Evidence map›Paper›PMID 42823711›Full record

SynthesisBMC oral health2026

Factors affecting the experience of procedural and postoperative pain in children and adolescents - a systematic review.

Rikard Roxner, Henrik Berlin, Helena Domeij, Martina Vall, Susanne Brogårdh-Roth, Lubna Alward, Sofia Petrén, Liselotte Paulsson, Gunilla Klingberg

Abstract readSystematic Review
In one paragraph

Synthesis in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Rikard RoxnerDepartment of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, SE-205 06, Sweden. rikard.roxner@mau.se.ORCID http://orcid.org/0000-0002-9192-4035
Henrik BerlinDepartment of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, SE-205 06, Sweden.ORCID http://orcid.org/0000-0003-3362-3362
Helena DomeijHealth Technology Assessment - Odontology, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID http://orcid.org/0000-0002-4936-7124
Martina VallMalmö University Library, Malmö University, Malmö, Sweden.ORCID http://orcid.org/0009-0004-5177-2526
Susanne Brogårdh-RothDepartment of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, SE-205 06, Sweden.ORCID http://orcid.org/0000-0003-2745-1816
Lubna AlwardDepartment of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, SE-205 06, Sweden.ORCID http://orcid.org/0009-0005-4118-7718
Sofia PetrénDepartment of Orthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID http://orcid.org/0009-0001-1726-5473
Liselotte PaulssonDepartment of Orthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID http://orcid.org/0000-0003-1823-7850
Gunilla KlingbergDepartment of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, SE-205 06, Sweden.ORCID http://orcid.org/0000-0002-1371-8770

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo conduct a systematic review of factors contributing to 3-18-year-old children's and adolescents' experiences of procedural and postoperative pain. MATERIALS AND

methodsA PECO protocol was constructed. Searches were conducted in PubMed, CINAHL, PsycINFO, and Web of Science, up to January 2026. The researchers (reading in pairs) assessed identified studies independently, according to the defined inclusion and exclusion criteria. The report followed the PRISMA statement.

resultsTen thousand, seven hundred twenty records were screened, 109 reports read in full text, and finally 18 articles were evaluated for risk of bias. Eight studies based on seven study populations were judged to have low or moderate overall risk of bias and were included in the review. These studies investigated whether the following exposure factors can influence pain experiences in children and adolescents: sex, age, dental anxiety, personal traits, parental anxiety, previous painful experiences, and genotype. For the factors sex, age and dental fear and anxiety, which were studied in at least two studies, synthesis without meta-analysis (SWiM) were conducted, and the certainty of evidence in the findings was determined using GRADE. The results show that there is a low certainty of evidence that female adolescents (12-18 years) rate procedural or postoperative pain higher than males. Furthermore, there is a very low certainty of evidence regarding the findings concerning age and dental anxiety. Consequently, the findings should be interpreted with caution. Ethical concerns were highlighted, as three of the eight included studies lacked complete information on ethical review and informed consent procedures.

conclusionsAlthough several factors may be associated with children's and adolescents' pain experiences in conjunction with dental and medical treatment, the available evidence remains limited and the present review's results should be interpreted with caution. The results imply that pain may be multifactorial which calls for individualised care.

trial registrationThe study protocol was registered in PROSPERO (CRD42022342566), available at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022342566 .

Indexed as

Postoperative PainProcedural PainAdolescentAge FactorsChildChild, PreschoolDental AnxietyFemaleHumansSex FactorsAdolescentsChildrenExposurePostoperative painProcedural painSystematic review

Identifiers

PMID42823711
PMCPMC13632072

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.