title: Children with intellectual disabilities and pain perception: a review and suggestions for future assessment protocols.
abstract: OBJECTIVE
  This was to review what is known about pain assessment in children with intellectual disabilities and to translate findings into clinical dental practice.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  The association between anxiety and pain as reported in the literature was explored. The specific pain expressions for individuals with Down's syndrome and those with autism are discussed with available literature. Various pain assessment instruments for cognitively impaired children have comparable content but vary in number of items. However, none of these instruments has been tested or implemented in the dental setting. Five pain assessment instruments for children with intellectual disabilities are described in more detail and these instruments were primarily tested for postoperative children. There are only limited data available on their use in dental treatments. Suggestions for step-by step implementation of pain assessment in dental practice are given.
  
  
  CONCLUSIONS
  Further studies in dental practice are recommended to achieve optimal pain management during dental procedures in individuals with intellectual disabilities.
authors.affiliation: Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. m.vandijk.3@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: van Dijk
authors.forename: A
authors.initials: A
authors.lastname: Valkenburg
authors.forename: A A
authors.initials: AA
authors.lastname: Boerlage
authors.forename: D
authors.initials: D
authors.lastname: Tibboel
authors.forename: J S
authors.initials: JS
authors.lastname: Veerkamp
mesh_terms: D001321:Autistic Disorder / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D016854:Dental Anxiety / Q000175:diagnosis; D019140:Dental Care for Children; D003730:Dental Care for Persons with Disabilities; D004314:Down Syndrome / Q000503:physiopathology; D006801:Humans; D009633:Nonverbal Communication; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*; D010465:Perception; D019989:Persons with Intellectual Disabilities; D014098:Toothache / Q000175:diagnosis