Pain In Adolescents Research Articles

Association between adverse childhood experiences and bodily pain in early adolescence.

We aimed to examine the relationship between lifetime exposure to adverse childhood experiences (ACEs) during the first decade of life and recent pain features reported in early adolescence. We conducted a prospective study using data from 4564 adolescent Generation XXI birth cohort participants recruited in 2005-2006. Adverse childhood experiences were reported by children at ages 10 and 13years using a 15-item questionnaire. Recent pain features (e.g., any pain, pain sites, recurrent pain intensity, and recurrent pain duration) were measured using structured questionnaires, including the Luebeck pain screening questionnaire at age 13. Using hierarchical binary and multinomial logistic regression analyses with progressive adjustments for confounders, we estimated the associations [adjused odds ratios (aOR) with their 95% confidence intervals (95% CI)] between exposure to ACEs at 10 and pain features at 13years. The study revealed a statistically significant association between exposure to ACEs reported at age 10 and any pain experienced at age 13 (OR=1.09; 95% CI [1.07, 1.12]). Even after accounting for the newly reported ACEs at age 13, the association with ACEs at age 10, remained significant (aOR=1.11 [95% CI, 1.08-1.14]). Consistent patterns were observed when the number of pain sites, recurrent pain intensity, or recurrent pain duration were used as outcome variables instead of any pain at age 13. Adverse childhood experiences occurring during the first decade of life predict the onset of pain features during early adolescence. Consequently, childhood exposure to adversity should be considered a pivotal initial exposure in a pathway leading to chronic pain later in life.

Cross-disorder comparison of sensory reactivity, pain, gastro-intestinal symptoms and obsessive-compulsive symptoms in adolescents and young adults with autism and other neurodevelopmental disorders

There is considerable evidence of the relationship among sensory reactivity, abdominal pain, and gastrointestinal symptoms in individuals with Autism Spectrum Disorder (ASD). Furthermore, these events are linked to the gut-microbiota-brain axis via the enteric nervous system. However, few studies have compared autism with other neurodevelopmental disorders in terms of sensory reactivity, pain, or gastrointestinal symptoms. Consequently, this study aimed to analyze the differences in sensory reactivity, pain, and gastrointestinal symptoms between adolescents and young adults with ASD and other neurodevelopmental and neurotypical disorders. Differences in sensory reactivity, pain, gastrointestinal symptoms, and obsessive-compulsive symptoms between a group of individuals with ASD level I (n = 37), Attention Deficit Hyperactivity Disorder or ADHD (n = 15), Learning Difficulties or LD (n = 23), and a control or neurotypical group (n = 76) were analyzed. Higher levels of sensory hyperreactivity were found in individuals with ASD than in the other clinical (ADHD and LD) and neurotypical groups. Sensory hyporeactivity was greater in individuals with ASD as well as in individuals with ADHD than that in the neurotypical group. Higher levels of pain were found in the ADHD group than in the ASD or neurotypical group. Gastrointestinal symptoms of the abdominal type were more severe in the ASD group than in the ADHD, and LD groups, whereas dyspepsia was more severe in the ADHD group. The results indicate a sensory and gastrointestinal profile in individuals with ASD and ADHD. Future studies should increase the number of participants for each neurodevelopmental disorder and perform a more comprehensive analysis of the gut microbiota-brain axis.

The prevalence of chronic pain in adolescents in Central Switzerland: A cross- sectional school-based study protocol.

Chronic pain is associated with substantial personal suffering and societal costs and is a growing healthcare concern worldwide. While chronic pain has been extensively studied in adults, limited data exists on its prevalence and impact in adolescents. Understanding the prevalence and impact of chronic pain and pain beliefs in adolescents is crucial for developing effective prevention and treatment strategies. This study aims to estimate the prevalence, characteristics, and impact of chronic pain, and explore adolescents' knowledge and beliefs about pain. This is an observational cohort study of school-going adolescents aged 11 to 17 years in Central Switzerland. The study will estimate the point prevalence, characteristics (location, intensity, frequency, duration) and impact (PROMIS Pediatric Short Form v2.0 -Pain Interference Scale, PPIS) of chronic pain in school-going adolescents. We will also measure and investigate pupils' beliefs about pain (Concept of Pain Inventory (COPI)). Data will be collected through manual and digital self-report questionnaires and from participants in primary, secondary, and high schools between September 2023 and January 2024. The primary analyses will utilise descriptive statistics to estimate the point prevalence, characteristics, and impact of chronic pain. Secondary analyses will analyse associations and correlations between chronic pain, impact of pain and beliefs about pain. This study will provide an estimate of the prevalence, characteristics and impact of chronic pain in adolescents in Central Switzerland and a measure of adolescents' understanding and beliefs about pain. In doing so, this study will provide insights into the scale of chronic pain as a public health concern. By understanding adolescents' pain beliefs and their influence on pain experience, this study can contribute to the development of educational approaches to enhance adolescents' knowledge and understanding of pain in order to optimise the prevention and treatment of chronic pain in adolescents. The findings may be useful to healthcare professionals and funders, policymakers, and researchers involved in the prevention, assessment, and treatment of pain in adolescents.

Sex related difference in postoperative pain and opioid use following posterior spinal fusion for adolescent idiopathic scoliosis

PurposeThis project aims to evaluate the relationship between biological sex and postoperative pain and in patients receiving posterior spinal fusion for adolescent idiopathic scoliosis.MethodsThis is a retrospective study of patients (n=137) aged 10-17 receiving posterior spinal fusion for adolescent idiopathic scoliosis between 01/2018 and 09/2022. Each patient received surgery by the same pediatric orthopedic surgeon with identical postoperative pain management regimen at a children’s hospital or a tertiary referral center with a pediatric spine program.ResultsThere were no significant differences in any background characteristics between the male and female patients, including age, BMI, number of levels fused, preoperative degree of scoliosis, and length of surgery and anesthesia (p>0.05). There were no differences in amount given of any intraoperative medications, nor in amount of postoperative scheduled analgesics (p>0.05). Female patients demonstrated higher average pain scores on Visual Analogue Scale evaluations during the first 24 hours postoperatively (5.0 vs 3.6, p<0.0001), 24-48 hours postoperatively (4.9 vs 4.0, p=0.03), and at the first physical therapy evaluation (5.3 vs 3.8, p<0.001). These patients received significantly greater amounts of morphine milligram equivalents in the first 24 hours postoperatively (42.2 vs 31.5, p=0.01) and for the hospitalization in total (63.8 vs 51.3, p=0.048). There was no difference in hours until hospital discharge (44.3 vs 42.6, p=0.62) nor until first ambulation (20.1 vs 21.3, p=0.24) between the female and male patients.ConclusionThe influence of biopsychosocial factors on postoperative pain in adolescents is complex. This study adds to the existing pool of literature suggesting differences in pain perception between adolescent female and male patients. Female patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis may benefit from increased preoperative counseling and more aggressive intra- and postoperative pain management regimens.

The Relationship of Respiratory Relaxation Techniques with the Intensity of Dysmenorrhea Menstrual Pain in School-Out Adolescents

This study aims to determine the effect of breathing relaxation techniques on reducing the intensity of dysmenorrhea menstrual pain in out-of-school teenagers in Bone district. This research design is a quasi-experimental design with a one group pretest-posttest approach. The samples taken in this study were 34 respondents from 102 populations using consecutive sampling. Data collection using a questionnaire sheet and observations then analyzed using the paired sample t test. The instrument used was the NRS observation sheet, research time atdo it from August to October. The research results were obtained after being given breathing relaxation techniques, less than half (39.4%) experienced mild and moderate pain, with a p-value = 0.001 (p &lt; 0.05) meaning that H1 was accepted which means there issignificant effect after being given deep breathing relaxation techniques. This result is influenced by the breathing relaxation technique given for 15 minutes which can provide a feeling of comfort, reduce uterine tension and improve circulation blood. Future researchers are advised to develop research by paying attention to physical factors that can reduce differences in the intensity of menstrual pain as well as the need to monitor the implementation time in carrying out breathing relaxation techniques correctly in a more relaxed and comfortable manner.​

Non-Pharmacologic Intensive Interdisciplinary Pain Treatment in Pediatrics: Impact on Symptoms, Daily Functioning, and the Family Unit.

Objectives: To assess non-pharmacologic treatment outcomes pertaining to health-related quality of life (HRQoL) in youth with chronic idiopathic pain and their families. Methods: We conducted a retrospective cohort study of 115 youth with chronic idiopathic pain enrolled in a non-pharmacologic, hospital-based intensive interdisciplinary pain treatment (IIPT) program. HRQoL measures for the patient (Pediatric Quality of Life Inventory [PedsQL] short form) and family unit (PedsQL Family Impact) were collected on admission and discharge as part of routine clinical care. Changes in PedsQL scores were calculated using the Wilcoxon signed-rank test. Multivariable linear regression was used to explore factors associated with patient-level HRQoL. Results: Both individuals and the family unit reported that their HRQoL improved in all domains by program completion. Improvements in pain and allodynia were present for program participants at the time of completion as well as at the 3-month follow-up, suggesting durability of these effects. Conclusions: A non-pharmacologic IIPT program is a compelling treatment for pediatric and adolescent chronic idiopathic pain, for both patients and the family unit. Patients participating in this program had positive treatment outcomes with significantly improved subjective and objective measures of physical, emotional, social, and cognitive function.

Cochrane Corner

This edition of the Cochrane Corner looks at the three reviews that were published in the second half of 2023: surgical versus non-surgical interventions for displaced intra-articular calcaneal fractures; cryotherapy following total knee arthroplasty; and physical activity and education about physical activity for chronic musculoskeletal pain in children and adolescents.

Gait biomechanics do not differ between adolescents with and without patellofemoral pain.

To determine if adolescents with patellofemoral pain exhibit different biomechanical characteristics to asymptomatic adolescents during walking and running. Twenty-eight adolescents with patellofemoral pain (16 male, 12 female, mean [SD] age: 14.3 [1.7] years) and 24 asymptomatic adolescents (13 male, 11 female, mean [SD] age: 14.1 [1.6] years) participated. Participants walked and ran on an instrumented treadmill in a standardized athletic shoe. Continuous hip, knee, and ankle joint angles and moments, and frontal plane pelvic motion were compared between groups using one-dimensional statistical parametric mapping independent t-tests (alpha <0.05). Cadence and stride length were compared between groups using independent t-tests. During walking, adolescents with patellofemoral pain had a higher hip extension moment at 7%-8% of the gait cycle (p = 0.04) and walked with a shorter stride length (mean difference [95% confidence interval] = -0.07 [-0.1, -0.01] m). There were no other differences between groups during walking. During running, adolescents with patellofemoral pain had greater knee flexion than asymptomatic adolescents at 35%-40% of the gait cycle (p = 0.04) and ran with a higher cadence (mean difference [95% confidence interval] = 5.8 [2.0, 9.5] steps/min). There were no other statistically significant differences between groups during running. Adolescents with patellofemoral pain demonstrate few biomechanical differences to asymptomatic adolescents during walking and running. The identified differences are likely of limited clinical importance. Biomechanical alterations which have been previously associated with patellofemoral pain in adults, may not need to be the target of management of adolescent patellofemoral pain.

Clinical characteristics of children and adolescents admitted with chest pain

Abstract Background: Chest pain is a common disease in children. Chest pain is the second most common symptom referred to by paediatric cardiologists after cardiac murmurs. Objective: In this prospective study, we aimed to evaluate clinical characteristics and causes of chest pain in children admitted to our paediatric cardiology outpatient clinics. Methods: We conducted this prospective study among 446 patients with chest pain in a tertiary care hospital from 1 June 2017 to 1 June 2020. The demographic data and clinical characteristics of the patients were analysed. All patients were evaluated with a medical history, physical examination, laboratory tests, electrocardiogram and echocardiogram and if necessary telecardiogram, 24-hour electrocardiogram monitoring, exercise stress test and psychological evaluation were made. Results: The ratio of admissions with acute pain was 4% when 20% of the patients had chronic chest pain. The most common symptoms associated with chest pain were shortness of breath and palpitations. The non-cardiac causes were as follows: 25% musculoskeletal, 14% psychological, 9% respiratory, and 7% gastrointestinal, respectively. We found cardiac chest pain in 49 (11%) of patients. Idiopathic chest pain was found in 153 (34%) patients. Conclusions: Our study showed that the aetiology of chest pain in children and adolescents admitted with chest pain is mostly due to non-cardiac causes. We found the slightly frequency of elevated rate for cardiac aetiologies of paediatric chest pain compared to the literature. We suggest that in addition to anamnesis and careful examination, further investigation, if necessary, is important in determining the aetiology of chest pain.

Pain and self-pressure relief in adolescents with cerebral palsy

ABSTRACT Adolescents with CP classified as Gross Motor Functional Classification System Level V attend school up to 8 h daily with limited ability to self-reposition. Despite pain reported within this population, perceived pain and self-pressure relief during prolonged classroom sitting is unknown. A case series design was used with a convenience sample of six students (13–18 years) with CP. Pain assessments were taken every 30 min for 5 h. Self-relief assessments using the SensiMATTM were recorded while students were in their wheelchairs. One student self-reported pain and three students proxy reported pain movements. All students had unrelieved pressure or did not self-relieve pressure for at least 1.5 consecutive hours. Four students increased their self-pressure relief movements after 3.5 h. This study provided preliminary data regarding perceived pain and self-pressure relief during prolonged sitting and demonstrated that the SensiMATTM can capture pressure relief movements in sitting of students with severe CP. Although there was no trend of reported pain, students may either be moving enough, as demonstrated by recorded pressure relief movements, to independently relieve pressure and pain, or current pain assessments may not be sensitive enough for those with the most severe disabilities.

Resilience in adolescent chronic pain: an exploration of coping mechanisms and personal growth

Adolescents living with chronic pain (CP) are vulnerable to negative outcomes such as disability and impaired quality of life. They often miss opportunities for social engagement and suffer from anxiety and depression. Central to all accounts is a sense of interrupted life—phrases with negative connotations such as “couldn’t do” and “had to stop” are repeatedly used to express feelings of loss of control.&#x0D; To regain control over their situation, participants create within themselves a positive internal dialogue whereby they reconstruct the meaning of normalcy, practice acceptance, make downward social comparisons, and engage in daily positive affirmations. They also create a positive external environment, surrounding themselves with compassionate individuals as well as advocating for proper accommodations at school. While CP disrupts their personal and academic trajectories, the experience of living with pain has instilled in them the pursuit of significance.&#x0D; This pursuit is propelled by the imagery of a fulfilled life and seems to be particular to this age group. Ironically, some participants are grateful for their pain for granting them intuitive empathy for the suffering of others and the emotional credibility to help others.

Obesity and overweight as risk factors for low back pain in children and adolescents: a meta-analysis.

Childhood obesity and overweight are associated with musculoskeletal pain, but the association between low back pain (LBP) and overweight/obesity in this population needs clarification. The objective of this meta-analysis is to ascertain the relationship between LBP and obesity/overweight in children and adolescents. Various databases and specialized journals were queried from inception to October 2022. Encompassed were all studies examining the association between overweight or obesity and LBP among participants aged 6 to 18 years. The ROBINS-E tool was employed to assess bias. Random-effects models were used to pool results across studies, with location-scale models used to search for moderator variables where evidence of heterogeneity was found. In total, 34 studies were incorporated. Four studies had a low risk of bias, while the remaining studies had some concerns. Nine studies evinced an association between overweight and LBP, in contrast to normal weight, yielding an OR of 1.13 (95% CI 1.10-1.16) and no heterogeneity. Eight studies demonstrated a similar association between obesity and LBP compared to normal weight, with an OR of 1.27 (95% CI 1.20-1.34) and no heterogeneity. Ten studies established an association between overweight/obesity and LBP compared to normal weight, yielding an OR of 1.18 (95% CI 1.14-1.23) and no heterogeneity. Finally, nineteen studies showcased an association between body mass index (BMI) and LBP, with an OR of 1.19 (95% CI 1.03-1.39) with evidence of heterogeneity. For this last analysis, we compared the mean BMI in groups and transformed results to log OR, and then retransformed to OR. Overweight and obesity may be risk factors for LBP in children and adolescents. The association between LBP and obesity appears to be stronger than with overweight. However, the analysis revealed considerable heterogeneity and risk of bias across studies.

PEMBERIAN PILATES EXERCISE TERHADAP PENURUNAN NYERI HAID

Dysmenorrhea is a disruption in menstrual blood flow/menstrual pain. If dysmenorrhea pain is not treated immediately, it will affect the individual's mental and physical function so that non-pharmacological measures are needed. Non-pharmacological therapy that can be done is Pilates exercise.. The aim of providing pilates exercise is to reduce menstrual pain at SMPN 7 Kota Kediri. Method of providing pilates exercise counseling to reduce menstrual pain to 15 female students at SMPN 7 Kota Kediri. The results of counseling on providing pilates exercise to reduce menstrual pain in teenagers at SMPN 7 Kota Kediri, can apply pilates exercise to reduce dysmenorrhea pain which does not cause side effects in reducing the incidence of dysmenorrhea pain.Conclusion Giving pilates exercuse can reduce menstrual pain in adolescents at SMPN 7 Kota Kediri, so adolescents are advised to apply pilates exercise to reduce dysminorea pain that does not cause side effects in reducing dysminorea pain

Direct and Indirect Effects of Stress and Self-Esteem on Primary Dysmenorrhea in Korean Adolescent Girls: A Cross-Sectional Survey Study.

Positive and negative emotions have recently revealed a link with primary dysmenorrhea in adults. Among them, roles of stress and self-esteem have been less studied specially in adolescents and the direction of causality has not been clearly established. Therefore, this study investigated whether stress and self-esteem independently affect primary dysmenorrhea after adjustment for the known risk factors in adolescents. Additionally, indirect effects of stress and self-esteem were determined using mediation analyses. This survey was conducted in adolescent girls aged 15-18 yr in metropolitan regions in South Korea in 2021. The survey included general, menstrual, and lifestyle characteristics, menstrual pain and symptom, perceived stress, self-esteem, depression, and state-trait anxiety. Stress, depression, and anxiety were associated positively with menstrual pain and symptom (all P<0.001) in adolescent girls (n=519). Self-esteem was also associated inversely with negative emotions and dysmenorrhea (all P<0.001). Additionally, stress independently affected frequency and severity of menstrual symptom (both P<0.05), but not pain intensity after adjustment for covariates. Stress also had indirect effect through depression and anxiety on menstrual pain and symptom. Effect of self-esteem vanished after adjustment for covariates, but indirectly reduced menstrual pain and symptom through mediations of stress, depression, and anxiety. Mental health such as stress and self-esteem are important for managing menstrual pain and symptom in adolescents. It should be considered in managing dysmenorrhea.

Immigration background as a risk factor of chronic pain and high-impact chronic pain in children and adolescents living in Spain: differences as a function of age.

The number of people immigrating from one country to another is increasing worldwide. Research has shown that immigration background is associated with chronic pain (CP) and pain disability in adults. However, research in this issue in children and adolescents has yielded inconsistent results. The aims of this study were to examine (1) the association between immigration background, CP, high-impact chronic pain (HICP) in a community sample of children and adolescents; and (2) the extent these associations differed as a function of sex and age. Participants of this cross-sectional study were 1115 school children and adolescents (mean age = 11.67; 56% girls). Participants were asked to provide sociodemographic information and respond to a survey including measures of pain (location, extension, frequency, intensity, and interference). Results showed that having an immigration background was associated with a greater prevalence of CP (OR = 1.91, p <.001) and HICP (OR = 2.55, p <. 01). Furthermore, the association between immigration background and CP was higher in children (OR = 6.92, p <.001) and younger adolescents (OR = 1.66, p <.05) than in older adolescents. Children and adolescents with an immigration background are at higher risk for having CP -especially younger children- and HICP. More resources should be allocated in the prevention of CP and HICP in children and adolescents with an immigration background.

Musculoskeletal Pain in Adolescents Engaged in Impact and Nonimpact Sports-ABCD Growth Study.

This study aimed to identify, through a 28-week follow-up, the association between pain and engagement in different sports among adolescents. In total, 63 adolescents reported the occurrence of pain, which was tracked weekly. Participants were categorized into 2 groups based on their sports participation: "swimming group" and "other sports group." Researchers directly measured the time spent in different intensities during sports participation for 1 week using a heart rate monitor. For the covariates, body mass, body fatness, and whole-body lean soft tissue were assessed using a dual-energy X-ray absorptiometry scanner. Kaplan-Meier plots and risk of pain were calculated for the absence of pain during the follow-up. The association between the sport type and pain occurrence remained significant even after adjusting the models for potential confounders, showing that swimmers had an increased risk of reporting pain in the neck (HR = 3.33; 95% CI, 1.53-7.25), shoulders (HR = 2.21; 95% CI, 1.17-4.21), and trunk (HR = 5.60; 95% CI, 2.28-13.70). The association between the sport type and pain occurrence is evident even when controlling for confounding factors.

Back pain in adolescents and young adults with idiopathic scoliosis. Identifying factors associated with severe pain. A multivariate logistic regression analysis

Back pain in adolescents and young adults with idiopathic scoliosis. Identifying factors associated with severe pain. A multivariate logistic regression analysis

A Longitudinal Study on the Rare Entity of Acromial Apophysitis in Paediatric and Adolescent Ages

Introduction: Acromial apophysitis is a traction apophysitis caused by repetitive stress to the distal acromion. Although it is a common non-traumatic cause of shoulder pain in adolescence, data is scarce in the literature. There is a need for a better understanding of acromial apophysitis regarding its cause, diagnosis and management. Aim: To determine the cause, clinical features, radiological findings, management, and outcome of the patients diagnosed with acromial apophysitis. Materials and Methods: A longitudinal descriptive study was carried out at Jaipur National University Institute for Medical Sciences and Research Centre (JNUIMSRC), Jaipur, Rajasthan, India, from August 2018 to August 2022. A total of 30 patients aged 10-20 years with shoulder pain, diagnosed with acromial apophysitis based on history, clinical, and radiological examination, were included in the study. The treatment given, duration of disease, and outcome were noted. Descriptive statistics were performed using Microsoft Office Excel. Results: Out of 30 patients diagnosed with acromial apophysitis, 24 (80%) were male, and 6 (20%) were female, with a mean age of 13.47 (range 10-18) years. The cause was repetitive microtrauma following chronic overuse during athletic and sports activities in 24 patients (80%). Among these patients, 13 played cricket, three played basketball, three played volleyball, two did weightlifting, one was a wrestler, one was a tennis player, and one was a judo player. Six patients (20%) did not give a history of playing any kind of sports. All patients had anterior shoulder pain with tenderness at the antero-lateral acromion. Radiographs showed fragmentation, sclerosis, and irregularity of the acromial apophysis. Conservative treatment included rest and restriction of sporting activities. The duration for the analgesics taken by patients was 8.9 days (range 3-21). The duration from the onset of symptoms to recovery was 5.8±1.61 weeks. None of the patients showed a recurrence of symptoms after complete recovery. Conclusion: Acromial apophysitis is a common cause of shoulder pain in paediatric and adolescent age. It occurs due to repeated overhead abduction, overuse, and throwing activities, mostly in sports persons. It is diagnosed clinically and confirmed with plain radiographs. It is a self-limiting disease with a short benign course. It is treated conservatively with rest and analgesics and has an excellent outcome. This diagnosis should be kept in mind for shoulder pain in young patients to prevent undue investigations and surgery.

Prevalence of disabling musculoskeletal pain in children and adolescents in Brazil: A cross-sectional study

BackgroundEstimates of prevalence of musculoskeletal pain in children and adolescents vary considerably and the impact of pain on children's life is often not considered. ObjectiveTo determine the one-month prevalence of disabling musculoskeletal pain in children and adolescents. The secondary aims are to: 1) determine the body region with the highest prevalence; 2) understand the characteristics of the children with disabling musculoskeletal pain; and 3) describe the parents' perception of the prevalence. MethodsThis cross-sectional study was conducted in public and private schools in the states of São Paulo and Ceará, Brazil. Children self-reported presence and impact of pain, pain intensity, psychosomatic symptoms, and quality of life. Parents completed parent-proxy versions and perception of the child's sleep quality. Descriptive statistics were used to summarise the data. ResultsA total of 2,688 children and adolescents were included in this study. The prevalence of disabling musculoskeletal pain in the previous month was 27.1%. The back was the region most often affected (51.8%). Children with disabling musculoskeletal pain were older, heavier, had worse relationships with their family, perceived their backpacks as heavy, carried their backpacks more with one shoulder, had more negative psychosomatic symptoms, had poorer quality of life, and had higher pain intensity. Parents tended to underestimate the presence of pain in their children. ConclusionThe one-month prevalence of activity limiting musculoskeletal pain in children and adolescents was 27.1% with the back being the most often affected body region. Parents tended to underestimate the presence of pain in their children.

Factors affecting oral health in children and adolescents in Ecuador

Globally, the highest prevalence of caries in permanent teeth is found in the Andean region of Latin America. In countries such as Ecuador, the burden of oral diseases has shown an increase in recent years. The present study aimed to identify the risk factors associated with dental pain in children and adolescents aged 5 to 18 years in Ecuador, in order to base preventive actions to improve oral health in this population. Using the database of the National Health and Nutrition Survey, a sample of 23,621 participants was analyzed. The analysis included variables such as ethnic self-identification, region of residence, housing area, and maternal educational level, in addition to the economic impact of dental pain. The results showed that approximately one third of children and adolescents experienced dental problems that affected their quality of life in the last 12 months. The data revealed that dental pain, difficulties in chewing, speaking, and sleeping, as well as school absences due to dental problems, were common. Significant differences were found in the impact on quality of life associated with ethnicity, region, area of residence and maternal educational level. Residents of rural areas, indigenous people and children of mothers with basic education had a higher prevalence of dental problems. The conclusions highlight the need to develop preventive strategies adapted to risk groups, promoting specific interventions to reduce dental pain and improve oral health