Is pain during pediatric dental sedation associated with children’s pre-operative characteristics? An exploratory study

Abstract Introduction Little is known about the factors associated with the pain of children in dental treatment under conscious sedation. Objective To investigate the association between preoperative characteristics and pain during pediatric dental treatment under sedation. Material and method This exploratory study was conducted with 27 children in restorative treatment under sedation. Information on age, sex and experience of the children with previous dental treatment was obtained through interviews with parents. Oral health status, determined from the presence of dental caries, was verified using the dmf-t index. Pain was assessed by analyzing videos of the dental treatments by two previously calibrated examiners, using the items “legs”, “activity” and “crying” of the observational scale “face, legs, activity, consolability and crying” (FLACC). Data were analyzed using bivariate tests. Result Most of the children (n=14, 51.8%) had no pain during dental treatment under sedation. Among the other children, lower or moderate pain scores (median 1.1; minimum 0 to 3.8) were observed. The FLACC scores did not vary according to sex (P=0.38), previous experience with dental treatment (P=0.32) and history with local anesthesia (P=0.96). The FLACC scores did not correlate significantly with age (Spearman rho= -0.08, P=0.67) and dmf-t (Spearman rho= -0.04, P=0.84). Conclusion In this group of children, pain during dental treatment under sedation was of low frequency and intensity and did not associate with age, sex, oral condition and previous dental experience.

摘要：目前学界对清醒镇静（conscious sedation）下儿童牙科治疗（pediatric dental treatment）疼痛相关影响因素的认知仍较为匮乏。研究目的：探讨清醒镇静下儿童牙科治疗期间的疼痛与术前特征（preoperative characteristics）之间的关联。材料与方法：本探索性研究纳入27名接受镇静下牙科修复治疗（restorative treatment）的儿童。通过与患儿家长进行访谈，收集患儿年龄、性别及既往牙科治疗史相关信息；采用龋失补指数（dmf-t index）评估龋病（dental caries）存在情况，以此确定其口腔健康状态（oral health status）。由两名经过校准的检查者，通过分析牙科治疗录像，采用面部、腿部、活动、安抚反应及哭闹（FLACC）观察量表的「腿部、活动、哭闹」维度对疼痛程度进行评估。采用双变量检验（bivariate tests）对数据进行分析。研究结果：多数患儿（n=14，51.8%）在镇静下牙科治疗期间未出现疼痛；其余患儿的疼痛评分均处于较低或中等水平（中位数1.1；范围0~3.8）。FLACC评分未因患儿性别（P=0.38）、既往牙科治疗史（P=0.32）及局部麻醉史（P=0.96）出现显著差异；其评分与年龄（斯皮尔曼rho=-0.08，P=0.67）及dmf-t指数（斯皮尔曼rho=-0.04，P=0.84）均无显著相关性。研究结论：本研究纳入的儿童群体中，镇静下牙科治疗期间的疼痛发生率与强度均较低，且与患儿年龄、性别、口腔健康状况及既往牙科治疗经历均无显著关联。