Dietary Intake, Not Oral Hygiene, is Associated With Location of Dental Erosion in Children With Gastroesophageal Reflux

Abstract

Background: Psychosocial variables (e.g., marital status, parent's educational level) have been found to be associated with pediatric chronic pain syndromes (i.e., headaches, back pain). Whether these factors are related to pain symptoms in children with FAP/IBS remains unclear. The aims of our study were to assess how psychosocial variables are related to child self-report and parent report of child's pain intensity, frequency, and pain related interference with activities in children with FAP/IBS. Methods: Participants included 94 children 7-10 years of age with FAP or IBS meeting Pediatric Rome II criteria were studied. Parents completed a demographic questionnaire and rated their child's pain intensity (0-10 scale), pain frequency (episodes/month), and whether or not pain interfered with activities (yes/ no). Children completed a 2-wk daily pain diary (pain intensity, frequency, pain interference with activities). Results: Girls (n=57) self reported higher mean (P=0.002) and maximum pain ratings (P=0.005) but parent report of child's pain did not differ between genders. African-American children (n=13) reported more pain episodes interfering with activities (P=0.05) compared with other racial/ethnic groups. However, parent report yielded no difference with regard to race/ethnicity. The child's pain self-report (intensity, frequency, interference with activities) did not differ based on the number of parents in the household. In contrast, parent rating of child mean pain intensity was higher for single parents (n= 16) (P=0.03). Furthermore, parents from 2-parent households reported greater child pain frequency (P =0.003) and more pain episodes interfering with activities (P=0.01). The child's self-report of pain did not differ based on the number of siblings. Parents reported more pain episodes interfering with activities in subjects with one sibling as compared to those with no or two or more siblings (P =0.05). Child self-report and parent report of child's pain did not differ based on the parent's educational level or the family's socioeconomic status. Child self-report did not differ depending on where the child lived within the city. In contrast, according to parent report, children living in suburban areas had higher mean pain (P =0.04) and more pain episodes per month than those in urban areas (P =0.03). Whether the child met criteria for FAP (n=39) or IBS (n=55) did not affect either the child or parent report results. Conclusions: 1) Pain intensity, frequency, and pain interference with activity may be influenced by psychosocial factors; 2) Child self-report and parent report of child's pain often differ; 3) Even in young children, child pain self-reports differ based on gender and race/ethnicity. Family living environment should be taken into account in assessing child and parent reports of child abdominal pain in FAP/IBS.