Carers' and paediatric dentists' perceptions of children's pain during restorative treatment

Purpose Parents/carers' and dentists' evaluations are important when assessing young children's pain. However, there is little evidence on agreement regarding children's pain according to proxy reports. The aims of this cross-sectional study were to investigate the agreement among paediatric dentists and parents/carers about children's pain during treatment and the association between the reporting of pain and child behaviour. Methods Participants were 81 parents/carers of uncooperative children undergoing restorative treatment, and five paediatric dentists. Pain during dental treatment was assessed after dental procedures using the Visual Analogue Scale (0-4 mm: no pain; 5-44 mm: mild pain; 45-74 mm: moderate pain; 75-100 mm: severe pain). Child behaviour was assessed by calibrated researchers using the Ohio State University Behavioural Scale. The agreement between respondents about a child's pain was evaluated using the weighted kappa test. The association between the pain report and child behaviour was verified using the Kruskal-Wallis and Mann-Whitney tests. Results Parents/carers (36, 44.4%) and paediatric dentists (40, 49.4%) reported that children felt mild pain in all sessions. The parents/carers reported that the children experienced higher pain intensities compared to paediatric dentists. The agreement between respondents was slight (weighted Kappa < 0.20). Higher pain intensities were more frequent when the children's behaviour was uncooperative. Conclusion Parents/carers and paediatric dentists showed slight agreement regarding the pain felt by children in dental treatment. Pain proxy reporting in children is influenced by the children's behaviour.