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Orofacial pain evaluation in children
E Lamart1, M Santagata1, G Tartaro1
1Policlinico I, Università Luigi Vanvitelli, Naples, Italy.
Insights
Accurate orofacial pain assessment in children is crucial for diagnosis and treatment. This study reviews pain scales and diagnostic tools to help clinicians effectively manage pediatric head and neck pain.
Area of Science:
- Pediatric Dentistry
- Pain Management
- Child Psychology
Background:
- Evaluating and diagnosing pain in children, especially orofacial pain, presents unique challenges due to their communication and cognitive immaturity.
- Difficulties in accurately assessing pain intensity and characteristics can lead to diagnostic uncertainty and hesitation in initiating drug therapy for pediatric patients.
Purpose of the Study:
- To propose essential tools for evaluating and measuring pain in children, suitable for use alongside clinical assessment.
- To aid in formulating precise differential diagnoses for head and neck pathologies causing orofacial pain in pediatric populations.
- To present a list of common painful diseases affecting the head and neck region in children.
Main Methods:
- A systematic literature review was conducted on methods for evaluating and measuring pain in children.
- Commonly used pain measurement scales such as the Visual Analog Scale (VAS), Visual Simple Numerical (VSN), Color Analog Scale (CAS), Faces Pain Scale (FPS), and the Oucher Scale were examined.
- Causes of orofacial pain were categorized into extracranial and intracranial to facilitate diagnosis.
Main Results:
- Orofacial pain is a frequent concern in pediatric dentistry, and its evaluation is feasible despite challenges with patient compliance.
- Modern techniques and knowledge enable realistic and reproducible pain assessment in children.
- Pain evaluation scales are adaptable to various child ages and abilities, supporting accurate diagnosis.
Conclusions:
- Pain evaluation scales, combined with thorough patient history (anamnesis) and clinical examination, are effective tools for diagnosing pediatric orofacial pain.
- These methods empower clinicians to establish precise differential diagnoses and tailor optimal therapeutic strategies for young patients experiencing head and neck pain.
Aim:
Pain evaluation in children and its diagnosis are problems not always easy to solve. Children, because of their immaturity, are not always able to well communicate or to describe the clear characteristics of the disease by which they are affected. Moreover, they are often unable to report the real intensity of the pain they experience. These problems are related to their immature, not fully evolved psyche. Such problems can create difficulties to the physician who is called to examine and evaluate the origin of orofacial pain, as well as hesitation regarding when it could be necessary to start a drug therapy. Aim of this work is to propose the basic tools for the evaluation and measurement of pain that are better suitable for children, as these instruments can be used together with an accurate anamnesis and a meticulous examination, in order to formulate a precise differential diagnosis among the pathologies that affect the head and neck. A list of the most common painful diseases affecting this area is also presented.
Methods:
A systematic literature review about the methods for evaluation and measurement of pain in children was conducted. The commonly used scales of measurement were examined: VAS, VSN, CAS, FPS and the Oucher SCALE. The different pathologies of head and neck and their characteristics are described and the possible causes of orofacial pain have been divided into extracranial and intracranial, in order to easily direct diagnosis.
Results:
Orofacial pain in children is an issue of great interest in consideration of its high frequency in paediatric dentistry. Its measurement and evaluation is possible despite the small compliance of paediatric patients. Thanks to the modern technique and knowledge this evaluation can be realistic and reproducible.
Conclusion:
Evaluation scales of pain are suitable at any age and skill of the child and, together with a careful anamnesis and a proper clinical examination, allow the clinician to conduct a precise differential diagnosis of the pain so as to set the ideal therapy for the little patient.
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