Rech Bruna de Oliveira, Borges Ana Carolina Costa, Tenório Jefferson R, Souza Beatriz Dulcineia Mendes, Camargo Alessandra Rodrigues de
School of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.
Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Spec Care Dentist. 2025 Sep-Oct;45(5):e70097. doi: 10.1111/scd.70097.
Systematically review the literature to answer the focused question: "What is the best way to facilitate pain communication for patients with intellectual disabilities (ID) in dental care?"
A systematic search strategy was conducted in five databases and gray literature. Studies evaluating pain communication in dental care for patients with ID were included. The risk of bias was assessed according to the Meta-Analysis of Statistics Assessment and Review Instrument.
A total of 1525 studies were screened, and after applying exclusion criteria, 10 articles remained. The included studies were published between 2003 and 2021, with sample sizes ranging from 28 to 270 participants with developmental disabilities. The Dental Discomfort Questionnaire (DDQ) was the most commonly used tool in the studies. Most studies showed a low risk of bias.
The DDQ is the most validated tool for assessing dental pain in individuals with ID, though evidence in adults is limited. Other tools provide useful behavioral cues but may not clearly differentiate pain from discomfort or anxiety. The absence of a gold standard underscores the need for context-appropriate tool selection and clinician training to interpret nonverbal pain, enhancing diagnostic accuracy and promoting equitable care.
系统回顾文献，以回答聚焦问题：“在牙科护理中，促进智障患者疼痛沟通的最佳方法是什么？”
在五个数据库和灰色文献中进行了系统检索策略。纳入评估智障患者牙科护理中疼痛沟通的研究。根据统计评估与审查工具的荟萃分析评估偏倚风险。
共筛选出1525项研究，应用排除标准后，剩余10篇文章。纳入的研究发表于2003年至2021年之间，样本量从28名至270名发育障碍参与者不等。牙科不适问卷（DDQ）是研究中最常用的工具。大多数研究显示偏倚风险较低。
DDQ是评估智障个体牙科疼痛最有效的工具，尽管成人方面的证据有限。其他工具提供了有用的行为线索，但可能无法清楚地区分疼痛与不适或焦虑。缺乏金标准凸显了根据具体情况选择合适工具以及对临床医生进行培训以解读非语言疼痛表现的必要性，从而提高诊断准确性并促进公平护理。
