title: Recognizing preschool children with primary teeth needing dental treatment because of caries-related toothache.
abstract: OBJECTIVE
  The Dental Discomfort Questionnaire (DDQ), which is an observational instrument that assesses dental pain in preschool children, has not been extensively tested for its ability to identify dental treatment needs in this population. This study aimed to explore the accuracy of the Brazilian version of the DDQ (DDQ-B) to identify preschool children needing dental treatment.
  
  
  METHODS
  The participants were 326 children (57.7% boys), aged 15-72 months [mean 49.8, standard deviation (SD) 14.8], who were examined to assess their dental treatment needs at the same time that their parents filled out the DDQ-B. The DDQ-B median score (outcome variable) was compared to the median index of dental treatment needs or categories (nonparametric tests). The area under the receiver operating characteristic (ROC) curve (AUC) and diagnostic tests were performed to test the DDQ-B accuracy for identifying preschoolers with untreated teeth needing dental treatment. The data were analysed using SPSS 19.0, and the significance level was set at 5%.
  
  
  RESULTS
  Overall, 326 questionnaires were completed and considered for analyses. Additionally, 63.5% of children had untreated teeth needing dental care. The median DDQ-B score, 2.0 (first-third quartile 1.0-5.0), was positively associated with the median index for needing dental care, 3.0 (0.0-5.0) (ρ = 0.49, P < 0.001). Children with more invasive intervention needs, such as pulp therapy, 5.0 (2.0-7.0), and extraction, 6.0 (4.0-8.5), had the highest DDQ-B scores (P < 0.001). The DDQ-B could identify children with more invasive dental care needs [AUC 0.86, 95% confidence interval (CI) 0.80-0.91, P < 0.001]. A score of 5 or higher was a reliable cut-off point to confirm that children who were screened with caries-related toothache by the DDQ-B do, in fact, have untreated teeth needing dental treatment, especially for pulpal care and extraction.
  
  
  CONCLUSIONS
  The DDQ-B is an accurate observational tool for identifying preschool children with dental treatment needs; children who scored 5 or higher require dental care for more invasive procedures.
authors: Faculty of Dentistry, Federal University of Goias, Goiania, Brazil.
authors: Anelise
authors: A
authors: Daher
authors: Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors: Mauro H N G
authors: MH
authors: Abreu
authors: Faculty of Dentistry, Federal University of Goias, Goiania, Brazil.
authors: Luciane R
authors: LR
authors: Costa
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data; D003731:Dental Caries / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014094:Tooth, Deciduous; D014098:Toothache / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology
keywords: caries; dental care for children; pain; pediatric dentistry; sensitivity and specificity