title: Expression of pain and distress in children during dental extractions through drawings as a projective measure: A clinical study.
abstract: OBJECTIVE
  To evaluate the efficacy of drawings as a projective measure of pain and distress in children undergoing dental extractions.
  
  
  METHODS
  Children in the age range of 4-13 years with existence of untreatable caries or over-retained primary teeth, indicated for extractions were included. Pain was assessed using one behavioral [faces, legs, activity, cry and consolability (FLACC)] scale; and a self report measure; faces pain scale-revised (FPS-R), at two points of time, after completion of local anesthetic administration and after extraction. The general behavior of children was assessed with Wright's modification of Frankl rating scale. At the end of the session, children were instructed to represent, themselves along with the dentist and their experiences of the dental treatment through drawing. The drawings were scored utilizing Child drawing: Hospital scale (CD: H) manual and correlated with FLACC, FPS-R and Frankl using Pearson correlation test.
  
  
  RESULTS
  A positive correlation, though statistically not significant, was observed between CD: H scores and all other considered parameters (Frankl, FPS-R and FLACC) in the present study.
  
  
  CONCLUSIONS
  Drawings could not act as surrogate measure of child's pain; however, they acted as a narrative of his/her experiences and reflection of inner emotions. Hence, drawings can be used as an additional dental armamentarium.
authors: Sai Priya Pala, Sivakumar Nuvvula, Rekhalakshmi Kamatham, Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore 524003, India.
authors: Sai Priya
authors: SP
authors: Pala
authors: Sai Priya Pala, Sivakumar Nuvvula, Rekhalakshmi Kamatham, Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore 524003, India.
authors: Sivakumar
authors: S
authors: Nuvvula
authors: Sai Priya Pala, Sivakumar Nuvvula, Rekhalakshmi Kamatham, Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore 524003, India.
authors: Rekhalakshmi
authors: R
authors: Kamatham
keywords: Anxiety; Child; Distress; Drawings; Pain