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Pamungkas SA, Effendy C, Hartami E, Istifiani LA, Ulhaq ZS. The impact of animated video cartoons as a distraction technique on anticipatory anxiety levels among children during class I GIC restoration procedures. Eur Arch Paediatr Dent 2024; 25:685-693. [PMID: 39278892 DOI: 10.1007/s40368-024-00927-1] [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: 10/01/2023] [Accepted: 07/07/2024] [Indexed: 09/18/2024]
Abstract
PURPOSE Investigating the effect of visual distraction using animated video cartoons (AVCs) on anxiety of children during class I class I glass-ionomer cement (GIC) restoration procedures. PATIENTS AND METHODS This randomized clinical trial, 42 children between the ages of 5-6 years were enrolled. These participants were divided into two groups: Group 1, consisting of 21 individuals (AVCs), who were exposed to a cartoon as a visual distraction tool, and Group 2, a control group with 21 participants who did not receive any form of distraction during their first visit. Both groups underwent class I GIC restoration procedures that were conducted in a consistent manner. To evaluate the anxiety levels of the children, measurements of their pulse rate (PR) were taken at the beginning and end of the treatment. Additionally, patient behavior was assessed using the Frankl behavior rating scale (FBRS) as well as validated self-reported dental anxiety scale, the Visual Analog Scale - Anxiety (VAS-A) score. RESULTS In the control group, postoperative PR increased significantly, while the AVC group experienced a decrease compared to their preoperative PR levels. Additionally, audio-visual distraction had a notable impact on FBRS scores compared to the standard approach. Similarly, the VAS-A score displayed a significant reduction when patients received audio-visual distraction compared to the control condition. Subgroup analysis by gender showed that girls tended to be more responsive to AVCs than boys when evaluated by PR and FBRS, but such findings were not observed using VAS-A. Patients with deeper caries had higher VAS-A scores than those with shallower ones. Despite the caries depth, those who received AVC seemed to be calmer, especially to those with deeper lesions, as indicated lower postoperative VAS-A scores compared to their preoperative levels, unlike the control group. CONCLUSION Our study suggests that the use of AVCs can be an effective method for reducing anxiety in children undergoing class I GIC restoration procedures.
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Affiliation(s)
- S A Pamungkas
- Faculty of Dentistry, Brawijaya University, Malang, Indonesia.
- YDSF Clinic, Malang, Indonesia.
| | - C Effendy
- Faculty of Dentistry, Brawijaya University, Malang, Indonesia
| | - E Hartami
- Faculty of Dentistry, Brawijaya University, Malang, Indonesia
| | - L A Istifiani
- Department of Nutrition, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Z S Ulhaq
- Research Center for Pre-Clinical and Clinical Medicine, National Research and Innovation Agency Republic of Indonesia, Cibinong, Indonesia.
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Somero A, Suominen A, Pohjola V, Ogawa M, Sipilä K, Kakko N, Tulppo M, Lahti S. Autonomic Nervous System Activity and Dental Anxiety in the Northern Finland Birth Cohort (NFBC1966) Population. Dent J (Basel) 2024; 12:81. [PMID: 38534305 DOI: 10.3390/dj12030081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
Autonomic nervous system (ANS) activity may be associated with dental anxiety; however, no studies exist on the topic. The aim of this study was to assess if ANS activity and dental anxiety are associated. Data were collected as part of a Northern Finland Birth Cohort Study, NFBC1966, at the age of 46 years with eligible data on 1905 participants. Dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS) categorized as follows: 19-25 = high, 10-18 = moderate, 5-9 = no to low dental anxiety. Heart rate variability (HRV) data were collected using an HR monitor and a standard lead-II electrocardiogram (ECG). Baroreflex sensitivity (BRS) was calculated from continuous ECG and blood pressure signals. Participants were categorized into three groups as follows: Low = the lowest 20th percentile, Mid = medium 21-79th percentile, and High = the highest 20th percentile according to their ANS variables. The associations between the MDAS and ANS activity parameters were evaluated using unordered multinomial logit models adjusted for comorbidities, β-blockers, BMI, smoking, and education. High heart rate, reduced HRV, low cardiac vagal modulation, and poor BRS were associated with moderate dental anxiety, and high cardiac vagal modulation and good BRS were associated with no to low dental anxiety. Poorer ANS activity might predispose some to dental anxiety, and better ANS activity might protect from dental anxiety.
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Affiliation(s)
- Atte Somero
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Vesa Pohjola
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mika Ogawa
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Kirsi Sipilä
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Niklas Kakko
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mikko Tulppo
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, 90014 Oulu, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
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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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Arellano-Cabezas FJ, Carranza-Samanez KM. [Anxiety level and physiological response to invasive dental treatments. a longitudinal study]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e175. [PMID: 38312469 PMCID: PMC10831990 DOI: 10.21142/2523-2754-1104-2023-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/05/2023] [Indexed: 02/06/2024] Open
Abstract
Objective To determine the relationship between the level of anxiety and the physiological response to invasive dental treatments. Materials and methods A convenience sample of 180 patients was formed (73 men and 107 women) ≥18 years (range: 18-58) undergoing treatment with local anesthetics from three private dental offices in the city of Lima. Measurements were made before, during and after treatment on anxiety according to the IDARE questionnaire of 40 questions (20 trait and 20 state) and their physiological response was evaluated according to oxygen saturation (OS), pulse and blood pressure (BP) measured. with digital pulse oximeter and blood pressure monitor. The Friedman and Spearman correlation tests were used, working with a value of P<0.05. Results Most patients had a medium level of anxiety before dental treatment (state 49.4% and trait 55.6%). OS, pulse and BP increased after application of the anesthetic and decreased at the end of treatment, with significant differences (P<0.05). Anxiety scores were significantly correlated only with pulse (state: r=0.238-0.564; trait: r=0.174-0.323) and BP (state: r=0.429-0.699; trait: r=0.312-0.465) (P<0.05). Conclusion State-trait anxiety had a positive relationship with the physiological dimensions of blood pressure and pulse before dental treatment with local anesthetics.
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Affiliation(s)
- Fernando Jesús Arellano-Cabezas
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - Kilder Maynor Carranza-Samanez
- Research Group in Dental Sciences, Carrera de Estomatología, Universidad Científica del Sur. Lima, Universidad Científica del Sur Research Group in Dental Sciences Carrera de Estomatología Universidad Científica del Sur Lima Peru
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Alkanan SAM, Alhaweri HS, Khalifa GA, Ata SMS. Dental pain perception and emotional changes: on the relationship between dental anxiety and olfaction. BMC Oral Health 2023; 23:175. [PMID: 36966288 PMCID: PMC10040111 DOI: 10.1186/s12903-023-02864-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/07/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND The purpose of the study was to determine to what extent olfactory aromatherapy reduces the intensity of dental pain and the level of dental anxiety. It also attempted to corelate between olfactory aromatherapy, stages of dental visits, and various dental procedures. METHODS Female patients were enrolled in a randomized controlled study. Olfactory aromatherapy was performed using lavender oils. Patients were randomly assigned to one of two groups: the lavender group, in which patients inhaled 2% lavender vapors, and the control group, in which patients inhaled water vapors. Pain score, anxiety score, and changes in vital signs were among the predictable variables. Anxiety and pain were assessed using the Modified Dental Anxiety Scale (MDAS), Speilberger State-Trait Anxiety Inventory (STAI), and visual analog scales (VAS). The vital signs were systolic (SBP) and diastolic (DBP), heart rate (HR), respiratory rate (RR), and oxygen saturation (Spo2). Variables were evaluated before inhalations, 20 min after inhalations, at the end of settings, and on the following day. RESULTS Each group had 175 participants. Pain and anxiety scores were significantly reduced, and all vital signs improved, except for DBP. The MDAS, STAI, and pain scores are reduced by 3.4, 4.2, and 2.4 times, respectively, compared to the control group. Olfactory aromatherapy had the greatest impact during the phase of waiting rooms. CONCLUSION When compared to the control group, olfactory aromatherapy reduces anxiety scores three to four times more. Pain perception is reduced by twice as much as in the control group. It also significantly reduces the anxiety associated with minor to moderately stressful dental procedures.
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Affiliation(s)
| | - Hadeel Saleh Alhaweri
- Resident Dentist, Aljreir Alshamaly Primary Health Care Center, Qassim, Saudi Arabia
| | - Ghada Amin Khalifa
- Professor of Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Qassim University, Qassim, Saudi Arabia.
| | - Shaimaa Mohamed Saeed Ata
- Lecturer of Community Dentistry and Oral Epidemiology, College of Dentistry, Qassim University, Qassim, Saudi Arabia
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Management of fear and anxiety in dental treatments: a systematic review and meta-analysis of randomized controlled trials. Odontology 2023; 111:20-32. [PMID: 35536282 DOI: 10.1007/s10266-022-00711-x] [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: 12/21/2021] [Accepted: 04/15/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This systematic review was to compare the effects of interventions for the management of fear and anxiety for dental treatments. METHODS This research project was applied to PubMed, CENTRAL, Web of Science, Cochrane library databases. The last search was run on March 31st, 2021. A list of references of relevant articles and previous reviews were checked. Qualitative and quantitative analyses were performed. RESULTS A total of 20 eligible randomized controlled trials were included, and 969 participations in experimental group and 892 participations in the control group were involved. Anxiety levels decreased more in intervention groups than in control groups (Z = 3.47, P = 0.0005, SMD = - 0.62, 95% CI - 0.98 to - 0.27). For adults, there was statistical difference between experimental and control groups [Z = 2.14, P = 0.03, 95% CI - 0.54 (- 1.03, - 0.04)], while there was not no such statistical difference in children and adolescents [Z = 1.62, P = 0.11, 95% CI - 0.60 (- 1.32, 0.13)]. Patients experienced a significant decrease in anxiety level using sedation drugs [Z = 2.44, P = 0.01, 95% CI - 0.61 (- 1.10, - 0.12)] and audio-visual distractions [Z = 3.1, P = 0.002, 95% CI - 0.86 (- 1.40, - 0.32)]. For the informative intervention groups, patients did not show significant difference than control groups [Z = 1.22, P = 0.22, 95% CI - 0.55 (- 1.43, 0. 33)]. There was no statistical difference in vital signs [Z = 1.39, P = 0.16, 95% CI - 0.25 (- 0.61, 0.10)] and pain levels [Z = 0.69, P = 0.49; SMD = - 0.06, 95% CI (0.27, 0.11)] between intervention and control groups. CONCLUSIONS Interventions should be used in managing anxiety and fear for dental treatment. It might be effective for anxiety alleviating for adults, but there was a low certainty of evidence that interventions could reduce anxiety level in children and adolescents. Sedation drugs and audio-visual distractions might be useful for managing dental fear and anxiety. Pain levels and vital signs could not be improved form our study. High-quality randomized clinical trials are required for further study.
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De Haro JC, Rosel EM, Salcedo-Bellido I, Leno-Durán E, Requena P, Barrios-Rodríguez R. Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16216. [PMID: 36498295 PMCID: PMC9739953 DOI: 10.3390/ijerph192316216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.
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Affiliation(s)
| | - Eva María Rosel
- Departamento de Estomatología, Facultad de Odontología, Universidad de Granada, 18011 Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18011 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), 18014 Granada, Spain
| | - Ester Leno-Durán
- Departamento de Obstetricia y Ginecología, Universidad de Granada, 18011 Granada, Spain
| | - Pilar Requena
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18011 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), 18014 Granada, Spain
| | - Rocío Barrios-Rodríguez
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18011 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), 18014 Granada, Spain
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