Children with intellectual disabilities and pain perception:
A review and suggestions for future assessment protocols
M. van Dijk*, A. Valkenburg*, A. A. Boerlage*, D. Tibboel*, J. S.Veerkamp**
ABSTRACT
AIM: This was to review what is known about pain assessment
in children with intellectual disabilities and to translate
findings into clinical dental practice. Methods: Literature
review. Review: The association between anxiety and pain
as reported in the literature was explored. The specific pain
expressions for individuals with Down’s syndrome and those
with autism are discussed with available literature. Various
pain assessment instruments for cognitively impaired children
have comparable content but vary in number of items.
However, none of these instruments has been tested or implemented
in the dental setting. Five pain assessment instruments
for children with intellectual disabilities are described
in more detail and these instruments were primarily tested for
postoperative children. There are only limited data available
on their use in dental treatments. Suggestions for step-bystep
implementation of pain assessment in dental practice are
given. Conclusion: Further studies in dental practice are
recommended to achieve optimal pain management during
dental procedures in individuals with intellectual disabilities.
Key words: intellectual disabilities, pain assessment, pain measurement
Eur Archs Paediatr Dent 2009;10(2):57-60.
* Dept. Paediatric Surgery, Erasmus MC-Sophia Children’s Hospital, Rotterdam;
**Academic Centre for Dentistry Amsterdam, Louwesweg, Amsterdam, The Netherlands
Postal address: Dr. M. van Dijk, Dept of Paediatric Surgery, Erasmus MC-Sophia Children’s Hospital,
PO Box 2060, 3000 CB Rotterdam, The Netherlands.
Email: m.vandijk.3@erasmusmc.nl
