Can dental pain be a cause of irritability in children and family distress?

  • Monalisa Cesarino Gomes
  • Matheus França Perazzo
  • Érick Tássio Barbosa Neves
  • Emilly Gabrielle Carlos Souza
  • Luíza Jordânia Serafim Araújo
  • Carolina Castro Martins
  • Saul Martins Paiva
  • Ana Flávia Granville-GarciaEmail author
Original Article



This study aimed to evaluate the association between dental pain and both child irritability and family distress.

Subject and methods

A cross-sectional study was conducted among 833 children aged 3 to 5 years from preschools in the city of Campina Grande, Brazil. The parents answered questionnaires addressing socio-demographic data and history of dental pain. Child irritability and family distress were evaluated using questions from the Early Childhood Oral Health Impact Scale (ECOHIS). The children were submitted to clinical examinations by dentists who had undergone training and calibration exercises. All children were diagnosed with regard to dental caries, caries activity, traumatic dental injury, and malocclusion. Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%).


The prevalence of child irritability due to oral problems was 16.1%. The prevalence of family distress was 19.1%. After the data analysis, only a history of dental pain remained associated in the final model for child irritability [prevalence ratio (PR) = 9.77; 95% confidence interval (CI): 6.22–15.33] and family distress due to oral problems (PR = 3.18; 95% CI: 2.34–4.31).


Dental pain can make a child irritable and cause family distress. Socio-economic factors do not exert an influence on the emergence of these feelings.


Oral health Child Dental caries Traumatic dental injury Malocclusion 



This study was supported by the State University of Paraíba (UEPB), the Brazilian Coordination of Higher Education, Ministry of Education (CAPES), the Research Foundation of the State of Minas Gerais (FAPEMIG), and the National Council for Scientific and Technological Development (CNPQ), Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study received approval from the Human Research Ethics Committee of the State University of Paraíba (approval no.: 00460133000-11) in compliance with Resolution 196/96 of the Brazilian National Health Council. The study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. All parents/guardians received information regarding the objectives of the study and signed a statement of informed consent.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. Abanto J, Paiva SM, Raggio DP, Celiberti P, Aldrigui JM, Bönecker M (2012) The impact of dental caries and trauma in children on family quality of life. Community Dent Oral Epidemiol 40:323–331CrossRefGoogle Scholar
  2. Andreasen JO, Andreasen FM, Andersson L (2007) Textbook and color atlas of traumatic injuries to the teeth, 4th edn. Blackwell, OxfordGoogle Scholar
  3. Arora A, Bedros D, Bhole S, Do LG, Scott J, Blinkhorn A, Schwarz E (2012) Child and family health nurses’ experiences of oral health of preschool children: a qualitative approach. J Public Health Dent 72:149–155CrossRefGoogle Scholar
  4. Baer RD (1996) Health and mental health among Mexican American migrants: implications for survey research. Hum Organ 55:58–66CrossRefGoogle Scholar
  5. Carvalho AC, Paiva SM, Viegas CM, Scarpelli AC, Ferreira FM, Pordeus IA (2013) Impact of malocclusion on oral health-related quality of life among Brazilian preschool children: a population-based study. Braz Dent J 24:655–661CrossRefGoogle Scholar
  6. Clementino MA, Pinto-Sarmento TC, Costa EM, Martins CC, Granville-Garcia AF, Paiva SM (2015) Association between oral conditions and functional limitations in childhood. J Oral Rehabil 42:420–429CrossRefGoogle Scholar
  7. Deater-Deckard K, Wang Z (2012) Anger and irritability. In: Zentner M, Shiner RL (eds) Handbook of temperament. Guilford Press, New York, pp 124–144Google Scholar
  8. Freeman R (2007) A fearful child attends: a psychoanalytic explanation of children’s responses to dental treatment. Int J Paediatr Dent 17:407–418CrossRefGoogle Scholar
  9. Gomes MC, Clementino MA, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM (2014) Association between parental guilt and oral health problems in preschool children: a hierarchical approach. BMC Public Health 14:854CrossRefGoogle Scholar
  10. Gomes MC, Perazzo MF, Martins CC, Paiva SM, Granville-Garcia AF (2015) Oral health problems and smile avoidance among preschool children. J Dent Child (Chic) 82:122–127Google Scholar
  11. Grabowski R, Stahl F, Gaebel M, Kundt G (2007) Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition. Part I: prevalence of malocclusions. J Orofac Orthop 68:26–37CrossRefGoogle Scholar
  12. Granville-Garcia AF, Clementino MA, Gomes MC, Costa EM, Pinto-Sarmento TC, Paiva SM (2015) Influence of oral problems and biopsychosocial factors on the utilization of dental services by preschool children. J Dent Child (Chic) 82:76–83Google Scholar
  13. Hetherington EM, Parke RD, Locke VO (1999) Child psychology: a contemporary viewpoint. McGraw-Hill, New YorkGoogle Scholar
  14. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB (2007) The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 35:170–178CrossRefGoogle Scholar
  15. Kramer PF, Feldens CA, Ferreira SH, Bervian J, Rodrigues PH, Peres MA (2013) Exploring the impact of oral diseases and disorders on quality of life of preschool children. Community Dent Oral Epidemiol 41:327–335CrossRefGoogle Scholar
  16. Lee GHM, McGrath C, Yiu CKY, King NM (2010) A comparison of a generic and oral health-specific measure in assessing the impact of early childhood caries on quality of life. Community Dent Oral Epidemiol 38:333–339CrossRefGoogle Scholar
  17. Neves ÉTB, Firmino RT, Perazzo MF, Gomes MC, Martins CC, Paiva SM, Granville-Garcia AF (2016) Absenteeism among preschool children due to oral problems. J Public Health 24:65–72CrossRefGoogle Scholar
  18. Pagano E, Baldi I, Mosso ML, di Montezemolo LC, Fagioli F, Pastore G, Merletti F (2014) The economic burden of caregiving on families of children and adolescents with cancer: a population-based assessment. Pediatr Blood Cancer 61:1088–1093CrossRefGoogle Scholar
  19. Perazzo MF, Gomes MC, Neves ÉT, Martins CC, Paiva SM, Granville-Garcia AF (2017) Oral health-related quality of life and sense of coherence regarding the use of dental services by preschool children. Int J Paediatr Dent 27:334–343CrossRefGoogle Scholar
  20. Ribeiro GL, Gomes MC, de Lima KC, Martins CC, Paiva SM, Granville-Garcia AF (2015) Work absenteeism by parents because of oral conditions in preschool children. Int Dent J 65:331–337CrossRefGoogle Scholar
  21. Scarpelli AC, Oliveira BH, Tesch FC, Leão AT, Pordeus IA, Paiva SM (2011) Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). BMC Oral Health 11:19CrossRefGoogle Scholar
  22. Scarpelli AC, Paiva SM, Viegas CM, Carvalho AC, Ferreira FM, Pordeus IA (2013) Oral health-related quality of life among Brazilian preschool children. Community Dent Oral Epidemiol 41:336–344CrossRefGoogle Scholar
  23. Viegas CM, Paiva SM, Carvalho AC, Scarpelli AC, Ferreira FM, Pordeus IA (2014) Influence of traumatic dental injury on quality of life of Brazilian preschool children and their families. Dent Traumatol 30:338–347CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Monalisa Cesarino Gomes
    • 1
  • Matheus França Perazzo
    • 2
  • Érick Tássio Barbosa Neves
    • 1
  • Emilly Gabrielle Carlos Souza
    • 1
  • Luíza Jordânia Serafim Araújo
    • 1
  • Carolina Castro Martins
    • 2
  • Saul Martins Paiva
    • 2
  • Ana Flávia Granville-Garcia
    • 1
    Email author
  1. 1.Department of Dentistry, Dental SchoolUniversidade Estadual da Paraíba – UEPBCampina GrandeBrazil
  2. 2.Department of Pediatric Dentistry and Orthodontics, Dental SchoolUniversidade Federal de Minas Gerais – UFMGBelo HorizonteBrazil

Personalised recommendations