J Am Dent Assoc. 2023 Dec;154(12):1067-1076. doi: 10.1016/j.adaj.2023.09.003. Epub 2023 Oct 25.
Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and perceptions among providers. The authors assessed pediatric dentists' use of and attitudes toward evidence-based pain management (EBPM) strategies.
The authors used a 27-item online survey to assess attitudes about EBPM, pain management and assessment practices, tools for disseminating knowledge about EBPM, and opinions regarding priority areas for improving pain management. Descriptive statistics were used to summarize findings; open-ended items were analyzed thematically.
Participants (N = 625) were pediatric dentists (89.2%) and pediatric dentistry residents (10.8%). Most respondents agreed that pain management is an important aspect of clinical care and thought that improvements in pain management practices are needed. Providers reported spending the most time facilitating pain management during the procedure (compared with before or after), and 73.2% said they feel this is an adequate amount of time. Distraction, tell-show-do techniques, and supportive language were the most used nonpharmacologic pain management strategies, and providers' observational approaches were used most frequently for pain assessment. Top priority areas for improving pain management were reported as developing tools for caregivers and provider resources on nonpharmacologic pain management (ie, continuing education courses).
Providers reported high use of EBPM strategies, low use of validated pain assessment tools, and a particular interest for professional development opportunities and patient resources focused on nonpharmacologic pain management.
Findings from this survey can inform dissemination and implementation of science efforts to improve pain management in pediatric dentistry.
牙科疼痛在年轻人中很常见，但研究不足，且常常治疗不足。为了改善儿童牙科的疼痛管理，有必要了解提供者的实践和看法。作者评估了儿科牙医对循证疼痛管理（EBPM）策略的使用情况和态度。
作者使用了 27 项在线调查来评估对 EBPM、疼痛管理和评估实践、传播 EBPM 知识的工具的态度，以及对改善疼痛管理的优先领域的看法。使用描述性统计来总结发现；对开放式项目进行了主题分析。
参与者（N=625）为儿科牙医（89.2%）和儿科牙科住院医师（10.8%）。大多数受访者认为疼痛管理是临床护理的重要方面，并且认为需要改进疼痛管理实践。提供者报告在治疗过程中（与治疗前或治疗后相比）花费最多的时间来促进疼痛管理，并且 73.2%的人表示他们认为这是足够的时间。分散注意力、讲-示-做技术和支持性语言是最常用的非药物性疼痛管理策略，并且提供者的观察方法最常用于疼痛评估。改善疼痛管理的首要优先领域是为护理人员和提供者提供非药物性疼痛管理的资源（例如，继续教育课程）。
提供者报告说他们高度使用 EBPM 策略，很少使用经过验证的疼痛评估工具，并且特别关注非药物性疼痛管理的专业发展机会和患者资源。
这项调查的结果可以为改善儿童牙科疼痛管理的科学工作的传播和实施提供信息。
