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Galdino FF, Bendo CB, Fidalgo TKDS. Acceptability of dental students and professionals concerning child behaviour management techniques: Systematic review. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024. [PMID: 38733094 DOI: 10.1111/eje.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/15/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION During child dental treatment, different behavior management techniques (BMTs) are applied and it is important to understand the possible discomfort in the operator. OBJECTIVE The present systematic review aimed to evaluate the acceptability of dental students and professionals concerning BMTs applied with paediatric dentistry patients. MATERIALS AND METHODS A systematic search was conducted, following the PEOS strategy: Population (P) - dental students/professionals (S); Exposure (E) - BMTs preconized by the American Academy of Paediatric Dentistry, Outcome (O) - proportion of BMT acceptance; and Study design (S) - observational studies based on data from PubMed, Scopus, Web of Science, BVS (Lilacs/BBO), Cochrane, and Open Grey databases up to September 2021. The eligible studies were submitted to data extraction and to the evaluation of methodological quality, using the Joanna Briggs Institute Critical Appraisal Tool. The certainty of evidence was evaluated by GRADE. RESULTS The search retrieved 710 articles; a total of 21 fulfilled the eligibility criteria and were used for qualitative analysis. Among the undergraduate students and dentists, the most accepted techniques were tell-show-do and positive reinforcement, while paediatric dentists preferred the tell-show-do technique and dental professionals with graduate degrees preferred sedation using nitrous oxide and positive reinforcement. The least accepted technique was protective stabilization. Seven students presented a low risk for bias, while 14 presented a high risk. The certainty of evidence was classified as very low. CONCLUSION Although the basis of available certainty of evidence is scarce and with a considerable risk for bias, it is still possible to conclude that the more accepted techniques were based on communication.
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Affiliation(s)
- Fabíola Fontes Galdino
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane Baccin Bendo
- Departament of Children and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Del Carmen MDC, Cagigas-Muñiz D, García-Robles R, Oprescu AM. Reducing Dental Anxiety in Children Using a Mobile Health App: Usability and User Experience Study. JMIR Form Res 2023; 7:e30443. [PMID: 37889521 PMCID: PMC10638634 DOI: 10.2196/30443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/11/2021] [Accepted: 09/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dentistry interventions cause common anxiety and fear problems in children (6-11 years), and according to scientific evidence, this causes a decrease in their quality of life. Therapies mediated by IT-based tools have been shown to positively influence children's mood based on distraction as well as relaxing activities, but there is no evidence of their use to reduce dental anxiety in children. OBJECTIVE The aim of this study was to answer the following research question: Does our new children-centered codesign methodology contribute to achieving a usable mobile-based product with a highly scored user experience? METHODS A mobile health app was developed to reduce dental anxiety in children using rapid application development following the usage-centered design methodology. Structured interviews were conducted to test the usability and user experience of the app prototype among 40 children (n=20, 50%, boys and n=20, 50%, girls; age 6-11 years) using a children-adapted questionnaire and the 7-point Single Ease Question rating scale. The Smiley Faces Program-Revised questionnaire was used to assess the level of dental anxiety in participants. RESULTS There were no significant differences between girls and boys. The task completion rate was 95% (n=19) for children aged 6-8 years (group 1) and 100% (n=20) for children aged 9-11 years (group 2). Group 1 found watching the relaxing video (task C) to be the easiest, followed by playing a video minigame (task B) and watching the narrative (task A). Group 2 found task C to be the easiest, followed by task A and then task B. The average time spent on the different types of tasks was similar in both age groups. Most of the children in both age groups were happy with the app and found it funny. All children thought that having the app in the waiting room during a dental visit would be useful. CONCLUSIONS The findings confirmed that the app is usable and provides an excellent user experience. Our children-adapted methodology contributes to achieving usable mobile-based products for children with a highly scored user experience.
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Affiliation(s)
| | - Daniel Cagigas-Muñiz
- Department of Architecture and Computer Technology, Universidad de Sevilla, Sevilla, Spain
| | - Rocío García-Robles
- Department of Architecture and Computer Technology, Universidad de Sevilla, Sevilla, Spain
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Participant Observation to Apply an Empirical Method of Codesign with Children. ADVANCES IN HUMAN-COMPUTER INTERACTION 2022. [DOI: 10.1155/2022/1101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dental anxiety in children is a well-documented problem in the scientific literature. Tools mediated by Information Technology have been shown to positively influence children’s mood based on distraction as well as relaxing activities. We propose an empirical method of codesign with children to generate app content for reducing dental anxiety. The results are embedded in text through a thick description as an ethnographic technique. The method was applied to 163 children (6–8 years old) from a summer school and a primary school, obtaining multimedia products that were integrated into an app prototype. Finally, although this use case of the presented method is applied to the health field, it can be transferred to any other field of application of codesign to children by using material that is specific to new scenarios.
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Rienhoff S, Splieth CH, Veerkamp JSJ, Rienhoff J, Krikken JB, Campus G, Wolf TG. Hypnosis and Sedation for Anxious Children Undergoing Dental Treatment: A Retrospective Practice-Based Longitudinal Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050611. [PMID: 35626788 PMCID: PMC9139918 DOI: 10.3390/children9050611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 12/11/2022]
Abstract
To assess whether the treatment of children with oral midazolam and pediatric hypnosis techniques can improve the compliance in consecutive sessions, a retrospective longitudinal practice-based observational study was designed and carried out. A total of 311 children between 3 and 12 years of age were treated under hypnosis and sedation with midazolam (0.40 mg/kg body weight). Treatments were performed in one to a maximum of three sessions. A total of 183 children received one, 103 received two and 25 children received three treatment sessions. The behavior of the children during the sessions was examined by means of the Venham score. The self-evaluation of the children was based on the Wong−Baker Scale. Child behavior using midazolam and hypnosis techniques showed little difference and good compliance between the sessions. Venham scores did not increase significantly regarding total treatment from the first (0.99 ± 1.41) to the second (1.17 ± 1.39) and to the third session (1.27 ± 1.20) (p > 0.05). However, considering the highest Venham scores that occurred in each case, the behavior of the children worsened significantly (p < 0.01) during the three treatment sessions, from 1.37 ± 1.31 (first) to 1.87 ± 1.74 (second) to 2.32 ± 1.33 (third). In 6.11% of the children, treatment was discontinued in the first session (n = 19), 0.96% in the second (n = 3) and 0% in the third. Treatment with low-dose midazolam, combined with hypnosis techniques, showed to be an effective option for dental treatment in children. Within the limitations of the current study, and with consideration of highest possible compliance, no more than two treatment sessions for pediatric dental treatment should be performed.
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Affiliation(s)
- Sabine Rienhoff
- Pediatric Dental Practice, D-30177 Hannover, Germany; (S.R.); (J.R.)
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, Center for Oral Health, Ernst Moritz Arndt University Greifswald, D-17475 Greifswald, Germany;
| | | | - Jan Rienhoff
- Pediatric Dental Practice, D-30177 Hannover, Germany; (S.R.); (J.R.)
| | - Janneke B. Krikken
- Snoet Kindermondzorgcentrum, Pediatric Dental Practice, NL-1061 Amsterdam, The Netherlands;
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, I-07100 Sassari, Italy
- Correspondence: ; Tel.: +41-31-632-2580
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, D-55131 Mainz, Germany
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Aarvik RS, Agdal ML, Svendsen EJ. Restraint in paediatric dentistry: a qualitative study to explore perspectives among public, non-specialist dentists in Norway. Acta Odontol Scand 2021; 79:443-450. [PMID: 33587861 DOI: 10.1080/00016357.2021.1881159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to explore the perspectives of non-specialist dentists on the use of restraint in paediatric dentistry in the Public Dental Service in Norway. MATERIALS AND METHOD Two focus group interviews involving four and five dentists, respectively, were conducted in one of the most populated counties in Norway in September 2019. The thematic analysis by Braun and Clarke informed the qualitative analysis. RESULTS According to the dentists, physical restraint in paediatric dentistry is usually used when dental treatment is absolutely necessary. The qualitative analysis revealed the following three main themes: (1) some dentists justify the use of restraint in paediatric dentistry; (2) physical restraint is often legitimised by the fact that the child is sedated; (3) the use of restraint evokes difficult ethical evaluations. Additionally, the dentists had an overarching perspective of acting in the child's best interest, but they sometimes struggled to find a justifiable path in situations involving restraint. CONCLUSIONS Dentists seem to consider the use of restraint combined with sedation as legitimate for absolute necessary dental treatment. Furthermore, the use of restraint involves difficult ethical evaluations.
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Affiliation(s)
- Regina Skavhellen Aarvik
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Gómez-Polo C, Vilches AA, Ribas D, Castaño-Séiquer A, Montero J. Behaviour and Anxiety Management of Paediatric Dental Patients through Virtual Reality: A Randomised Clinical Trial. J Clin Med 2021; 10:3019. [PMID: 34300185 PMCID: PMC8304330 DOI: 10.3390/jcm10143019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/30/2022] Open
Abstract
Clinicians should appreciate the effectiveness of virtual reality (VR) headsets for managing both the anxiety and the behaviour of non-cooperative paediatric patients who require treatment over several dental appointments. The aim of this study was to assess the effectiveness of using a VR headset as a distraction for managing the anxiety and behaviour of paediatric patients during their dental treatment. Eighty patients, aged between five and ten years old and who required dental treatment over three or more appointments, were randomly allocated into two groups. One group used a VR headset during all their appointments, and the other one did not use any distraction technique. The patients were asked to take a Facial Image Scale Test during their first and last appointments to assess their level of anxiety. Additionally, the dentist completed the Frankl Test to quantify the child's behaviour at the beginning and the end of their treatment. The results obtained, both from the group using the VR headset and from the control group, were compared using the chi-square test. The use of a VR headset during dental treatment significantly reduced anxiety (95% of the children were happy) and improved behaviour (100% positive behaviour) as compared with the control group (40% and 57.5%, respectively). A VR headset can effectively distract a paediatric patient, helping to reduce anxiety and manage behaviour during dental treatment.
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Affiliation(s)
- Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | | | - David Ribas
- Department of Stomatology, Faculty of Dentistry, University of Seville, Calle Avicena S/N, 41009 Seville, Spain; (D.R.); (A.C.-S.)
| | - Antonio Castaño-Séiquer
- Department of Stomatology, Faculty of Dentistry, University of Seville, Calle Avicena S/N, 41009 Seville, Spain; (D.R.); (A.C.-S.)
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
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Hauge MS, Stora B, Vassend O, Hoffart A, Willumsen T. Dentist-administered cognitive behavioural therapy versus four habits/midazolam: An RCT study of dental anxiety treatment in primary dental care. Eur J Oral Sci 2021; 129:e12794. [PMID: 33960536 DOI: 10.1111/eos.12794] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/01/2021] [Indexed: 01/07/2023]
Abstract
The study aimed to test the effectiveness of cognitive behavioural therapy (CBT) administered by a general dental practitioner (GDP) in a general dental practice. In a two-arm parallel randomised controlled trial, the experimental group received a short dentist-administered CBT-intervention (D-CBT). A best-practice control group (FHM) received dental treatment during sedation with midazolam combined with an evidence-based communication model (The Four Habits Model). Ninety-six patients with self-reported dental anxiety were allocated to the treatment arms at a 1:1 ratio. Modified Dental Anxiety Scale (MDAS) scores spanned from 12 to 25, and 82 patients (85%) had a score of 19 or more, indicating severe dental anxiety. In both treatment arms, scores on MDAS and Index of Dental Anxiety and Fear (IDAF-4C) decreased significantly, but no differences were found between treatment arms. Mean reductions were: MDAS scores: -6.6 (SD = 0.5); IDAF-4C scores: -1.0 (SD = 1.1). In conclusion, local GDPs in general dental practices with proper competence have the ability for early detection of dental anxiety and, with the use of a manual-based D-CBT or FHM treatment, GDPs could offer efficient first-line treatment suitable for dental anxiety of varying severities.
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Affiliation(s)
- Mariann Saanum Hauge
- Faculty of Dentistry, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise, Stavanger, Norway
| | - Bent Stora
- Oral Health Services Agder, Kristiansand, Norway
| | - Olav Vassend
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Institute, Modum Bad Psychiatric Hospital, Vikersund, Norway
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Costa LR, Bendo CB, Daher A, Heidari E, Rocha RS, Moreira APDSC, Moura LS, Banerjee A, Newton JT, Hosey MT. A curriculum for behaviour and oral healthcare management for dentally anxious children-Recommendations from the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE). Int J Paediatr Dent 2020; 30:556-569. [PMID: 32112461 DOI: 10.1111/ipd.12635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/11/2020] [Accepted: 02/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Dentists need training in the management of children's anxiety (DA), fear (DF) and behaviour management problems (DBMP) but little is known of their competence on this topic. AIM To report dentists' opinions and attitudes about protective stabilisation and pharmacological techniques for the management of children with DA/DF/DBMP; to propose a postgraduate curriculum focussing on DA/DF/DBMP. DESIGN A survey of 301 Brazilian dentists and later a modified Delphi process to outline the curriculum in two phases: (a) face-to-face discussions with 33 early career researchers mentored by six researchers, both from UK and Brazil; (b) online discussions by eight early and senior researchers on the knowledge, experience, and competencies necessary for a specialist in paediatric dentistry in Brazil that should be included in the core curriculum of postgraduate courses. RESULTS Almost all (99.0%) of the survey respondents provide treatment to children with DA/DF/DBMP, and 91.2% do not systematically diagnose these conditions; 94.3% use protective stabilisation, and 20.0%-30.0% have training in pharmacological techniques. The four-domain framework supporting the proposed curriculum is as follows: DA/DF/DBMP assessment, non-pharmacological and pharmacological approaches, and decision-making. CONCLUSION Dental curricula should be customised to solve the misconceptions and promote a comprehensive and positive attitude to DA/DF/DBMP by paediatric oral healthcare practitioners.
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Affiliation(s)
- Luciane R Costa
- Paediatric Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Cristiane B Bendo
- Department of Children's and Adolescents' Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Anelise Daher
- Paediatric Dentist, Brazilian Dental Association - Goiás section, Goiânia, Brazil
| | - Ellie Heidari
- Department of Sedation and Special Care Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - Renata Sá Rocha
- Faculty of Dentistry, Universidade Federal de Campina Grande, Patos, Brazil
| | | | | | - Avijit Banerjee
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - J Tim Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Marie T Hosey
- Paediatric Dentistry Centre of Oral Clinical and Translational Science, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Zhu M, Yu H, Xie B, Li H, He Q, Li H, Su J, Li X. Experiential learning for children's dental anxiety: a cluster randomized trial. BMC Oral Health 2020; 20:216. [PMID: 32736555 PMCID: PMC7395402 DOI: 10.1186/s12903-020-01204-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/23/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children's oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA. METHODS In September 2018, we recruited 988 children aged 7-8 years from 24 classes to participate in a cluster-randomized trial. Classes were randomly assigned to EL (in which children received a lively presentation on oral health and participated in a role play in a simulated dental clinic in the classroom) or the Tell-Show-Do (TSD) group (in which children received a conventional TSD behavior management). The primary outcome was the prevalence of high DA after the procedure of pit and fissure sealant (PFS), assessed by a modified Children's Fear Survey Schedule-Dental Subscale. Secondary outcomes were changes in blood pressures (BP) and pulse rates (PR) before and after the PFS procedure. The intervention effects were estimated by means of mixed effect models, which included covariates of gender and school (and baseline value for BP and PR only), and a random cluster effect. RESULTS In 396 children of the EL group who received the PFS treatment, the prevalence of high DA (score ≥ 38) was 18.5%, compared with 24.3% in 391 children of the TSD group (OR = 0.65; 95% confidence interval, 0.46-0.93; P = 0.019). The increases in BP and PR after the PFS were also significantly less in the EL group. CONCLUSION School-based experiential learning intervention before a dental visit is feasible and effective in reducing children's dental anxiety during PFS. TRIAL REGISTRATION The trial was registered in Chinese Clinical Trial Registry on 5 January 2020 (No.: ChiCTR2000028878 , retrospectively registered).
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Affiliation(s)
- Minmin Zhu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
| | - Hongbing Yu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Bo Xie
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Hongwen Li
- Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen, 518054, China
| | - Qian He
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Huimin Li
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Jing Su
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Xueqi Li
- Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen, 518054, China.
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Abstract
Objective: To estimate the prevalence of dental anxiety, and to explore factors that may increase the risk of reporting dental anxiety among 18-year-old Norwegians in 2016. A further objective was to report changes in dental anxiety since 1996.Material and methods: An anonymous survey from a strategic sample of upper secondary students (n = 351) in 2016 with high response rate (93%) was compared with the results of an investigation of a similar population conducted in 1996.Results: The prevalence of dental anxiety and dental distrust was reduced from 1996 to 2016. Dental Fear Survey (DFS) from 19 to 8% (p < .001), and Dental Belief Survey (DBS) from 15 to 6% (p < .001). Geer Fear Scale (GFS) which measure phobic anxiety did not show a similar reduction (17 versus 15%, p = .37). Phobic anxiety, avoidance behaviour, self-reported poor oral health and previous experiences of pain were all associated with dental anxiety.Conclusion: The prevalence of dental anxiety was reduced from 1996 to 2016, but 8% still report dental anxiety. Proper pain management and use of behavioural management techniques still needs to be highlighted to prevent development of dental anxiety, avoidance behaviour and poor oral health.
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Affiliation(s)
- Kjetil Strøm
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Anne B. Skaare
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Dental anxiety in first- and final-year Indian dental students. BDJ Open 2019; 5:15. [PMID: 31632694 PMCID: PMC6795851 DOI: 10.1038/s41405-019-0017-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives The study aims to investigate dental anxiety in first- and final-year undergraduate dental students in India. Design Questionnaire Study Setting: BDS Students in four University dental colleges in India carried-out during 2013 and 2014. Subjects (materials and methods) The students (n = 614) were assessed using a pre-tested questionnaire. We estimated the level of dental anxiety by using the Modified-Dental-Anxiety-Scale (MDAS). ANCOVA and Mann–Whitney U, and Chi-squared contingency tests were employed to analyze the extensive dataset acquired. Univariate clustering analysis and principal component regression were also applied. Students had similar demographic and lifestyle patterns. Interventions Assessments of the level of dental anxiety amongst undergraduate dental students. Main outcome measures Mean ± SD MDAS scores for first- and final-year Bachelor of Dental Surgery (BDS) students were 12.96 ± 4.00 and 10.54 ± 3.41, respectively. Results Six hundred and fourteen (n = 614) students from four dental colleges were included in this study. In total 77% were female (n = 478) and 23% were male (n = 136). The mean age of the first- and final-year students were 18.31 and 21.54 years, respectively. First-year BDS students had dental anxiety score (Mean ± SD 12.96 ± 4.00) compared to that of the final year (10.54 ± 3.41), a difference which was very highly statistically significant (p < 0.0001). Conclusion(s) Dental anxiety was moderately higher amongst first year BDS students over that of final-year students but it is lesser than the dental phobic threshold level.
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12
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Grindefjord M, Persson J, Jansson L, Tsilingaridis G. Dental treatment and caries prevention preceding treatment under general anaesthesia in healthy children and adolescents: a retrospective cohort study. Eur Arch Paediatr Dent 2018; 19:99-105. [PMID: 29480502 PMCID: PMC5893663 DOI: 10.1007/s40368-018-0332-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/19/2017] [Indexed: 12/29/2022]
Abstract
AIM This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007. Data was extracted from the patient records at the PDS, including variables such as number of dental visits, treatment/prophylaxis prior to GA, number of missed and cancelled appointments, and number of decayed teeth. RESULTS On average, the treatment group had significantly more decayed teeth (p < 0.001) than the control group. Furthermore, the treatment group had significantly more restorations (p < 0.01), had visited the dentist significantly more often (p < 0.001), and had undergone significantly more behaviour management treatment and preventive treatment (p < 0.001). In the treatment group 65% of the children and adolescents, had received no behaviour management treatment and 48%, no preventive treatment. CONCLUSIONS In the Stockholm PDS, over half of the children and adolescents referred by general dentists to paediatric specialists had no behaviour management treatment and nearly half, no preventive treatment, despite receiving significantly more operative treatment compared with matched controls. General dentists should target high caries-risk patients for additional behaviour management and preventive care to reduce the need for treatment under GA.
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Affiliation(s)
- M Grindefjord
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - J Persson
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - L Jansson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Periodontology, Public Dental Health Services, Eastmaninstitutet, Stockholm, Sweden
| | - G Tsilingaridis
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden. .,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Center of Pediatric Oral Health, Stockholm, Sweden.
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13
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Variation in caries treatment proposals among dentists in Norway: the best interest of the child. Eur Arch Paediatr Dent 2017; 18:345-353. [DOI: 10.1007/s40368-017-0298-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 07/10/2017] [Indexed: 02/06/2023]
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14
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Berge KG, Agdal ML, Vika M, Skeie MS. Treatment of intra-oral injection phobia: a randomized delayed intervention controlled trial among Norwegian 10- to 16-year-olds. Acta Odontol Scand 2017; 75:294-301. [PMID: 28270029 DOI: 10.1080/00016357.2017.1297849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the effect of five sessions of cognitive behavioural therapy (CBT) for 10- to 16-year-olds with intra-oral injection phobia. MATERIAL AND METHODS This was a randomized delayed intervention controlled trial in 67 patients, fulfilling the DSM-5 criteria for specific phobia. All patients received the same CBT performed by dentists specially trained in CBT. The patients were randomly assigned to either an immediate treatment group (ITG) (34 patients) or a waitlist-control group (WCG) (33 patients). The WCG was put on a waitlist for 5 weeks. After treatment, all patients were combined for post-treatment analyses. Assessments including the psychometric self-report scales Intra-oral injection fear scale (IOIF-s), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Injection Phobia Scale for children (IS-c) and Mutilation Questionnaire for children (MQ-c) and a behavioural avoidance test (BAT) followed by a questionnaire on cognitions during the BAT, occurred pre-, post-treatment/waitlist and at a 1-year follow-up. RESULTS CBT had a significant effect compared to no treatment (WCG). After treatment, the scores on the psychometric self-report scales were significantly reduced and higher levels in the BAT were achieved. The results were maintained at 1-year follow-up. Of the 67 patients, 70.1% received intra-oral injections during CBT treatment, whereas 69.4% of those completing the CBT, in need for further dental treatment, managed to receive the necessary intra-oral injections at their regular dentist. CONCLUSIONS The 10- to 16-year-olds diagnosed with intra-oral injection phobia benefitted positively on CBT performed by specially trained dentists.
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Affiliation(s)
- Karin G. Berge
- Oral Health Centre of Expertise in Western Norway, Hordaland, Bergen, Norway
- Department of Clinical Dentistry Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Maren Lillehaug Agdal
- Oral Health Centre of Expertise in Western Norway, Hordaland, Bergen, Norway
- Department of Clinical Dentistry Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Margrethe Vika
- Oral Health Centre of Expertise in Western Norway, Hordaland, Bergen, Norway
- Department of Clinical Dentistry Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Williams KA, Lambaria S, Askounes S. Assessing the Attitudes and Clinical Practices of Ohio Dentists Treating Patients with Dental Anxiety. Dent J (Basel) 2016; 4:dj4040033. [PMID: 29563475 PMCID: PMC5806958 DOI: 10.3390/dj4040033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/16/2016] [Accepted: 09/07/2016] [Indexed: 11/16/2022] Open
Abstract
Dental anxiety (DA) negatively affects patients' oral and overall health. This study explored attitudes and clinical practices of licensed Ohio general dentists who treat patients with DA. Methods: An anonymous self-administered mail survey was sent to 500 general dentists licensed and practicing in Ohio. Responses to 21 pre-coded questions were analyzed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer's Exact Test were calculated for statements according to dentists' gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found nitrous oxide to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Ohio general dentists are most familiar with using distraction and nitrous oxide during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with DA. PRACTICE IMPLICATIONS By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with DA may be reduced.
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Affiliation(s)
- Kristin A Williams
- School of Dental Medicine, Department of Community Dentistry, Case Western Reserve University, 2124 Cornell Road, Cleveland, OH 44106, USA.
| | - Sarah Lambaria
- School of Dental Medicine, Department of Community Dentistry, Case Western Reserve University, 2124 Cornell Road, Cleveland, OH 44106, USA.
| | - Sara Askounes
- School of Dental Medicine, Department of Community Dentistry, Case Western Reserve University, 2124 Cornell Road, Cleveland, OH 44106, USA.
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16
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Kawia HM, Mbawalla HS, Kahabuka FK. Application of Behavior Management Techniques for Paediatric Dental Patients by Tanzanian Dental Practitioners. Open Dent J 2015; 9:455-61. [PMID: 26962374 PMCID: PMC4768663 DOI: 10.2174/1874210601509010455] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/30/2015] [Accepted: 10/31/2015] [Indexed: 12/12/2022] Open
Abstract
Background: Management of children’s behavior is an integral component of pediatric dental practice. Objective: To investigate the oral health care providers’ awareness, use and factors for choice of behavior management techniques when attending paediatric dental patients. Methods: A cross-sectional study among dental practitioners in Dar es Salaam, Tanzania. Data collection was done through interview using a structured questionnaire. The recorded information included: awareness and application of behavior management techniques (BMT) when attending a child dental patient, factors influencing choice of a particular technique, socio-demographics, level of professional training, working experience and facility profile. Using SPSS program version 18, frequency distributions and cross tabulations analyses were performed. Results: 74 dental practitioners participated in the study, of whom 49 (66.2%) were males and 44 (59.5%) were graduates. Most participants were aware of the behavior management techniques, ranging from 100% for Tell-Show-Do to 86% for distraction. A small proportion (9.5%) reported to have adequate skills, all of them were graduates. The use of universally accepted BMTs was reported by 65% of experienced practitioners, 61% of graduates, 59% of those reporting to have received formal training and all of those reporting to have fair/inadequate skills to apply BMTs (p= 0.01). Conclusion: Most participants were aware of BMTs, although few acknowledged having adequate skills to apply the techniques. They use BMTs during treatment of paediatric dental patients and their choice of the technique is mainly influenced by children’s factors.
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Affiliation(s)
- Hassan Mohamed Kawia
- Department of Orthodontics, Paedodontics and Preventive Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65014, Dar es Salaam, Tanzania
| | - Hawa Shariff Mbawalla
- Department of Orthodontics, Paedodontics and Preventive Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65014, Dar es Salaam, Tanzania
| | - Febronia Kokulengya Kahabuka
- Department of Orthodontics, Paedodontics and Preventive Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65014, Dar es Salaam, Tanzania
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