Factors Associated with Paediatric Dentists' Perception of Dental Pain in Pre-schoolers: a Mixed-methods Study

Background: Children dental pain recognition is pointed as a priority in paediatric dentistry, but little is known about dentists' perception of pre-schoolers' dental pain.

Aim: To understand paediatric dentists' viewpoint on dental pain (toothache) in pre-schoolers and to identify the associated factors.

Design: Mixed-methods with two phases: (i) preliminary qualitative study (focus group of paediatric dentists), with responses analysed by content analysis and (ii) quantitative survey (self-administered questionnaire answered by 223 paediatric dentists), with the main outcome 'perception' assessed as 'feel or not prepared' to identify a pre-schooler with dental pain. Triangulation was used to discuss the results of each approach.

Results: (i) Paediatric dentists can observe dental pain in pre-schoolers when there are normative signs; this pain is related to the changes in a child's behaviour and in dental planning. (ii) Participants were 40.1 ± 8.4 years old, 17.1 ± 8.3years since graduation, 65.9% did not feel prepared to identify a pre-schooler with dental pain. This feeling of unpreparedness was associated with younger specialists (P = 0.01) and less time since graduation (P < 0.01). Triangulation showed a convergence of the qualitative and quantitative approaches.

Conclusion: Noticing dental pain in pre-schoolers was associated with specialists' experience and the need for visible signs; dentists do not always feel completely prepared to recognise pain in pre-schoolers.