Understanding the pain experienced at the dentist should be a basis for improving the welfare of children in dental care ,and as a starting point for being able to develop treatment guidelines in the future. These are the findings of a Malmö University researcher.

Pain is one of the most common causes of dental fear, especially among children. Therefore, they should be given time and receive good care at the dentist. This is the opinion of researcher Henrik Berlin, who has studied how young people experience pain at the dentist and how it is treated. He wants to see common guidelines for pain treatment, and more research in the field.

The fewer people who develop fear of dental care later in life and therefore need the care of specialist dental care, the better both for the individual patient and for society.

Henrik Berlin

Children and young people have many dental visits ahead of them. So it is, of course, very important that they receive good care and pain-free treatment as early as possible,” says Berlin.

His dissertation consists of four sub-studies: two deal with the experience of pain, and two focus on pain treatment.

In the first, a survey shows a difference in how general and specialist dental care treats both milk and permanent teeth, and that local anaesthesia is used too little in general dental care.

“There is uncertainty about these issues, and there is a need to develop guidelines for pain treatment in paediatric dentistry. The children and their parents should be able to know that the same care is given everywhere,” says Berlin.

In the second study, 31 children aged 10-15 years old were asked to estimate the pain they felt after routine tooth extractions. The pain was generally perceived as mild to moderate. According to Berlin, this, together with other results from the study, suggests that tooth extraction is well suited for pain studies.

The third study is concerned with research in this field which could neither confirm nor dismiss the effect of pain relief after a surgical procedure on children between the ages of 0-19 years old.
“There was nothing published, which shows a crying need for more research on this. There are knowledge gaps,” says Berlin.

In the final sub-study, children were interviewed about their experiences of a tooth extraction and the time immediately after. The conclusion is that children can handle some pain and a degree of discomfort, if they have received the right information from staff beforehand.

“Therefore, the early preventive work must take time, to avoid increased suffering and to reduce the risk of dental fear arising later,” says Berlin, who also highlights a socio-economic aspect.

Children do not have the same strategic ability as adults when it comes to dealing with discomfort such as pain. Berlin therefore stresses how important it is for dental care to spend time and talk to children before a treatment and to always prevent pain with, for example, local anaesthesia.

“The fewer people who develop fear of dental care later in life and therefore need the care of specialist dental care, the better both for the individual patient and for society.”

Text: Magnus Jando