title: Epidemiology of dental pain and dental caries among children and adolescents.
abstract: OBJECTIVE
  The aim was to critically evaluate published epidemiological studies of dental pain among children and adolescents, primarily to answer the question 'Does the probability of dental pain increase as the population level of dental caries increases?'.
  
  
  METHODS
  The MEDLINE database was searched electronically for epidemiological studies of dental pain and caries, and supplemented with hand searching of bibliographies. Ecological associations were evaluated visually, by plotting published caries levels and dental pain prevalence, and quantitatively, by computing correlation coefficients between community-level caries experience (dmft and DMFT) and prevalence of toothache in those communities.
  
  
  RESULTS
  Most studies enumerated dental pain by asking parents whether their child had ever experienced toothache, with reported prevalence ranging from 5 to 33% among countries. Lifetime prevalence was greater among older children and among children from lower socio-economic groups. Ecological analysis of published data revealed moderate to strong correlations (Spearman's coefficient 0.53 to 0.83) between caries experience and prevalence of toothache. Correlations were stronger (0.86 to 0.95) among lower social classes, consistent with a 5 to 6% increase in probability of toothache for each additional deciduous tooth with caries experience. The direction and magnitude of these ecological associations was similar to person-level correlations.
  
  
  CONCLUSIONS
  Dental pain is highly prevalent among children, even in contemporary populations with historically low levels of caries experience. Dental pain is consistently associated with population levels of caries experience, the association being most apparent in lower socioeconomic groups with reduced access to care.
authors.affiliation: Department of Dental Ecology, University of North Carolina, Chapel Hill 27599-7450, USA. gary_slade@dentistry.unc.edu
authors.forename: G D
authors.initials: GD
authors.lastname: Slade
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D015995:Prevalence; D018434:Sickness Impact Profile; D012923:Social Class; D013021:South Australia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014098:Toothache / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology