Assessment of pain by the child, dentist, and independent observers.
OBJECTIVE
The objective of this study was to analyze the assessment of pain and distress by the child, dentist, and independent observers during a dental injection and study the relationship between the different assessments.


METHODS
The amount of pain experienced by the child during local anesthesia was reported independently by the child to both the dentist and parent on a 4-point scale running from "no pain" to "a lot of pain." The dentist and observers also gave a score for the pain experienced on a 4-point scale. The amount of distress experienced by the child during local anesthesia was assessed by the dentist and observers using a 6-point scale (from "relaxed" to "out of contact").


RESULTS
The dentists' pain assessment was the lowest. A substantial correlation was found between the child's self-reported pain and the pain as assessed by independent observers. There was a moderate correlation between the amount of distress and pain intensity as reported by the child during the anesthesia phase.


CONCLUSIONS
Observation of a child in a videotaped procedure is apparently the most reliable method to accurately assess pain behavior and to discriminate pain from distress. A combination of the child's report and video observation is advised to assess pain in young children.
Department of Cariology, Edodontology and Pedodontology, University of Amsterdam, the Netherlands. j.versloot@acta.nl
Judith
J
Versloot
Jaap S J
JS
Veerkamp
Johan
J
Hoogstraten
D000704:Analysis of Variance; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016854:Dental Anxiety / Q000523:psychology; D003815:Dentists; D005157:Facial Pain / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D015588:Observer Variation; D010147:Pain Measurement / Q000379:methods*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D014743:Videotape Recording