UW News

December 16, 2019

New study seeks to improve the way dentists measure children’s pain during appointments

UW News

Child in dentist chair during procedure

Getting a better read on a child’s pain during dental care could help alleviate a lot of future anxiety and lead to better health.Jason wilson/Flickr

If you fear a trip to the dentist, you are among a majority of adults that report moderate to high levels of anxiety related to dental care, according to a review of research. And, if you’re afraid of getting into a dental chair, you are more likely to avoid going and are at risk of oral and overall health problems, such as worsened cardiovascular disease.

Studies show that, of those adults with such fear, more than 70% say they started experiencing it when they were kids. Painful dental experiences are known to be a risk factor for dental fear, and research has found that 35% of kids between the ages of 6 and 14 say they have experienced pain in the dental chair.

So, since childhood fears of the dentist last into adulthood and can lead to health problems, why isn’t more being done to understand young people’s experience of dental pain?

That’s exactly what Cameron Randall, a clinical psychologist and acting assistant professor at the UW School of Dentistry, hopes to find out with a roughly $800,000, 5-year career development grant from the National Institutes of Health.

“We know that dental care providers don’t always systematically and uniformly measure patients’ pain during treatment,” Randall said. “So, my study will be looking at the pain assessment practices of pediatric dentists and general dentists who work with a lot of pediatric patients.”

Randall has a history of researching pain perception and the interaction between pain and fear. He has explored the genetics behind the experience of pain –– determining that “fear of pain, a predictor of dental fear, is genetically linked to dental phobia.”

In his research and clinical practice outside of dentistry, he saw how effective assessment of pain has been standardized and implemented in medical settings such as burn units and pediatric outpatient clinics, where standard behavioral pain measurement tools and patient-reported scales, such as faces depicting rising levels of distress, are used.

“And I knew from my experience doing dental research, that’s not how pain is being assessed in dentistry, at least not routinely. Pain measurement in dentistry appears to be less structured, with more variability from provider to provider,” he said.

His newly funded research will tackle this issue in three main phases:

  • First, determine what dentists know about assessing pain and how they currently go about it. Randall plans a series of surveys, starting with what aspiring dentists are taught in school and then conducting a nationally representative survey of practicing dentists to identify barriers to using standardized assessment tools.
  • Second, create an implementation strategy to improve use of these assessment tools and conduct pilot studies with dentists to test “appropriateness, acceptability and feasibility” of the strategy.
  • Third, develop a plan to scale up the implementation strategy so that more pediatric dental practices can use it to improve approaches to pain management and prevent patient distress, with the long-term goal of reducing dental fear and related health consequences.

“That children can experience pain in the dental chair –– combined with some genetic predisposition to experiencing and fearing pain more acutely –– makes the routine, systematic assessment of pain important for improving adult feelings about dental care and motivation for going,” Randall said.

For more information, contact Randall at clr333@uw.edu.