1. Bhavana Reddy .B
CRI
Meenakshi Ammal Dental College

9. How do we
measure
pain…???
Using
Specific
scales…
CHEOPS
TPPPS FPS?
?
There’s something
new called…
FLACC!!!

11. • 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.

12. 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expression or frown, withdrawn frown, clenched jaw,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

16. 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 :

21. 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

22. 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

23. 73%
27% Extremities of
the scale (0,2,10)
Others (4,6,8)
% OF CHILDREN POINTINGTOTHE RESPECTIVE SCORE

24. 30%
70%
FLACC = FPM
FLACC = FPM

25. </= 7 years > 7 years
45.45%
6.66%
54.55%
93.33%
Similar FLACC & FPM scores Different FLACC & FPM scores

29. •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.

30. Dr. Sharath Asokan MDS, PhD
Department of Pediatric dentistry
Dr. Siva Kumar. N. MDS
Departement of Pediatric Dentistry
Dr. P. Jayakumar MDS
Principal
Dr. Ambalavanan MDS
Vice - Principal
MEENAKSHI AMMAL DENTAL COLLEGE
CHENNAI