Vol. 65, No. 1, Winter2005 3 zy Dental Pain in Maryland School Children zy Clemencia M. Vargas, DDS, PhD; Mark D. Macek, DDS, DrPH; Harold S. Goodman, DMD, MPH; Mark L. Wagner, DMD Abstract zyxwvutsrqp Objective: zyxwvutsrqp To describe the lifetime prevalence of dental pain among Maryland’s school age children. Methods: Data come from the Survey of Oral Health Status of Maryland School Children conducted in 2000-01. History of dental pain, as reported by an adult respondent, was analyzed for 2,411 kindergarten and third grade stu- dents. Percentages with their zyxwvutsrq 95% confidence interval were calculated to obtain state representation of the distribution of dental pain by sociodemographic charac- teristics and caries status. Results: Overall, 11.8 percent of Maryland school age children in kindergarten and third grade have had some dental pain. Among chil- dren who have had caries, the report of dental pain increases to 28.2 percent. Children from families with low educational attainment or eligible for free or re- duced meals or covered by Medicaid were more likely to have experienced dental pain. Conclusion: Almost a third of Maryland kindergartens and third graders who have caries have experienced dental pain. Key Words: dental pain, toothache, children, Maryland, low socioeconomic status. Introduction Dental pain in children is a pre- ventable but unfortunate event that can diminish the quality of life and schoolwork of affected individuals. Yet, little is known about dental pain in children in the United States. A Rand Health Insurance Experiment report published in 1987 (1) found that 20% of children 5 to 13 years of age have had a little or some pain on their teeth or gums. Recent data from preschool children attending Head Start centers in Maryland show that 16% of these children have com- plained of tooth pain and that 8% have cried (2). There is also a paucity of data from other countries on den- tal pain in children; a study in Har- row, England indicates that 47.5% of children 8 years of age have had some of dental pain zyxwvutsrq (3). The objective of this report is to present the distribution of parent-re- ported dental pain among school age children in Maryland. We present the prevalence of dental pain by socioeco- nomic characteristics for all children and specifically for those who have a history of dental caries. Methods Data for this study are from the Survey of Oral Health Status of Mary- land School Children (2) conducted during the 2000-2001 schoolyear. The survey’s target population was chil- dren attending kindergarten or grades Yd-, 9th-, and loth in Maryland public schools. Participants were seIected according to a two-stage sample de- sign. During the first stage,50 elemen- tary schools were selected from 5 geo- graphic regions in Maryland accord- ing to a zyxwvu probability-proportional-to- size design. During the second stage, two kindergarten and two Yd-grade classrooms were selected at random from each first-stage school. All stu- dents who were present at the se- lected schools during the scheduled oral examination day and who pro- vided signed informed consent (and assent for children older than 12 years) were eligible for inclusion in the survey. For this study, we limited the sample to kindergarten and Yd- grade students, because the response rates for high school students were considerably lower and did not pro- vide for reliable population estimates. The cross-sectional Maryland Sur- vey consisted of an oral examination and a health questionnaire.Data were representative of all but two Maryland counties, which refused to participate because they did not wish to have stu- dents miss curricular time. A total of 4,964 kindergarten and 3‘”-gradechil- dren were eligible for inclusion in the Maryland Survey. Of these, 2,581 re- ceived an oral examination (52%) and 3,296 returned a questionnaire (66.4%). Since oral examination and questionnairedata were combined for this analysis, we included only chil- dren who had data for both compo- nents (2,581). From these, we ex- cluded any child with unknown pain history (n=170), unknown race/ ethnicity (n=144), and unknown edu- cation level (n=121) data. The final sample was 2,411, representing 110,381 public school children in the State. ~ ~~ ~~~~~~~~~ Send correspondence and reprint requests to Clemencia M. Vargas, DDS, PhD, Department of Health Promotion and Policy, University of Maryland Dental School, 666 West Baltimore Street, Room 3-E-11, Baltimore, Maryland, 20201-1586, Phone: 410-706-2678; Fax: 410-706- 3028; E-mail: cmvOOlt3dental.umaryland.edu. Dr. Vargas, Dr.Macek and Dr.Goodman are with the University of Maryland Dental School. Dr. Wagner is with the Special Olympics. Acknowledgement: Dr. Vargas was supported by a Ruth L.Kirschstgein National Research Service Award through the University of Maryland Dental Schoo1,Department of Biomedical Sciences, T32 DE7309-07. The authors thank Dr. Ronald Dubner for comments on this manuscript. Manuscript received: 3/2/2004; returned to authors for revision: 4/8/2004; final version accepted for publication 6/25/2004.