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Mac Giolla Phadraig C, Healy O, Fisal AA, Yarascavitch C, van Harten M, Nunn J, Newton T, Sturmey P, Asimakopoulou K, Daly B, Hosey MT, Kammer PV, Dougall A, Geddis-Regan A, Pradhan A, Setiawan AS, Kerr B, Friedman CS, Cornelius BW, Stirling C, Hamzah SZ, Decloux D, Molina G, Klingberg G, Ayup H, Buchanan H, Anjou H, Maura I, Bernal Fernandez IR, Limeres Posse J, Hare J, Francis J, Norderyd J, Rohani MM, Prabhu N, Ashley PF, Marques PF, Chopra S, Pani SC, Krämer S. Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management. Community Dent Oral Epidemiol 2024; 52:550-571. [PMID: 38516782 DOI: 10.1111/cdoe.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. METHODS Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. RESULTS The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. DISCUSSION Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.
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Affiliation(s)
| | - Olive Healy
- Trinity College Dublin, Lincoln Place Dublin 2, Ireland
| | | | | | - Maria van Harten
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | - June Nunn
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | - Peter Sturmey
- The Graduate Center and Queens College, City University of New York, New York, USA
| | | | - Blánaid Daly
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | | | - Alison Dougall
- School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
| | | | - Archana Pradhan
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, Australia
| | - Arlette Suzy Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Bryan Kerr
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Clive S Friedman
- Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | | | | | | | | | - Gustavo Molina
- Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Cordoba, Argentina
| | - Gunilla Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Hani Ayup
- Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
| | | | - Helena Anjou
- Department of Paediatric Dentistry, National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | | | | | | | - Jennifer Hare
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jessica Francis
- Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Johanna Norderyd
- The Institute for Postgraduate Dental Education, Jönköping and CHILD research group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Neeta Prabhu
- The University of Sydney, School of Dentistry, Faculty of Medicine and Health AND Westmead Centre for Oral Health | Western Sydney Local Health District, Surry Hills, Australia
| | | | - Paula Faria Marques
- Faculdade de Medicina Dentária, Unidade Odontopediatria, Universidade de Lisboa, Lisboa, Portugal
| | - Shalini Chopra
- Berkshire Community Dental Service, Skimped Hill Health Centre, Berkshire, UK
| | - Sharat Chandra Pani
- Faculty of Dentistry, University of British Columbia B.C. Children's Hospital, Vancouver, British Columbia, Canada
| | - Susanne Krämer
- Facultad de Odontología, Universidad de Chile, Santiago, Chile
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Alzubaidi MA, Drummond BK, Wu J, Jones A, Aggarwal VR. Interventions to Reduce Intra-Operative and Post-Operative Pain Associated with Routine Dental Procedures in Children: A Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:163. [PMID: 38920864 PMCID: PMC11202832 DOI: 10.3390/dj12060163] [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: 04/09/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE implementing appropriate pharmacological and non-pharmacological interventions to alleviate pain related to routine dental procedures in paediatric patients could enhance children's ability to manage dental care. The aim of this review was to investigate the effectiveness of and provide recommendations for interventions that can be used to reduce intra-operative and post-operative pain associated with routine paediatric dental procedures. METHODS A systematic review of randomised controlled clinical trials (RCT) was conducted. Multiple electronic databases were systematically searched. The Cochrane risk-of-bias tool for RCTs was used to evaluate the quality of the included studies. A meta-analysis was performed to determine the effectiveness of the interventions using the Cohen's d standardised mean differences (SMD) and 95% confidence intervals (CIs) for continuous outcomes. The GRADE tool was used to assess the certainty of evidence to make recommendations. RESULTS The review included forty-five RCTs comprising 3093 children. Thirty-seven RCTs were included in the meta-analysis, which showed the effectiveness of behavioural interventions (SMD = -0.50, 95% CI -0.83 to -0.18), mechanoreceptor and thermal receptor stimulation (SMD = -1.38, 95% CI -2.02 to -0.73) for intra-operative pain, and pre-emptive oral analgesics (SMD = -0.77, 95% CI -1.21 to -0.33) for reducing post-operative pain in children receiving routine dental care. CONCLUSION The GRADE results for these interventions were strong recommendation (IB) for their use, based on moderate evidence and their benefits far outweighing the harm, and they can be delivered readily with minimal training to reduce the pain experience of paediatric patients.
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Affiliation(s)
- Mohammed A. Alzubaidi
- Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia;
| | - Bernadette K. Drummond
- Faculty of Medicine & Health, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (B.K.D.); (J.W.); (A.J.)
| | - Jianhua Wu
- Faculty of Medicine & Health, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (B.K.D.); (J.W.); (A.J.)
- Wolfson Institute of Population Health, Queen Mary University of London, London E1 4NS, UK
| | - Adam Jones
- Faculty of Medicine & Health, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (B.K.D.); (J.W.); (A.J.)
| | - Vishal R. Aggarwal
- Faculty of Medicine & Health, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (B.K.D.); (J.W.); (A.J.)
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Teichfischer J, Weber R, Kaiser E, Poryo M, Weise JJ, Nisius A, Meyer S. SimSAARlabim study - The role magic tricks play in reducing pain and stress in children. Vaccine 2024; 42:2572-2577. [PMID: 38472068 DOI: 10.1016/j.vaccine.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/03/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Vaccination is an essential preventative medical intervention, but needle fearandinjection painmay result in vaccination hesistancy. STUDY PURPOSE To assess the role of magic tricks - no trick vs. one trick ("disappearing handkerchief trick") vs. three tricks ("disappearing handkerchief trick", "jumping rubber band trick", and "disappearing ring trick") - performed by a professional magician and pediatrician during routine vaccination in reducing discomfort/pain and the stress response (heart rate, visual analogue scale (VAS), and biomarkers (cortisol, Immunoglobulin A (IgA), α-amylase, and overall protein concentration in saliva before and after vaccination). PATIENTS AND METHODS Randomized controlled trial (RCT) in healthy children aged 6-11 years undergoing routine vaccination in an outpatient setting. RESULTS 50 children (26 female) were enrolled (no trick: n = 17, 1 trick: n = 16, 3 tricks: n = 17) with a median age of 6.9 years (range: 5.3-10.8 years). We detected no significant differences among the three groups in their stress reponse (heart rate before and after vaccination and cortisol, IgA, α-amylase, and overall protein concentrations in saliva before and after vaccination) or regarding pain assessment using the VAS. CONCLUSIONS Although children undergoing routine outpatient vaccination appeared to enjoy a magician's presence, the concomitant performance of magic tricks revealed no significant effect on the stress response.
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Affiliation(s)
| | - Regine Weber
- Saarland University Medical Center, Department of General Pediatrics and Neonatology, Homburg, Germany
| | - Elisabeth Kaiser
- Saarland University Medical Center, Department of General Pediatrics and Neonatology, Homburg, Germany
| | - Martin Poryo
- Saarland University Medical Center, Department of Pediatrics Cardiology, Homburg, Germany
| | - Julius Johannes Weise
- Saarland University Medical Center, Institute for Medical Biometry, Epidemiology and Medical Informatics, Homburg, Saar, Germany
| | - Alexander Nisius
- Praxis für Kinderheilunde und Jugendmedizin, Neunkirchen, Germany
| | - Sascha Meyer
- Saarland University Medical Center, Department of General Pediatrics and Neonatology, Homburg, Germany; Franz-Lust Klinik für Kinder und Jugendliche, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
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Brum VDS, Borges MLV, Santos NMD, Kaufmann C, Rodrigues JDA. The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial. Braz Oral Res 2024; 38:e009. [PMID: 38198308 DOI: 10.1590/1807-3107bor-2024.vol38.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 01/12/2024] Open
Abstract
This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.
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Affiliation(s)
- Vanessa Dos Santos Brum
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Maria Luiza Vieira Borges
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Nicole Marchioro Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Camila Kaufmann
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Jonas de Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
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Quail KR, Ward CL. Using Non-Violent Discipline Tools: Evidence Suggesting the Importance of Attunement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7187. [PMID: 38131738 PMCID: PMC10742770 DOI: 10.3390/ijerph20247187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Training in non-violent discipline is important to prevent violence against children and ensure that their caregivers remain a safe base for them. This paper aims to deepen understanding of non-violent discipline by exploring attunement as a mechanism in the effectiveness of non-violent discipline tools. Attunement describes the sensitive responsiveness of caregivers towards their children and has been found to be central to the formation of secure attachment bonds and development of self-regulation. It includes understanding or being "in tune with" the child's needs and signals, matching these with appropriate responses. The objective of this paper is to explore attunement in relation to non-violent discipline. Peer-reviewed systematic reviews previously included in a systematic overview of evidence on non-violent discipline options were screened for information relevant to attunement. All reviews were published in English between 1999 and 2018 and offered evidence on at least one non-violent discipline tool. Although no reviews explicitly addressed attunement, evidence was found suggesting its importance in the use and effectiveness of discipline methods. Research directly investigating attunement in discipline is needed.
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Affiliation(s)
- Karen R. Quail
- Department of Psychology, Faculty of Humanities, University of Cape Town, Cape Town 7700, South Africa;
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Mac Giolla Phadraig C, Kammer PV, Asimakopoulou K, Healy O, Fleischmann I, Buchanan H, Newton JT, Daly B, Posse JL, Hosey MT, Yarascavitch C, MacAuley Y, Stirling C, Ahmad Fisal AB, Nunn J. Labels and descriptions of dental behaviour support techniques: A scoping review of clinical practice guidelines. Community Dent Oral Epidemiol 2023; 51:1065-1077. [PMID: 37368479 DOI: 10.1111/cdoe.12890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/15/2023] [Accepted: 06/11/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION There is no agreed taxonomy of the techniques used to support patients to receive professional oral healthcare. This lack of specification leads to imprecision in describing, understanding, teaching and implementing behaviour support techniques in dentistry (DBS). METHODS This review aims to identify the labels and associated descriptors used by practitioners to describe DBS techniques, as a first step in developing a shared terminology for DBS techniques. Following registration of a protocol, a scoping review limited to Clinical Practice Guidelines only was undertaken to identify the labels and descriptors used to refer to DBS techniques. RESULTS From 5317 screened records, 30 were included, generating a list of 51 distinct DBS techniques. General anaesthesia was the most commonly reported DBS (n = 21). This review also explores what term is given to DBS techniques as a group (Behaviour management was most commonly used (n = 8)) and how these techniques were categorized (mainly distinguishing between pharmacological and non-pharmacological). CONCLUSIONS This is the first attempt to generate a list of techniques that can be selected for patients and marks an initial step in future efforts at agreeing and categorizing these techniques into an accepted taxonomy, with all the benefits this brings to research, education, practice and patients.
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Affiliation(s)
| | | | | | - Olive Healy
- School of Dental Science, Trinity College Dublin, Dublin 2, Ireland
| | | | | | | | - Blánaid Daly
- School of Dental Science, Trinity College Dublin, Dublin 2, Ireland
| | | | | | | | | | - Chris Stirling
- The Crisis Prevention Institute, Milwaukee, Wisconsin, USA
| | | | - June Nunn
- School of Dental Science, Trinity College Dublin, Dublin 2, Ireland
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Almajed OS, Alhujhuj R, Alshaheen E, Almujhim A, Albutayh M, Raghunath RG, Lele G. The Effectiveness of Virtual Reality in Controlling Pain and Anxiety Levels in Four-to-Six-Year-Old Children During Dental Treatment. Cureus 2023; 15:e51099. [PMID: 38274902 PMCID: PMC10809031 DOI: 10.7759/cureus.51099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background and objective Oral health is critical for children's overall well-being; however, dental anxiety often leads to the avoidance of necessary dental care among children. Virtual reality (VR) has emerged as a successful adjunctive tool in various clinical settings, including pain management. This cohort study explores the use of VR technology in reducing anxiety and pain perception during dental procedures for children. The primary objective of this study was to assess the efficacy of VR distraction in managing pain and anxiety levels in children aged four to six years during dental procedures. Additionally, the study aimed to compare children's anxiety levels with and without VR eyeglasses. Methodology This single-blind, crossover clinical trial was conducted at the Dental Complex of King Faisal University, Al Ahsa, Kingdom of Saudi Arabia. Of the 200 children screened initially, 20 aged four to six years who met the inclusion criteria were selected, and ethical approval for the study was obtained. The study comprised two groups: a control group and an experimental group. Dental procedures were conducted both with and without the use of VR, employing a split-mouth design. Results Our findings provide important insights into the clinical impact of using VR technology to alleviate children's anxiety during dental clinic visits. In our study, we used ANOVA and Tukey's post hoc test to evaluate the effect of VR glasses on vital metrics in children during dental procedures. Our results showed no significant differences before and after using the VR glasses, indicating limited effectiveness in reducing anxiety in this context. Conclusion Based on our findings, we reject the assumption that VR devices are highly effective in diverting children's attention and reducing their anxiety and pain during dental procedures; we recommend further investigations to identify potential confounding factors that could modulate the utility of VR in medical settings.
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Affiliation(s)
- Omar S Almajed
- Pediatric Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
- Dental Public Health, King's College London, London, GBR
| | - Rakan Alhujhuj
- Dental Department, King Abdulaziz National Guard Hospital, Al Hofuf, SAU
| | | | | | | | - Ravi G Raghunath
- Department of Preventive Dental Sciences, King Faisal University, Al Ahsa, SAU
| | - Gauri Lele
- Pediatric and Preventive Dentistry, Navrachana University, Gujarat, IND
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Reynolds K, Chimoriya R, Chandio N, Tracey D, Pradhan A, Fahey P, Stormon N, Arora A. Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses. BMC Oral Health 2023; 23:769. [PMID: 37858057 PMCID: PMC10585952 DOI: 10.1186/s12903-023-03445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety. METHODS This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software. RESULTS A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p = < 0.001) in reducing psychophysiological responses of dental anxiety. CONCLUSION Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD. TRIAL REGISTRATION The title of this review was registered with PROSPERO (CRD42022322083).
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Affiliation(s)
- Kaitlyn Reynolds
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW, 2144, Australia
| | - Navira Chandio
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Danielle Tracey
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
- Centre for Educational Research, Western Sydney University, Kingswood, NSW, 2747, Australia
| | - Archana Pradhan
- Sydney Dental School, The University of Sydney, Surry Hills, NSW, 2010, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Nicole Stormon
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
- Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia.
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Gao F, Wu Y. Procedural sedation in pediatric dentistry: a narrative review. Front Med (Lausanne) 2023; 10:1186823. [PMID: 37181379 PMCID: PMC10169594 DOI: 10.3389/fmed.2023.1186823] [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: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Procedural sedation and analgesia are now considered standard care for managing pain and anxiety in pediatric dental patients undergoing diagnostic and therapeutic procedures outside of the operating room. Anxiolysis, which combines both pharmacologic and non-pharmacologic approaches, plays a significant role in procedural sedation. Non-pharmacologic interventions such as Behavior Management Technology can help reduce preprocedural agitation, ease the transition to sedation, reduce the required amount of medication for effective sedation, and decrease the occurrence of adverse events. As the introduction of novel sedative regimen and methods in pediatric dentistry, the potential role of mainstay sedatives administered by new routes, for new indications, and with new delivery techniques, should be considered. The purpose of this paper is to examine and discuss the current state of sedation techniques in pediatric dentistry.
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Affiliation(s)
- Feng Gao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Laboratory of Oral Diseases and Biomediacal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yujia Wu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Laboratory of Oral Diseases and Biomediacal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Aburas S, Pfaffeneder-Mantai F, Hofmann A, Meller O, Schneider B, Turhani D. Dentophobia and dental treatment: An umbrella review of the published literature. SPECIAL CARE IN DENTISTRY 2023; 43:163-173. [PMID: 35700448 DOI: 10.1111/scd.12749] [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: 01/25/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022]
Abstract
AIMS Dentophobia is a well-know kind of phobia and psychological problem in dentistry. Although patients might suffer from severe oral pain and have serious health complications, dentophobia is still posing a threat to oral healthcare and remains an unresolved worldwide phenomenon. According to estimates, up to 80% of the general population are affected by this condition. Dentophobia is an unpleasant problem with serious consequences not only for patients but also for dentists and the public health system in general. This umbrella review provides a comprehensive overview of the various aspects of dentophoia as addressed in the published literature, and the current level of knowledge concerning their treatment. METHODS AND RESULTS Based on 35 reviews of the published literature, addressing various aspects of dentophobia and published between 2008 and 2021, this umbrella review was written. The search was based on the PubMed and PsycINFO databases. The extraction was structured by open coding and each aspect of the subject analyzed according to Ritchie and Lewis. CONCLUSION We conclude that the evidence concerning the efficacy of the various interventions is still rather weak and there is an obvious need for further research, because of the yet and unresolved challenges and the lack of standardised guidelines to deal with patients with dentophobia.
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Affiliation(s)
- Sarmad Aburas
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Alina Hofmann
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Oliver Meller
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems/Donau, Austria
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Leyda-Menéndez AM, Vidigal EA, Abanto J, Ribelles-Llop M. Efficacy of two behavioural management techniques during inferior alveolar nerve block administration in pre-school children: a randomised clinical trial. Eur Arch Paediatr Dent 2023; 24:85-93. [PMID: 36260279 DOI: 10.1007/s40368-022-00758-y] [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: 05/30/2022] [Accepted: 09/28/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate and compare the efficacy of the hands-eyes-mouth distraction technique (HEM-DT) in reducing anxiety and pain levels and improving the behaviour of pre-school children during inferior alveolar nerve block (IANB) administration to that of the covering patient's vision technique (CPV-T). METHODS This study included 52 children aged 3-5 years old with primary dentition, no history of receiving local anaesthesia, and whose treatments required an IANB. These children were randomly assigned into two groups: HEM-DT (G1; n = 26) and CPV-T (G2; n = 26). Anxiety and pain levels were assessed using the Facial Image Scale and the Wong-Baker Scale, respectively, while the patient's behaviour was evaluated using the Frankl Behaviour Scale. This study was divided into two sessions including the treatment session (administration of IANB) and the control session (7 days after anaesthesia). Chi-square test, the Mann-Whitney U test and Wilcoxon test were used for statistical analyses. RESULTS The patients' anxiety levels did not increase 7 days after IANB in G1 (p value = 0.798); however, higher anxiety levels were observed in the G2 group (p value = 0.039). No significant differences in pain levels and behaviour were observed between the groups during administration of anaesthesia (p value > 0.005). CONCLUSION HEM-DT and CPV-T showed efficacy in terms of pain and behaviour during IANB administration. Pre-school children in the HEM-DT group exhibited lower anxiety levels in the control session. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION ClinicalTrials.gov (NCT02591797). October 28, 2015.
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Affiliation(s)
- A M Leyda-Menéndez
- Department of Dentistry, Faculty of Health Sciences, CEU-Cardenal Herrera University, Valencia, Spain.
| | - E A Vidigal
- Division of Pediatric Dentistry, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - J Abanto
- Department of Pediatric Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - M Ribelles-Llop
- Department of Dentistry, Faculty of Health Sciences, CEU-Cardenal Herrera University, Valencia, Spain
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Caleza-Jiménez C, López-de Francisco MDM, Mendoza-Mendoza A, Ribas-Pérez D. Relationship between Children's Lifestyle and Fear during Dental Visits: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010026. [PMID: 36670577 PMCID: PMC9856752 DOI: 10.3390/children10010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
The purpose was to analyze the relationship between new family and social patterns and child emotions in the dental clinic. The sample consisted of 174 children between the ages of four and nine. Parents completed 20 questions that referred to social, family, cultural, and economic factors. The Wong−Baker scale was completed by the children after the end of the treatment. A total of 129 of the children were found to be extremely happy (45.4%) or happy (28.7%) with the dental care received. There were statistically significant differences (p < 0.05) between younger children and sad and incredibly sad faces on the Wong−Baker test with a strong association (V > 0.3). Regarding children who practiced team sports, the chi-square test revealed a very significant association with happy and incredibly happy faces (p < 0.001) and the Cramer statistic evidenced a strong relationship between team sports and less dental fear (V > 0.3). Considering the limitations, small children (4−6 years) would be more fearful. In addition, stable environments in the family life of children (appropriate routines, adequate time spent with videogames, sport activities) could be interesting factors for improved control of fear and emotions in children. Further research is needed in this field.
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Gizani S, Seremidi K, Katsouli K, Markouli A, Kloukos D. Basic behavioral management techniques in paediatric dentistry: A systematic review and meta-analysis. J Dent 2022; 126:104303. [PMID: 36152953 DOI: 10.1016/j.jdent.2022.104303] [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: 06/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To systematically retrieve and assess studies regarding the effectiveness of basic behavioral management techniques (BMTs) in paediatric patients. DATA SOURCES Electronic and hand searches were conducted to locate Randomized Controlled Trials (RCTs) reporting on objective and subjective evaluation of anxiety and behavior of children up to 12 years of age. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool (RoB 2.0 Tool), were performed independently and in duplicate for all included studies. Mean differences and standard deviations were used to summarize the data from each study and meta-analyses were conducted with studies of limited heterogeneity. STUDY SELECTION A total of 708 papers were identified and screened, 122 retrieved for full text appraisal and 62 finally included. Results suggested that all basic BMTs have acceptable effectiveness on paediatric patients' anxiety, fear and behavior during dental treatment. Meta-analysis showed a statistically significant difference in favor of distraction for subjective anxiety using facial scale (Mean diff.: 2.78; 95% CI: -3.08, -0.53; p=0.005) and Modified Child Dental Anxiety Scale (Mean diff.: 12.76; 95% CI: -6.09, -4.47; p=0.001) and a non-significant difference for heart rate (Mean diff.: 1.70; 95% CI: -6.54, 0.46; p=0.09). Music significantly reduced heart rate when compared to a control comparator, underlining the superiority of the BMT (Mean diff.: 2.71; 95% CI: -3.70, -0.59; p=0.007). CONCLUSIONS Limited evidence about efficacy of one technique over another raises important issues on the topic for future research regarding the management of the child patient in the dental setting of the 21st century. CLINICAL SIGNIFICANCE Behavioral management comprises a challenge for clinicians, who need to be familiar with a range of techniques to meet patients' needs at individual level and be flexible in their implementation. Appropriate technique should incorporate patients' personality and parents' active involvement, within the contents of the changes in modern societies.
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Affiliation(s)
- Sotiria Gizani
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece.
| | - Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Konstantina Katsouli
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Antigoni Markouli
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, Athens Greece
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Thosar NR, Bane SP, Deulkar PV, Deshpande MA, Gupta S. Effectiveness of Two Different Behavior Modification Techniques for Anxiety Reduction in Children. Cureus 2022; 14:e28141. [PMID: 36134077 PMCID: PMC9482440 DOI: 10.7759/cureus.28141] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/18/2022] [Indexed: 11/05/2022] Open
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Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042380. [PMID: 35206566 PMCID: PMC8872083 DOI: 10.3390/ijerph19042380] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.
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Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
- Correspondence:
| | | | - Willa Giffin
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - Natasha Hikita
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - José C. Polido
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
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MASSIGNAN C, SOARES JP, PIRES MMDS, DICK B, PORPORATTI AL, CANTO GDL, BOLAN M. Parental acceptance toward behavior guidance techniques for pediatric dental visits: a meta-analysis. Braz Oral Res 2022; 36:e0127. [DOI: 10.1590/1807-3107bor-2022.vol36.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
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Padminee K, Hemalatha R, Shankar P, Senthil D, Jayakaran TG, Kabita S. Effectiveness of biofeedback relaxation and audio-visual distraction on dental anxiety among 7- to 12-year-old children while administering local anaesthesia: A randomized clinical trial. Int J Paediatr Dent 2022; 32:31-40. [PMID: 33735517 DOI: 10.1111/ipd.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Local anaesthesia (LA) administration provokes dental anxiety in children. BrightHearts is a biofeedback relaxation application designed to reduce anxiety in children during painful procedural interventions. AIM To compare the effectiveness of biofeedback relaxation (BR) and audio-visual (AV) distraction on dental anxiety among 7- to 12-year-old children while administering LA. DESIGN A total of 70 children requiring dental treatment under LA for three visits were recruited for this single-blinded randomized control trial. They were randomly divided into two equal groups. Group A received BR and Group B received AV distraction during LA delivery in the first two visits, and both groups did not receive any intervention during LA in third visit. Outcomes were measured using heart rate and a cartoon-based anxiety measuring scale (Chotta Bheem-Chutki (CBC) scale). RESULTS AV group had statistically significant higher mean heart rates than BR group (P < .001) during needle penetration and post-intervention, respectively. CBC scale showed no statistical differences between the groups. CONCLUSION Both the interventions are effective in reducing dental anxiety during LA administration. Based on objective measures, BR is found to be better than AV distraction. Subjective scores, however, show no differences between the two.
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Affiliation(s)
- Krishnan Padminee
- Department of Pediatric and Preventive Dentistry, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, India
| | - R Hemalatha
- Department of Pediatric and Preventive Dentistry, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, India
| | - Paulindraraj Shankar
- Department of Pediatric and Preventive Dentistry, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, India
| | - D Senthil
- Department of Pediatric and Preventive Dentistry, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, India
| | | | - Sahoo Kabita
- Department of Pediatric and Preventive Dentistry, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, India
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Nirmala K, Kamatham R. Effect of Aromatherapy on Dental Anxiety and Pain in Children Undergoing Local Anesthetic Administrations: A Randomized Clinical Trial. J Caring Sci 2021; 10:111-120. [PMID: 34849354 PMCID: PMC8609116 DOI: 10.34172/jcs.2021.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/05/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: In dentistry, local anesthetic (LA) administration in children is often associated with behavioral problems. Hence, the present study evaluated the efficacy of aromatherapy in reducing the dental anxiety and pain during LA procedure.
Methods: This clinical trial was conducted upon 150 children in the age range of 8-12 years. Subjects were randomly divided into five groups; Group 1: Lavender essential oil using nebulizer; Group 2: Lavender essential oil using inhaler; Group 3: Orange essential oil using nebulizer; Group 4: Orange essential oil using inhaler; Group 5: Control (without aromatherapy). For all the children, baseline anxiety was recorded followed by aromatherapy (except for children in the control group). Following the standard protocol, LA was administered. The procedural pain was assessed using Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). Finally, anxiety was again recorded. Data were analyzed using SPSS version 17.0.
Results: A significant difference in ANOVA test was observed among anxiety scores after LA in aromatherapy groups 1, 3, and 4 compared to control. When the FLACC scores were analyzed using Kruskal-Wallis, there were significantly lower values in aromatherapy groups compared to the control group. The pain scores, as reported in FPS-R, were also lower in aroma groups 1, 3, and 4.
Conclusion: Aromatherapy with lavender or sweet orange, using either nebulizer or inhaler, decreased the dental anxiety of children, whereas, only sweet orange could reduce the pain as self-reported by children.
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Affiliation(s)
- Kamalapuram Nirmala
- Department of Pediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, India
| | - Rekhalakshmi Kamatham
- Department of Pediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, India
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Rafatjou R, Ahmadi B, Farhadian M, Moghadam NE. Evaluation effect of color in dental office and dentist's uniform while using two different distraction techniques on injection anxiety of 6-9 years' old children referring to Hamedan Dental School: Randomized clinical trial. Dent Res J (Isfahan) 2021; 18:71. [PMID: 34760062 PMCID: PMC8543103 DOI: 10.4103/1735-3327.326644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background: The management of children's anxiety in dental offices is still a challenge for the treatment team. The most important factors which affect children's dental anxiety are the clinician-related factors and the physical factors of the dental operatory. Color is an environmental factor whose relationship with the perceptive and emotional factors of children has been reported. On the other hand, distraction is essential factors in a treatment environment that can be used to manage children's anxiety. Materials and Methods: In this randomized clinical trial study, from 132 6 to 9 years of age children, 52.3% were male, and 47.7% were female, with a mean age of 7.45 ± 1.1 years. The children's anxiety levels were determined using the Venham Picture Test and pulse oximetry before and after the administration of local anesthesia. The children were randomly assigned to two groups (n = 66): Group 1, music, and Group 2, animated cartoons. The data were analyzed with SPSS 25, using descriptive statistics and the statistical tests consisting of one-way analysis of variance (ANOVA), t-test, and repeated-measures ANOVA, followed by Tukey honestly significant difference tests. Statistical significance was set at P < 0.05. Results: The anxiety levels were the lowest in the blue and pink environments and the highest in the black and red. Anxiety levels between different colors in terms of physiologic markers and the questionnaire in each distraction technique at different intervals was significantly different. Conclusion: The use of blue, pink, green, and yellow for dentists' attire, and the interior design of the dental operatory decreased the child patients' anxiety.
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Affiliation(s)
- Rezvan Rafatjou
- Department of Pediatric Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Bahar Ahmadi
- Department of Dental School, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, Hamedan University of Medical Sciences, Hamedan, Iran
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Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial. Am J Emerg Med 2021; 50:260-263. [PMID: 34418716 DOI: 10.1016/j.ajem.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The digital nerve block is an effective method of anesthesia before minor surgical interventions on the fingers. However, patients may experience a lot of pain and anxiety during this procedure. The efficacy of topical vapocoolant spray during minor procedures has been demonstrated in previous studies. we aimed to evaluate the effectiveness of topical vapocoolant spray in reducing pain during digital nerve block. METHODS This prospective, randomized clinical study was conducted to evaluate the effectiveness of vapocoolant spray application in reducing pain during digital block. The patients were categorized into 2 groups as spray-treated and control group. A routine digital block process was applied to the control group. Spray application was performed in two groups of 50 each, in a manner of bilateral and unilateral to the finger. Demographic data of the patients, such as gender, age, dominant hand, injury patterns, injection site and injury sites, were recorded. After the application, the patients' visual analog scale (VAS) was evaluated. RESULTS Of the participants, 100 were randomly assigned to the vapocoolant spray-treated group, and 50 were included in the control group. The VAS pain score during penetration in both spray groups was significantly lower than the control group (p < 0.001). Pain change during penetration was found to be significantly lower in the bilateral spray-treated group compared to the control group (p < 0.001). Pain change during infiltration was significantly lower in both spray groups compared to the control group (p < 0.001). CONCLUSIONS Spray application prior to digital nerve blocking can be used to reduce needle penetration pain associated with this procedure and pain associated with local anesthetic infiltration.
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21
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da Silva GS, Anabuki AA, Viana KA, Corrêa-Faria P, Moterane MM, Tedesco TK, Costa PS, Hosey MT, Raggio DP, Costa LR. Sedation versus protective stabilization for dental treatment of children with caries and challenging behavior at the dentist (CHOOSE): a study protocol for a non-randomized clinical trial. BMC Oral Health 2021; 21:256. [PMID: 33980232 PMCID: PMC8115863 DOI: 10.1186/s12903-021-01594-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of evidence on the effectiveness of moderate sedation in pediatric dentistry, compared to protective stabilization, which remains routinely used in Brazil despite moral questions. This prospective non-randomized clinical trial's objective is to evaluate the effectiveness of moderate sedation, compared to the protective stabilization, in the dental care of children with dental behavior management problems. METHODS Participants will be 152 children under seven years of age with early childhood caries (ECC) who need specialized dental treatment due to a history of challenging behavior during dental care. The interventions to be compared are moderate sedation with oral administration of ketamine and midazolam and protective stabilization. The primary endpoint will be the child's behavior during treatment assessed using the Ohio State University Behavioral Rating Scale (OSUBRS). The secondary outcomes are (A) child's - behavior according to the visual analogue scale, anxiety, pain, and physiological stress; (B) parent's - satisfaction and anxiety; (C) family and child - impact on oral health-related quality of life (OHRQoL); (D) dentist's - satisfaction and stress; (E) procedure - adverse events of the intervention and dental treatment longevity. A cost-effectiveness analysis will be performed from the perspective of the Brazilian Unified Health System (SUS). DISCUSSION Considering the primary outcome, this study hypothesis is that sedated children have better behavior during dental treatment than children whose behavior was managed by protective stabilization without sedation. Additionally, at the end of 12 months, we expect to identify participants' reported outcomes and objective measures related to dental behavior in early childhood. Trial registration Clinicaltrials.gov registration NCT04119180 on October 8th, 2019. https://clinicaltrials.gov/ct2/show/NCT04119180.
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Affiliation(s)
- Gabriela Seabra da Silva
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Anna Alice Anabuki
- Dentistry Graduate Program, Universidade Federal de Goias, Goiânia, GO, Brazil
| | | | | | | | | | | | - Marie Therese Hosey
- Pediatric Dentistry, Centre for Oral Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciane Rezende Costa
- Faculty of Dentistry, Universidade Federal de Goias, Primeira Avenida, s/n, Goiânia, GO, CEP 74605-220, Brazil.
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CustÓdio NB, Cademartori MG, Azevedo MS, Mendes MDA, Schardozim LR, Costa LRDRSD, Goettems ML. Efficacy of audiovisual distraction using eyeglasses during dental care: a randomized clinical trial. Braz Oral Res 2021; 35:e26. [PMID: 33605356 DOI: 10.1590/1807-3107bor-2021.vol35.0026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
This randomized parallel-group control trial tested the efficacy of distraction using audiovisual eyeglasses (AVE) during dental procedures [NCT03902158]. Forty-four 6-9 year-old children with low/moderate anxiety and who needed restorative treatment or exodontia of the primary molars were randomly allocated into two groups: the AVE (experimental) and the conventional behavior management techniques (control) groups. Motion sensors were used to measure the participants' body movements. Dental visits were video recorded, and their pain levels and behavior were assessed using the Faces, Legs, Activity, Cry, and Consolability Behavioral Pain Assessment Scale and the Venham Behavioral Scale, respectively. Anxiety was assessed via heart rate measurements. After treatment, the children scored their pain using the Faces Pain Scale. Mann-Whitney U and chi-square tests were used to compare the groups. The mean score on the behavioral scale was 0.59 in the experimental group and 0.72 in the control group under local anesthesia (p = 0.73). During the procedure, the mean score was 0.41 in the experimental group and 1.32 in the control group (p = 0.07). The mean heart rate was similar in both groups (p = 0.47), but a significant increase during treatment was observed in the control group. There was no difference between the groups in terms of pain, behavior, and self-reported pain scores (p = 0.08). Children aged 6-7 who used the AVE had fewer wrist movements (435.6) than that of children in the control group (1170.4) (p = 0.04). The AVE achieved similar results to the basic behavior management techniques, with good acceptance by the children.
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Affiliation(s)
- Natália Baschirotto CustÓdio
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Mariana Gonzalez Cademartori
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Marina Sousa Azevedo
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
| | - Márcio de Almeida Mendes
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Epidemiology , Pelotas , RS , Brazil
| | - Lisandrea Rocha Schardozim
- Universidade Federal de Pelotas - UFPel, Departament,of Social and Preventive Dentistry , Pelotas , RS , Brazil
| | | | - Marília Leão Goettems
- Universidade Federal de Pelotas - UFPel, School of Dentistry , Post-graduate program in Dentistry , Pelotas , RS , Brazil
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Wilde S, Sarti CS, Toniolo J, Oliveira BP, Gouvea DB, Santos NMD, Borges MLV, Rodrigues JA. Influence of Isolation Technique on the Survival of Resin-Modified Glass-Ionomer Restorations in Primary Molars: A 9-Months Randomized Controlled Trial. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Barasuol JC, Massignan C, Bortoluzzi EA, Cardoso M, Bolan M. Influence of hand and rotary files for endodontic treatment of primary teeth on immediate outcomes: Secondary analysis of a randomized controlled trial. Int J Paediatr Dent 2021; 31:143-151. [PMID: 32516507 DOI: 10.1111/ipd.12682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/14/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Endodontic treatment of primary teeth can be time-consuming. AIM To compare hand and rotary files regarding the time for root canal chemical-mechanical preparation, child's behavior, apical limit of the obturation, and post-operative pain. DESIGN This secondary data from a randomized clinical trial with two parallel arms evaluated endodontic instrumentation in 88 children aged 4-9 years. Stratified and block randomization was performed into two groups: K-file hand and ProDesign Logic rotary files. The evaluated outcomes were the chemical-mechanical preparation time, child's behavior using the Frankl scale, apical limit of the obturation, and post-operative pain using the Faces Pain Scale-Revised. One operator and all outcome appraisers were blinded to the chemical-mechanical technique. Multiple linear regression, chi-square, and Fisher's exact test were performed. RESULTS The mean time for chemical-mechanical preparation using hand files was 24.5 (SD 4.0) minutes, and using rotary files, it was 17.0 (SD 2.5) minutes (P < .001). No difference was found between the instrumentation methods in the child's behavior, apical limit of the obturation, or post-operative pain. CONCLUSIONS The ProDesign Logic file reduced the average procedure time but presented no difference in the other variables studied when compared to the K-file.
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Affiliation(s)
- Jéssica C Barasuol
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Carla Massignan
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Eduardo A Bortoluzzi
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Michele Bolan
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Cebalo N, Negovetić Vranić D, Bašić Kes V. The Effect of Transcutaneous Electric Nerve Stimulation (TENS) on Anxiety and Fear in Children Aged 9-14 Years. Acta Stomatol Croat 2020; 54:412-419. [PMID: 33642605 PMCID: PMC7871430 DOI: 10.15644/asc54/4/8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Dental fear or dental phobia is caused by previous unpleasant dental experiences and pain. It can result in delaying or avoiding dental visits. Most often it leads to individuals avoiding visiting the dentist until physical pain completely impairs the quality of life. Objectives Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current. The main aim of this study was to examine whether the TENS device affects the reduction of anxiety and fear during dental procedures. Material and Methods The study was conducted on a sample of 125 respondents, aged 9-14 years. Statistical significance of differences between pre- and post-treatment results on all applied measuring instruments was verified by the t-test for dependent samples. The calculation was performed for all respondents and individually for the three observed groups. The Children`s Fear Survey Schedule – Dental Subscale test was used to assess anxiety and fear. Results The results on the CFSS-DS scale in all subjects did not differ statistically significantly before and after treatment (p > 0.05). The results on the CFSS-DS scale in subjects who received TENS were statistically significantly different before and after treatment (p < 0.01). The results on the CFSS-DS scale in subjects who received local anesthesia were statistically significantly different before and after treatment (p < 0.05). Conclusion The TENS device had an anxiolytic effect after the first visit.
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Affiliation(s)
- Nina Cebalo
- Community Health Centre Zagreb-West, Postgraduate student, School of Dental Medicine, University of Zagreb, Croatia
| | - Dubravka Negovetić Vranić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Vanja Bašić Kes
- Department of Neurology at Sestre milosrdnice Hospital, School of Dental Medicine, University of Zagreb, Croatia
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Santos PS, Massignan C, de Oliveira EV, Miranda Santana C, Bolan M, Cardoso M. Does the pre-emptive administration of paracetamol or ibuprofen reduce trans- and post-operative pain in primary molar extraction? A randomized placebo-controlled clinical trial. Int J Paediatr Dent 2020; 30:782-790. [PMID: 32268439 DOI: 10.1111/ipd.12649] [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: 01/04/2020] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is no consensus whether the pre-emptive administration of analgesics reduces trans- and post-operative pain in primary molar extraction. AIM Investigate whether the pre-emptive administration of ibuprofen and paracetamol reduces trans- and post-operative pain on primary molars extraction compared to placebo. DESIGN A parallel, placebo-controlled, triple-blind, randomized clinical trial was conducted. Forty-eight children who needed primary molar tooth extraction were selected and treated under local anaesthesia and pre-emptive administration of placebo or analgesics. Self-reported pain was evaluated during the anaesthesia, extraction, and 2, 6, and 24 hours of post-operative period, using a visual analogue scale (VAS). Children's baseline anxiety, behaviour during the procedure, parents' anxiety, and post-operative analgesia were also assessed. Data analysis included descriptive statistics and multiple linear regression. RESULTS No association was found between the use of pre-emptive analgesic and lower scores of trans- and post-operative pain compared to placebo. Children who presented negative behaviour reported greater pain during anaesthesia (P = .04) regardless of pre-emptive analgesia group. Children from the placebo group were more likely to need post-operative analgesia at 2 hours of follow-up (P = .03). CONCLUSION The pre-emptive administration of analgesics did not significantly reduce trans- and post-operative pain in children after primary molars extraction.
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Affiliation(s)
- Pablo Silveira Santos
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Carla Massignan
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | | | - Carla Miranda Santana
- Department of Pediatric Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Michele Bolan
- Department of Pediatric Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Mariane Cardoso
- Department of Pediatric Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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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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Lima DSM, Barreto KA, Rank RCIC, Vilela JER, Corrêa MSNP, Colares V. Does previous dental care experience make the child less anxious? An evaluation of anxiety and fear of pain. Eur Arch Paediatr Dent 2020; 22:139-143. [DOI: 10.1007/s40368-020-00527-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
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Brilhante VOM, Corrêa-Faria P, Machado GCM, Costa LR. Carers’ and paediatric dentists’ perceptions of children’s pain during restorative treatment. Eur Arch Paediatr Dent 2020; 21:271-276. [DOI: 10.1007/s40368-019-00486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
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Bilge S, Aydin A, Gun C, Aldinc H, Acar YA, Yaylaci S, Cinar O, Balci V. Comparison of the efficacy of ShotBlocker and cold spray in reducing intramuscular injection-related pain in adults. A prospective, randomized, controlled trial. Saudi Med J 2020; 40:996-1002. [PMID: 31588477 PMCID: PMC6887882 DOI: 10.15537/smj.2019.10.24322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectives: To compare the efficacy of ShotBlocker and cold spray in reducing intramuscular (IM) injection-related pain in adults. Methos: A prospective, randomized, controlled study carried out between January 2018 and March 2018 at the Department of Emergency Medicine, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey. Adult patients receiving IM injection of diclofenac sodium (75 mg/3 ml) were included. The patients were randomized into 3 groups: ShotBlocker, cold spray, and control. Each group comprised 40 patients. Patients were instructed to rate the intensity of IM injection-related pain using a 100-mm visual analog scale (VAS). Visual analog scale scores of the patients were statistically analyzed. Results: Visual analog scale scores were lower in the ShotBlocker (11 mm) and cold spray (10 mm) groups than in the control group (31 mm) (p=0.001). There were no significant differences in VAS scores between the ShotBlocker and cold spray groups. The operators’ responses revealed that ShotBlocker was more difficult to administer than cold spray. Conclusion: ShotBlocker is an effective non-pharmacological method that reduces IM injection-related pain and is similar in efficacy, to cold spray.
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Affiliation(s)
- Sedat Bilge
- Department of Emergency Medicine, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey. E-mail.
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Bilsin E, Güngörmüş Z, Güngörmüş M. The Effıcacy of External Cooling and Vibration on Decreasing the Pain of Local Anesthesia Injections During Dental Treatment in Children: A Randomized Controlled Study. J Perianesth Nurs 2020; 35:44-47. [DOI: 10.1016/j.jopan.2019.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 12/14/2022]
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Zen R, Rigo L, Gaviolli E, Girotto LPS, Mário DN. Effect of Recreational Intervention on the Approach of Pediatric Patients in Dental Treatment: Analysis of Salivary Cortisol. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Prado IM, Carcavalli L, Abreu LG, Serra-Negra JM, Paiva SM, Martins CC. Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials. Int J Paediatr Dent 2019; 29:650-668. [PMID: 30908775 DOI: 10.1111/ipd.12499] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/04/2019] [Accepted: 03/15/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine whether distraction techniques (DT) reduce children's/adolescent's anxiety and fear during dental treatment. METHODS Randomized controlled trials (RCTs) in which any type of DT were used to manage dental anxiety and dental fear in children/adolescents were included. A systematic search of PubMed, Web of Science, Scopus, Cochrane Library, Lilacs, and Google Scholar was conducted. Two independent reviewers selected studies, extracted data, assessed methodological quality of studies using the Cochrane Collaboration's Risk of Bias tool (CCRBT), and approached certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Data were analysed descriptively. RESULTS Twenty studies covering several types of DT (audio, audiovisual, instruments camouflage, biofeedback, dental operating microscope, toys) were included. Qualitative analysis showed with very low certainty of evidence that DT effectively reduced dental anxiety and fear depending on the distraction type, instrument used to measure dental anxiety and dental fear, and dental procedure. CCRBT evaluation identified many methodological issues in included studies. CONCLUSION There is a very low certainty of evidence that DT can be effective in managing children's/adolescents' dental fear and anxiety during dental treatment. The heterogeneity of methodologies and findings in the studies, however, suggests more robust, and well-executed RCTs are needed.
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Affiliation(s)
- Ivana Meyer Prado
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Carcavalli
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Júnia Maria Serra-Negra
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Castro Martins
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Clinical Practice Guideline: Needle-Related or Minor Procedural Pain in Pediatric Patients. J Emerg Nurs 2019; 45:437.e1-437.e32. [DOI: 10.1016/j.jen.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Goettems ML, Dos Santos Costa F, da Costa VPP. The Challenge of Child Management During Dental Care: Use of Nonpharmacological Approaches. Acad Pediatr 2019; 19:495-496. [PMID: 31029738 DOI: 10.1016/j.acap.2019.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/16/2019] [Accepted: 04/21/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Marília Leão Goettems
- Postgraduate Program in Dentistry, School of Dentistry (ML Goettems, F dos Santos Costa, and VPP da Costa), Federal University of Pelotas, Pelotas, Brazil.
| | - Francine Dos Santos Costa
- Postgraduate Program in Dentistry, School of Dentistry (ML Goettems, F dos Santos Costa, and VPP da Costa), Federal University of Pelotas, Pelotas, Brazil
| | - Vanessa Polina Pereira da Costa
- Postgraduate Program in Dentistry, School of Dentistry (ML Goettems, F dos Santos Costa, and VPP da Costa), Federal University of Pelotas, Pelotas, Brazil
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Mathias FB, Cademartori MG, Goettems ML. Factors associated with children's perception of pain following dental treatment. Eur Arch Paediatr Dent 2019; 21:137-143. [PMID: 31236833 DOI: 10.1007/s40368-019-00456-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/26/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE To assess children's perception of pain during routine dental procedures and associated factors. METHODS A cross-sectional study was performed including 192 children aged 6-13 years, who visited a university paediatric dental clinic. Mothers were interviewed to obtain information about demographic and socioeconomic data, and psychosocial characteristics. During dental treatment, children's behaviour was assessed using Frankl's Behaviour Scale. Dental procedures were recorded according to complexity of treatment from dental records. Immediately after the dental procedure, perception of pain was assessed using the Faces Pain Scale-Revised. Poisson regression analysis was used to assess the association between potential predictor variables and perception of pain (P < 0.05 was considered significant). RESULTS Overall, the mean pain score was 1.5 (SD 2.4). Higher levels of pain were reported by children who demonstrated non-cooperative behaviour during the treatment (RR = 2.39, 95% CI = 1.23-4.64), who were administered local analgesia (RR = 2.36, 95% CI = 1.31-4.27), and who reported dental pain during the previous 4 weeks (RR = 1.60, 95% CI = 1.04-2.47). CONCLUSION Perception of pain may be influenced by pre-operative pain and use of local analgesia, and is associated with non-cooperative behaviour during treatment.
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Affiliation(s)
- F B Mathias
- School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brazil
| | - M G Cademartori
- Post-Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brazil
| | - M L Goettems
- School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves Street, Pelotas, RS, Brazil.
- Department of Social and Preventive Dentistry and Graduate Program in Dentistry, School of Dentistry (UFPel), Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
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Heaton LJ. Nonpharmacologic Interventions may Reduce Mental Distress in Adults Undergoing Dental Treatment. J Evid Based Dent Pract 2018; 18:165-167. [PMID: 29747799 DOI: 10.1016/j.jebdp.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Non-pharmacological interventions for reducing mental distress in patients undergoing dental procedures: Systematic review and meta-analysis. Burghardt S, Koranyi S, Magnucki G, Strauss B, Rosendahl J. J Dent. 2018;69:22-31. SOURCE OF FUNDING None reported TYPE OF STUDY DESIGN: Meta-analysis of randomized controlled trials.
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Chisini LA, Collares K, Cademartori MG, de Oliveira LJC, Conde MCM, Demarco FF, Corrêa MB. Restorations in primary teeth: a systematic review on survival and reasons for failures. Int J Paediatr Dent 2018; 28:123-139. [PMID: 29322626 DOI: 10.1111/ipd.12346] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several restorative materials with specific indications are used for filling cavities in primary teeth. AIM To systematically review the literature in order to investigate the longevity of primary teeth restorations and the reasons for failure. DESIGN Electronic databases were screened, and eligible studies were hand-searched to find longitudinal clinical studies evaluating the survival of restorations (class I, class II, and crown) placed with different materials in primary teeth with at least one year of follow-up. RESULTS Thirty-one studies were included, and a high bias risk was observed. Overall, 12,047 restorations were evaluated with 12.5% of failure rate. A high variation on annual failure rate (AFR) was detected (0-29.9%). Composite resin showed the lowest AFRs (1.7-12.9%). Stainless steel crowns (SSC) had the highest success rate (96.1%). Class I restorations and restorations placed using rubber dam presented better AFR. The main reason for failure observed was secondary caries (36.5%). CONCLUSIONS An elevated number of failures were observed due to recurrent caries, highlighting the need for professionals to work with a health-promoting approach. The high variation on failure rate among the materials can be due to children's behavior during the procedure, which demands short dental appointments and a controlled environment.
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Affiliation(s)
- Luiz Alexandre Chisini
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Kauê Collares
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | | | - Flávio Fernando Demarco
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Marcos Britto Corrêa
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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