large variation in the duration of pain (median = 4 days; minimum = 0; maximum = 180). The mean pain ratings reported by the children and parents were 6.5 (SD = 2.9) and 5.9 (SD = 2.7) respectively. There was no significant difference in children's or parent's pain ratings by gender, age and ethnicity. There was a significant association between parents’ and children's pain ratings (R = 0.78, P 0.001). Children who were diagnosed with irreversible pulpitis had the highest self‐reported pain scores (mean = 8.8; SD = 1.7) compared to children diagnosed with dental caries (mean = 7.8; SD = 2.3) and TDI (mean = 4.7; SD = 3.0). Conclusions: Children attending an emergency dental clinic reported highly variable patterns of pain with irreversible pulpitis producing the highest pain rating by children. There was a significant association between children's self‐reported pain scores and parents’ rating of their children's dental pain.