The relationship between pain catastrophizing and dental anxiety and oral health-related quality of life: The Turkish validity and reliability study of the pain catastrophizing scale for child (PCS-C) and parent (PCS-P)

Worrying about pain during medical and dental treatments is an expected common behavior. Catastrophizing is used as an exaggerated negative response to painful stimuli. Numerous studies to date have found that catastrophic people exposed to painful stimuli experienced more pain and emotional stress than non-catastrophic people. Pain experience and pain catastrophizing in pediatric dentistry is a new concept in the dentistry literature. Assessing the extent to which children are catastrophic in pain in their children is another important issue. In our study, we aimed to introduce the validity and reliability studies of the PCS-C and PCS-P scales into our language by making them with a large sample group. In addition, in our pioneering work; age, gender, education level (primary school, secondary school, high school, university, graduate), economic status (very low, low, medium, high), oral health control (brushing load, risk of going to the dentist, last visit to the dentist, when time has gone, own dental examination, type of previous dental treatments and pain experience in these treatments), oral-dental health assessment (plaque index, gingival index, DMFT/dmft index), dental anxiety and oral health-related quality of life and pain we aimed to evaluate the causality relationship between catastrophizing by using path analysis. In the first step of our study, which was carried out on 317 patients aged 8-14 years, who applied to the Necmettin Erbakan University Faculty of Dentistry Pediatric dentistry clinic for routine examination; Cross-cultural validity and reliability studies of the PCS-C and PCS-P scales were carried out, and in the second step; with the treatment of catastrophizing pain in children and their parents using these scales; The relationship between age, gender, education level, economic status, oral health, oral- dental health assessment, dental anxiety and oral health-related quality of life were evaluated. For dental anxiety crises of the patients, MCDASf, for pain catastrophizing deaths, PCS-C, and OHRQoL, for patients between 8-10 and 11-14 years of age, DAS was used. DAS was applied for dental anxiety deaths of children, PCS-P for pain catastrophizing patients, and OHRQoL-UK for burning OHRQoL. The influence of parents on children's tendency to catastrophize pain has also yet to be clarified results. All questions and scales in the study were read by the researcher physician (ÜA) and directed to the participants one-on-one. According to our study results; It has been found that the Turkish version of PCS-P can be used as a valid and reliable tool for the evaluation of catastrophizing pain experiences in adult patients, and the Turkish version of PCS-C can be used as a valid and reliable tool for the assessment of pain catastrophizing cases in children aged 8-14 years. While girls have a higher tendency to pain catastrophizing (p=0.001), there was no relationship between PCS-P and gender (p=0.415). There was no relationship between PCS-C and PCS-P and age (p=0.457)(p=0.456). While dental anxiety was found to be at the level of pain catastrophizing in children (p<0.001), no relationship was found between dental anxiety and catastrophizing pain level in parents (p=0.052). The rate of OHRQoL was found to be low in individuals with high levels of pain catastrophizing in both children and parents (p<0.001) (p=0.038). An increase in the level of pain catastrophizing in children was reported as the parental pain catastrophizing tendency increased (p=0.031). Given the results of our study; we reached the conclusion that due to the adverse effect of the level of pain catastrophizing caused by parents, the increase of pain catastrophizing caused by dental anxiety and the decrease of OHRQoL caused by pain catastrophizing; future studies should develop cost and time-effective methods for identifying catastrophic individuals and reducing anxiety levels in order to reduce clinical challenges. Accurately detecting the collective that shows the pain catastrophizing practices will help establish a healthy level of communication between the dentist and the patient, provide quality treatment, and help the groups come to the following appointments will benefit. Considering that dental pain is an important organ of avoiding dental treatment, we think that effective pain reduction has effective effects on individual's oral health, especially those who aim to experience high pain levels. Keywords: Dental Anxiety, Factor Analysis, Health-Related Quality of Life, Pain Catastrophizing, Reliability and Validity