Memojis Pain Scale: A novel pain assessment tool

Content validity of the electronic faces thermometer scale for pain in children: is a picture worth more than a thousand words?

Introduction

Early recognition of pain in children is crucial, and their self-report is the primary source of information. However, communication about pain in healthcare settings can be challenging. For non-verbal communication regarding different symptoms, children prefer digital tools. The electronic Faces Thermometer Scale (eFTS) utilizes a universal design with colors, face emojis, and numbers on an 11-point scale (0-10) for pain assessment. The aim of this study was to establish content validity of the eFTS for pain assessments in children.

Methods

A mixed methods design was used. The study took place at a university hospital in eastern Sweden, involving 102 children aged 8-17 years who visited outpatient clinics. Participants were presented with 17 pictures representing varying pain levels and asked to assess hypothetical pain using the eFTS. A think-aloud approach was employed, prompting children to verbalize their thoughts about assessments and the eFTS. Quantitative data were analyzed using descriptive and comparative statistics, together with a qualitative approach for analysis of think-aloud conversations.

Results

A total of 1,734 assessments of hypothetical pain using the eFTS were conducted. The eFTS differentiated between no pain (level 0-1) and pain (level 2-10). However, no clear agreement was found in the differentiation between hypothetical pain intensity levels (level 2-10). The analysis revealed that children utilized the entire scale, ranging from no pain to high pain, incorporating numbers, colors, and face emojis in their assessments.

Discussion

The variability in assessments was influenced by prior experiences, which had an impact on the statistical outcome in our study. However, employing the think-aloud method enhances our understanding of how children utilize the scale and perceive its design, including the incorporation of emotion-laden anchors. Children express a preference for using the eFTS to assess their pain during hospital visits.

Evaluation of child's behavior during the pit and fissure sealant administration using the rubber dam and MiniDam: A randomized clinical trial

BACKGROUND

Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam.

METHODOLOGY

Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05.

RESULTS

Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05).

CONCLUSIONS

The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.

Identification of the Ideal Reference Site and Pain Threshold Values for the Placement of Electric Pulp Testers in Permanent Upper and Lower Anterior Teeth: A Cross-Sectional Study

INTRODUCTION

Electric pulp testers (EPTs) are widely used diagnostic tools for diagnosing traumatized teeth. Several factors can affect the result of an electric pulp test. One such factor that will affect the diagnosis is the electrode tip placement. Hence, the current study aims to identify the most painful site and response time threshold in healthy anterior teeth.

METHODS

A total of 90 individuals, 48 male and 42 female, aged 19 to 25 years, were recruited. An EPT was placed on three different sites: the cervical, middle, and incisal third of the labial surface of both upper and lower anterior teeth (central incisor, lateral incisor, and canine) with an appropriate electrolyte as a conducting medium. Later, the threshold values were recorded, and pain assessment was done using the Memojis pain scale (MPS). Finally, the data was analyzed statistically using the Mann-Whitney U test.

RESULTS

Mean and standard deviation values of reaction time were collected from 540 EPT readings (three sites from 180 teeth). Among the three sites tested, the difference between the upper and lower central incisors was statistically insignificant (p > 0.05). Similarly, when upper and lower lateral incisors and canines were compared, a statistically significant difference was observed among the three sites (p<0.05). There was a significant difference (p<0.05) in the pain scores only on the incisal and cervical thirds of the upper and lower central incisors. Only the incisal third showed a statistically significant difference (p<0.05) between the pain scores in the upper and lateral incisors. At the same time, a statistically significant difference in the pain scores was observed among the three tested sites between the upper and lower canines (p<0.05).  Conclusion: Lower threshold values were appreciated at the incisal third of all the upper and lower anterior teeth for placing the EPT. Most individuals have experienced a score of 2 (hurts little bit) for the perceived pain using EPTs for both the upper and lower anterior teeth.

Determination of the Ideal Tooth Surface and Pain Threshold to Improve the Efficacy of an Electric Pulp Tester in the Diagnosis of Pulp Sensitivity and Vitality in Premolar and Molar Teeth: A Cross-Sectional Study

Introduction The electric pulp tester (EPT) is an extensively used diagnostic tool in endodontics. However, several factors, especially the location and thickness of the tooth structures, such as enamel and dentine, can affect the result of an electric pulp test. Further, these factors also alter the pain threshold, which may lead to an inaccurate diagnosis. Hence, it is crucial to ascertain the optimal tooth surface that requires minimal time to elicit a response and pain threshold to enhance the effectiveness of the electric pulp tester for diagnosing the status of the pulp. Methods Fifty volunteers (36 males and 14 females) aged 18 to 32 years without any prior experience with the EPT were recruited. The EPT was placed on the seven premolar sites, and molar teeth with an appropriate electrolyte as a conducting medium were tested. The pain threshold values were recorded using the stopwatch, whereas pain assessment was carried out using the Memojis pain scale. An independent sample t-test and descriptive statistics were used to analyze the data statistically. Results The buccal occlusal third in males (27.3±8.6 seconds) and the buccal middle third in females (28.5±8.2 seconds) showed lower response times than other sites in premolar teeth. The mesiobuccal cusp showed a lower response time for males (21.3±6.6 seconds) and females (21.5±6.2 seconds) in molar teeth. Of all the various sites tested, the majority of the individuals chose pain scores of 0 (36 in premolars, 84 in molars), two (138 in premolars, 180 in molars), and four (96 in premolars, 42 in molars) in both the premolars and molars. Conclusion The ideal sites for placing the EPT in premolars for males and females are the buccal occlusal third and the buccal middle third. At the same time, the mesiobuccal cusp is the ideal site for molars in both males and females, as it is responded to the quickest by the electric current. Most individuals have experienced a score of two (hurts a little bit) for the perceived pain using EPT for both the molars and premolars.