Development of Labeled Magnitude Scales for the Assessment of Pain of Dentin Hypersensitivity

Aims: To develop and test labeled magnitude (LM) scales that are sensitive to variations in pain associated with dentin hypersensitivity (DH). Methods: Qualitative methods were used first to obtain words that describe the pain of DH. Magnitude estimation was then used to determine the position of these descriptive terms by relative magnitude along four vertical LM scales. To assess their DH, patients used the four LM scales following dentin stimulation with 4°C and 25°C water. The LM scales were then compared to visual analog scale (VAS) ratings by using eight pain scenarios of varying severity. Finally, participants with DH completed the four horizontal LM scales and VAS after dentin stimulation with 4°C and 25°C water. Within-subject t tests were used for comparisons between scales and water temperatures, and between-subject t tests were used for comparisons between participants with and without DH. Results: Participants showed comparable differentiation between 4°C and 25°C water on VAS and three of the LM scale measures. Responses on the fourth LM scale showed better differentiation than VAS between the two water temperatures. Participants used a greater portion of the LM scales than VAS when rating low-level pain scenarios. Conclusion: LM scales were shown to provide some advantages compared to standard VAS when used to evaluate DH-associated pain. These advantages may be generalized to other low-level pain conditions.

dentin hypersensitivity; labeled magnitude scales; pain assessment

1. Beecher HK. The subjective response and reaction to sensation; The reaction phase as the effective site for drug action. Am J Med 1956 Jan;20:107–113.

2. Merskey H, Bogduk N (eds). Classification of Chronic Pain: Description of Chronic Pain Syndromes and Definitions of Pain Terms. Seattle: IASP Press, 1994.

3. Heft MW, Parker SR. An experimental basis for revising the graphic rating scale for pain. Pain 1984;19:153–161.

4. Gracely RH, McGrath F, Dubner R. Ratio scales of sensory and affective verbal pain descriptors. Pain 1978;5:5–18.

5. Heft MW, Gracely RH, Dubner R, McGrath PA. A validation model for verbal description scaling of human clinical pain. Pain 1980;9:363–373.

6. Green BG, Shaffer GS, Gilmore MM. Derivation and evaluation of a semantic scale of oral sensation magnitude with apparent ratio properties. Chem Senses 1993;18:683–702.

7. Halcomb EJ, Gholizadeh L, DiGiacomo M, Phillips J, Davidson PM. Literature review: Considerations in undertaking focus group research with culturally and linguistically diverse groups. J Clin Nurs 2007;16:1000–1011.

8. Heaton LJ, Garcia LJ, Gledhill LW, Beesley KA, Coldwell SE. Development and validation of the Spanish Interval Scale of Anxiety Response (ISAR). Anesth Prog 2007;54:100–108.

9. Breivik EK, Skoglund LA. Comparison of present pain intensity assessments on horizontally and vertically oriented visual analogue scales. Methods Find Exp Clin Pharmacol 1998;20:719–724.

10. Gagliese L, Weizblit N, Ellis W, Chan VW. The measurement of postoperative pain: A comparison of intensity scales in younger and older surgical patients. Pain 2005;117:412–420.

11. Gracely RH, Dubner R. Reliability and validity of verbal descriptor scales of painfulness. Pain 1987;29:175–185.

12. Ljunggren AE, Strand LI, Johnsen TB. Development of the Norwegian Short-Form McGill Pain Questionnaire (NSF-MPQ). Adv Physiotherapy 2007;9:169–180.

13. Melzack R. The short-form McGill Pain Questionnaire. Pain 1987;30:191–197.

14. Grushka M, Sessle BJ. Applicability of the McGill Pain Questionnaire to the differentiation of ‘toothache’ pain. Pain 1984;19:49–57.

15. Melzack R. The McGill Pain Questionnaire. In: Pain Measurement and Assessment. New York: Raven Press, 1983: 41–48.