Bhavana Reddy .BCRIMeenakshi Ammal Dental College

“Where a new invention promises to be useful,

It ought to be tried.”- Thomas Jefferson

Chapman and Kirby – Turner (1999)

When I run into

something. I say

‘OUCH’ even

though it doesn’t

hurt.O

UCH

How do we measure pain…???

Using Specific

scales…

CHEOPS

TPPPS

FPS??

There’s something new called…

FLACC!!!

FL AC C F - Face L - Legs

A - ActivityC - Cry

C - Consolability

Observational Pain Scale

REVIEW OF LITERATURE

• For scoring postoperative pain in young children after general anesthesia.• Children with cognitive impairment•Dennis Paul Nutter DDS. Good clinical pain practice for pediatric procedure pain: Metric considerations. Calif dent journal 2009.

SCORE Item 0 (none) 1 (small) 2 (big)

Face No particular Occasional grimace, Frequent to constant expression or frown, withdrawn frown, clenched jaw, smile or disinterested quivering chin

Legs Normal position Uneasy, restless, Kicking or legs or relaxed or tense drawn up

Activity Lying quietly, Squirming, shifting Arched, rigid, or normal position, back and forth, jerking moves easily or tense

Cry No cry Moans, whimpers, Crying steadily or occasional screams or sobs complaint frequent complaints

Consolability Content, relaxed Reassured by Difficult to occasional touching, console or being talked to, comfort distractable

AIM

To check the reliability of theFLACC scale in comparison with Facial Pain Measurement Scale

MATERIALS

&

METHODS

Actions speak louder than words?!

Name: Age/Sex: O.P.No:

Address & Contact no.:

Dental visit: Dental procedure:

FLACC Scale: F : Facial Pain Measurement Scale :

L :

A :

C :

C :

PROFORMA

FACIAL PAIN MEASUREMENT SCALE

(FPM)

37 Children

Age: 4 – 10

years

S.No Age / Sex

FLACC

FPM

1 8 yrs / F 2 2

2 8 yrs / F 6 10

3 10 yrs/ M 5 8

4 7 yrs / M 2 2

5 6 yrs / M 2 4

6 10 yrs / F 2 4

7 10 yrs / F 5 10

8 9 yrs / M 5 2

9 7 yrs / F 0 2

10 8 yrs /M 0 2

11 4 yrs / M 2 2

12 6 yrs / M 2 8

13 5 yrs / M 2 2

14 10 yrs / F 7 8

15 7 yrs / F 6 2

S.No Age /

Sex

FLACC

FPM

31 5 yrs / M

2 2

32 7 yrs / M

2 0

33 5 yrs / F 10 10

34 5 yrs / F 4 4

35 6 yrs / M

2 4

36 8 yrs / F

2 2

37 6 yrs / M

2 0

S.No

Age / Sex

FLACC

FPM

16 5 yrs / F 3 0

17 8 yrs / F 2 2

18 4 yrs / M 2 2

19 7 yrs / M 2 2

20 8 yrs / M 8 4

21 4.5 yrs / F 0 0

22 8 yrs / F 0 2

23 7 yrs / F 5 10

24 5 yrs / F 8 10

25 8 yrs / M 3 8

26 7 yrs / M 2 4

27 6 yrs / M 2 2

28 4 yrs / F 5 10

29 8 yrs / M 1 2

30 8 yrs / M 1 2

73%

27%Extremities of the scale (0,2,10)

Others (4,6,8)

SCORES ACCORDING TO FACIAL PAIN MEASUREMENT SCALE

% OF CHILDREN POINTING TO THE RESPECTIVE SCORE

FLACC SCORES =/≠ FPM SCORES

30%

70%

FLACC = FPMFLACC = FPM

</= 7 years > 7 years

45.45%

6.66%

54.55%

93.33%

Similar FLACC & FPM scoresDifferent FLACC & FPM scores

ACCORDING TO AGE…

Miles to go…

REFERENCES…•Dennis Paul Nutter DDS. Good clinical pain practice for pediatric procedure pain: Metric considerations. Calif dent journal 2009.

•Matsuoka et al. Face scales and facial expression analysis to assess clinical pain intensity. Volume 8, 2008.

•Sandra Merkel et al. AJN. Volume 102, Oct 2002. Pain Control.

Guide:Dr. Sharath Asokan MDS, PhD Department of Pediatric dentistry Dr. Siva Kumar. N. MDSDepartement of Pediatric Dentistry

Dr. P. Jayakumar MDSPrincipal

Dr. Ambalavanan MDSVice - Principal

MEENAKSHI AMMAL DENTAL COLLEGECHENNAI

GOOD

DAY