Centre Hospitalier Universitaire de Nantes Pole Hospitalo-Universitaire 4, Nantes, France.
Université de Nantes UFR d'Odontologie, Nantes, France.
Clin Exp Dent Res. 2020 Dec;6(6):650-658. doi: 10.1002/cre2.316. Epub 2020 Aug 23.
This prospective observational study aimed to evaluate discomfort after extraction of deciduous teeth under local anesthesia. The primary objective was to describe the prevalence of post-extraction pain (PEP), post-extraction bleeding (PEB), post-extraction biting injury (PEBI), and analgesic usage in children. The secondary objective was to define whether it is possible to determine a profile of patients or a type of extraction procedure predictive to PEP, administration of analgesics, PEB, or PEBI.
One hundred and twenty-five children, aged 3-13 years, with indications of at least one deciduous tooth extraction, were included. Immediately after extraction, information concerning the patient and the extraction were collected. Eighteen to 32 hr after extraction, parents were called by phone to request reports concerning the onset and intensity of PEP assessed using the Wong-Baker Faces (WBF) scale, the administration of paracetamol (acetaminophen) to their children, and the appearance of PEB and/or PEBI.
Of the children, 37.3% reported PEP (WBF ≥2), but 23.3% of these children did not receive any analgesic drugs to help relieve pain. Pain appeared before 3 hr after extraction in 69% of the children. Higher incidences of PEP and usage of analgesics were found both in the group of children with unfavorable socioeconomic level compared to favorable level and in the group with pre-operative pain compared to no pre-operative pain (p < .05).
About a third of the children reported pain after extraction, but the instructions for pain relief were not followed by all parents. The socioeconomic level of the young patient and the pain felt during the extraction were important predictors of discomfort. Therefore, our study could help the dentist to provide information on predicted post-operative discomfort and to allow suitable care depending on the patient's profile or procedure.
本前瞻性观察研究旨在评估局部麻醉下拔除乳牙后的不适。主要目的是描述拔除后疼痛（PEP）、拔除后出血（PEB）、拔除后咬伤（PEBI）和儿童使用镇痛药的发生率。次要目的是确定是否可以确定预测 PEP、使用镇痛药、PEB 或 PEBI 的患者特征或拔牙程序类型。
纳入 125 名年龄 3-13 岁、有至少一颗乳牙拔除指征的儿童。拔牙后立即收集有关患者和拔牙的信息。拔牙后 18-32 小时，通过电话询问家长报告 PEP 的发生和强度（使用 Wong-Baker 面部表情量表评估）、是否给孩子服用对乙酰氨基酚（acetaminophen）以及是否出现 PEB 和/或 PEBI。
37.3%的儿童报告有 PEP（WBF≥2），但其中 23.3%的儿童未服用任何镇痛药来缓解疼痛。69%的儿童在拔牙后 3 小时内出现疼痛。与社会经济水平有利的儿童相比，社会经济水平不利的儿童以及术前有疼痛的儿童，PEP 和使用镇痛药的发生率更高（p<.05）。
约三分之一的儿童报告拔牙后疼痛，但并非所有家长都遵循了缓解疼痛的医嘱。年轻患者的社会经济水平和拔牙过程中的疼痛是不适的重要预测因素。因此，我们的研究可以帮助牙医提供预测术后不适的信息，并根据患者特征或手术程序提供适当的护理。
