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Patil RU, Onkari PS, Gurunathan D. Effectiveness of Audiovisual Distraction in Reducing Children's Anxiety for Pain During Medical and Dental Treatments: A Systematic Review and Meta-analysis. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:252-258. [PMID: 39055078 PMCID: PMC11268543 DOI: 10.4103/sjmms.sjmms_275_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 12/03/2023] [Indexed: 07/27/2024]
Abstract
Background Audiovisual distraction is a potentially good technique to reduce medical treatment procedure-related fear and anxiety among children. However, few studies have assessed its effectiveness. Objective To conduct a systematic review and meta-analysis for evaluating the effectiveness of audiovisual distraction in reducing pain anxiety in pediatrics. Methods Randomized control trials and experimental studies that reported the use of audiovisual distraction during medical/dental treatments among children aged 3-8 years, used the Face, Legs, Activity, Cry, Consolability (FLACC) scale to assess pain, and were published between 2005-2021 and in English were retrieved from PubMed, Scopus, and Web of Science. A random-effects model was used for evidence analysis. Results A total of four studies were included in the systematic review and meta-analysis: two were from South Asia and one each were from Africa and North America. Three of these studies were randomized control trials. The variability among the studies was high. Three of the four studies found that AV techniques were significantly effective in reducing pain during procedures compared with the control group (P < 0.00001), while one study found no difference; the cumulative evidence in the forest plot was similar. Conclusion Cumulative evidence suggests that the use of audiovisual distraction is an effective strategy in reducing medical/dental procedures-related pain anxiety among children aged 3-8 years. However, evidence on this is currently limited, and thus further studies are required using various AD techniques and on different populations to substantiate these findings. Funding None. Registration PROSPERO (Ref no.: CRD42021245874).
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Affiliation(s)
- Raju Umaji Patil
- Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Prajakta Somappa Onkari
- Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Deepa Gurunathan
- Department of Pedodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
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Mehrotra D, Shetty AA, Rai K, Kumara. Effect of audio and virtual reality distraction on the dental anxiety of children with mild intellectual disability. SPECIAL CARE IN DENTISTRY 2024; 44:868-877. [PMID: 37849240 DOI: 10.1111/scd.12932] [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: 03/20/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND AIM Intellectual disability, is a neurodevelopmental disorder that typically manifests early in childhood and consists of both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. It can be categorized into mild, moderate, severe, and profound based on its severity. Cognitive impairment may be observed predominantly in children with intellectual disabilities. Marked deficits in areas of learning, planning, communication, social participation, and personal independence in children with mild intellectual disabilities make behavior guidance and communication a challenge during dental treatments. The aim was to evaluate and compare the use of two different distraction tools, audio, and virtual reality (VR) on the dental anxiety of children with mild intellectual disability during dental treatment. METHODS Twenty children diagnosed with mild intellectual disability were equally divided into two groups. A cross-over study design consisting of two appointments 1 month apart was employed. In the first appointment, audio and VR distractions were provided to participants in Groups 1 and 2, respectively, and the distraction tools provided to the participants were interchanged in the second appointment. A trained observer recorded physiological parameters (pulse rate and oxygen saturation) and observational parameters (Venham's anxiety rating scale) during both appointments at three-time intervals. Statistical intra-group and inter-group comparison analyses were performed using Friedman's and Mann-Whitney U tests. RESULTS A decrease in pulse, increase in oxygen saturation levels, and a decrease in Venham's Anxiety Rating Scores (statistically significant p < .05 / highly significant p < .01) was observed on introducing the distraction techniques in Groups 1 and 2 in both appointments. A statistically non-significant difference (p > .05) in physiological and observational parameters was observed between Groups 1 and 2 in both appointments. CONCLUSION Audio and VR distraction techniques can be employed for behavior guidance in children with mild intellectual disability during restorative dental procedures.
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Affiliation(s)
- Deepshikha Mehrotra
- Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
| | - Amarshree A Shetty
- Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
| | - Kavita Rai
- Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
| | - Kumara
- I.A.S, Zilla panchayat, Dakshina Kannada, Mangalore, Karnataka, India
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Hao T, Pang J, Liu Q, Xin P. A systematic review and network meta-analysis of virtual reality, audiovisuals and music interventions for reducing dental anxiety related to tooth extraction. BMC Oral Health 2023; 23:684. [PMID: 37735362 PMCID: PMC10515077 DOI: 10.1186/s12903-023-03407-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction. METHODS Four electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA. RESULTS A total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis. CONCLUSIONS Relaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.
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Affiliation(s)
- Tiedan Hao
- Department of Operating Room, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Pang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Qingmei Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Stomatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Pengfei Xin
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Department of Stomatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, 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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Yan X, Yan Y, Cao M, Xie W, O'Connor S, Lee JJ, Ho MH. Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: A systematic review and meta-analysis. J Dent 2023; 132:104455. [PMID: 36842625 DOI: 10.1016/j.jdent.2023.104455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/28/2023] Open
Abstract
OBJECTIVES To analyse the effectiveness of virtual reality (VR) distraction intervention for the management of dental anxiety in paediatric patients. DATA Randomised controlled trials (RCTs) of VR distraction interventions for reducing anxiety in paediatric patients, published in English were included. SOURCES Seven databases, including PubMed, Web of Science, Scopus, MEDLINE via ProQuest, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials, covering the period between January 2000 and September 2022 were searched. STUDY SELECTION A total of 12 RCTs involving 818 participants were included. Quality appraisal was undertaken using the Cochrane risk-of-bias tool for randomised trials by two authors independently. Random-effects model was used to summarise the effects of the interventions and pool data. CONCLUSIONS Results showed that VR distraction interventions were effective in reducing the dental anxiety of paediatric patients. In meta-analysis, the VR distraction interventions had a significant effect on reducing paediatric patients' anxiety (SMD = -1.74, 95%CI = -2.46, -1.02, p < 0.001, I² = 95%), pain (SMD = -1.57, 95%CI = -2.22, -0.91, p < 0.001, I² = 91%) and heart rate (MD = -10.54, 95%CI = -20.26, -0.81, p = 0.03, I² = 99%) during dental treatment. However, the evidence of VR in managing dental anxiety would become weak because of the publication bias. CLINICAL SIGNIFICANCE VR distraction interventions could be an effective approach to alleviate the dental anxiety of paediatric patients. Additional well-designed and high-quality RCTs with larger sample sizes are needed to determine the optimal way to deliver VR interventions in paediatric dental clinics.
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Affiliation(s)
- Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Yongyang Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Siobhán O'Connor
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester, United Kingdom
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China.
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
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Mehrotra D, Manju R. Comparative evaluation of the effect of audio and virtual reality distraction on the dental anxiety of healthy and mild intellectually disabled children. J Indian Soc Pedod Prev Dent 2023; 41:43-50. [PMID: 37282411 DOI: 10.4103/jisppd.jisppd_45_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Context Dental environment is one of the most anxiety-provoking stimuli for children, which makes patient management a constant challenge in both typically growing and intellectually disabled children. Distraction is a nonpharmacological technique to manage anxiety in children during dental treatment. Aim This study compares the effect of audio and virtual reality (VR) distraction on the dental anxiety of healthy and mild intellectually disabled children. Methods Forty children aged 6-14 years were divided into two groups (Group I: children with mild intellectual disability and Group II: healthy children). Groups I and II were further subdivided into two subgroups of 10 children each, based on the distraction technique given to them during the first appointment. After 1 month, we carried out a cross-over of the subgroups. Anxiety levels were measured using physiological and observational parameters at three-time intervals. Statistical Analysis Performed using paired t-test for the intergroup comparison and Wilcoxon Signed Rank test for the intra-group comparison. Results A decrease in the pulse rate, improvement in oxygen saturation levels, and lower Venham's anxiety rating scores were observed on introducing audio and VR distraction in all the subgroups. The inter-group comparison revealed that audio and VR were more effective in healthy children than children with mild intellectual disabilities. Conclusions Audio and VR distraction techniques can be employed successfully to reduce anxiety in children with mild intellectual disability and healthy children undergoing dental restorative treatment.
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Affiliation(s)
- Deepshikha Mehrotra
- Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangalore, Karnataka, India
| | - R Manju
- Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangalore, Karnataka, India
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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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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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Al-Jaloud MM, Al-Osaidi KS, Al-Anzi SS, Al-Jalban HA, Al-Shahrani FM, Al-Omari SD, Al-Shahrani AS, Al-Enezi MM, almusjan SA, Al-Faridi SA. Effect of Various Distraction Techniques on Pain and Anxiety of Pediatric Dental Patients: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/vtftdjbaws] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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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: 4] [Impact Index Per Article: 2.0] [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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Impact of Educational Videos on Dental Anxiety and Fear in Patients Undergoing Root Canal Treatment in Shiraz, Iran. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.3.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Felemban OM, Alshamrani RM, Aljeddawi DH, Bagher SM. Effect of virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric patients: a randomized clinical trial. BMC Oral Health 2021; 21:321. [PMID: 34172032 PMCID: PMC8234622 DOI: 10.1186/s12903-021-01678-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/14/2021] [Indexed: 12/02/2022] Open
Abstract
Background Different distraction techniques have been used in dentistry and have shown great results in managing anxious pediatric patients specially during local anesthesia administration. One of the recently invented techniques is virtual reality. The purpose of the study was to evaluate the effect of virtual reality distraction on anxiety and pain during buccal infiltration anesthesia in pediatric patients. Methods Healthy, cooperative 6- to 12-year-old children requiring buccal infiltration anesthesia were randomly assigned to a test or control group. In the test group, local anesthesia was administered while the subjects were watching a cartoon video using virtual reality goggles. Subjects in the control group watched a cartoon video on a screen during the administration of local anesthesia. To assess anxiety in both groups, heart rate was recorded using a pulse oximeter at five time points: (1) once the subject sets on the dental chair as a baseline; (2) when video is on; (3) at topical anesthesia application; (4) during needle insertion; (5) after the administration of local anesthesia. The face, legs, activity, cry, consolability (FLACC) behavioral pain assessment scale and the Wong–Baker FACES pain rating scale were used to assess pain. Results A total of 50 subjects were included with a mean age of 8.4 ± 1.46 years. Twenty-nine (58.0%) of the subjects were females. The mean heart rate at all time points except baseline was significantly higher among the test group compared to the control group. Multiple regression analysis showed that younger subjects and females had higher mean FLACC behavioral pain assessment scale scores (P = 0.034 and P = 0.004, respectively) regardless of the distraction technique used. Younger subjects and subjects with higher baseline heart rate reported higher mean Wong–Baker FACES pain rating scale score (P = 0.031 and P = 0.010, respectively), controlling for all other variables. Conclusion Female subjects and the younger age group were more likely to report higher pain scores during local anesthesia administration regardless of the type of distraction used. Trial registration The study was retrospectively registered in ClinicalTrials.gov with the identifier: NCT04483336 on 23/07/2020.
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Affiliation(s)
- Osama M Felemban
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Doha H Aljeddawi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Ministry of Health, Madinah, Saudi Arabia
| | - Sara M Bagher
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Comparison of two behavior management techniques used during mandibular block anesthesia among preschool children: a randomized clinical trial. Eur Arch Paediatr Dent 2021; 22:773-781. [PMID: 33826087 DOI: 10.1007/s40368-021-00617-2] [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: 02/24/2020] [Accepted: 02/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the Tell-Show-Do Technique (TSD-T) with Hiding Dental-Needle Technique (HDN-T) based on children's anxiety, pain, and behavior during first-time mandibular block anesthesia. METHODS A total of 52 children aged 3-5 years who had never received dental anesthesia and had at least one mandibular primary molar requiring extraction or pulpal therapy were included in the study. Children were randomly allocated into two groups: G1: TSD-T (n = 26) and G2: HDN-T (n = 26). This study included two sessions: intervention session (baseline) and control session (7 days after intervention). Facial Image Scale and Wong-Baker Pain Scale were used to evaluate anxiety and pain levels, respectively. Frankl Behavior Scale was used to assess children's behavior. RESULTS Anxiety and pain levels were not statistically significant between G1 and G2 groups (p > 0.05). Similar results were observed for children's behavior rating (p > 0.05). Higher pain level was associated with younger children (rate ratios (RR) = 0.41; p = 0.016) and negative behavior (RR = 1.11; p < 0.001). On the other hand, in within-groups comparisons, there was a statistical difference in anxiety levels between intervention session and control session (p = 0.032) in G2. CONCLUSIONS Even though there are no differences in the efficacy of TSD-T compared to HDN-T during first-time mandibular block anesthesia in preschool children in terms of children's anxiety, pain, and behavior, children from the HDN-T group can show reduced dental anxiety levels in the control sessions.
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Argüelles J, Echaniz M, Bowen J, Fatjó J. The impact of a stress-reducing protocol on the quality of pre-anaesthesia in cats. Vet Rec 2021; 188:e138. [PMID: 33645705 DOI: 10.1002/vetr.138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/16/2020] [Accepted: 01/26/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Transport to the clinic is a major source of stress for cats. The process involves being put into a carrier, driven in a car and handled. Cats are therefore removed from the safe-haven of their territory and experience many stressful stimuli and interactions. METHODS In the present study, 31 cats were transported to the clinic following a low-stress transport protocol and compared with a control group of 36 cats whose owners did not follow the protocol. This protocol involved preparing a cat carrier basket with F3 pheromone and keeping it covered and stable during the car journey from the home to the clinic. Pre-anaesthesia information was recorded for cardiac rate, respiratory rate, tolerance to handling, time for sedation to be achieved and dose of propofol required for induction and endotracheal intubation. RESULTS The group exposed to the low-stress transport protocol took less time to reach sedation and needed a lower dose of propofol for induction than the control group. CONCLUSION These results suggest that, in cats, pre-anaesthetic and induction requirements are influenced by lower-stress transport and handling.
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Affiliation(s)
- Juan Argüelles
- Centro Veterinario Integral La Cañada, Valencia, Spain.,Medicine and Surgery Deparment, Cardenal Herrera-CEU University, Valencia, Spain
| | | | - Jonathan Bowen
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, UK
| | - Jaume Fatjó
- Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Buldur B, Candan M. Does Virtual Reality Affect Children’s Dental Anxiety, Pain, And Behaviour? A Randomised, Placebo-Controlled, Cross-Over Trial. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kasimoglu Y, Kocaaydin S, Karsli E, Esen M, Bektas I, Ince G, Tuna EB. Robotic approach to the reduction of dental anxiety in children. Acta Odontol Scand 2020; 78:474-480. [PMID: 32730719 DOI: 10.1080/00016357.2020.1800084] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We introduced a humanoid robot for the use of techno-psychological distraction techniques in children aged 4-10 to reduce their anxiety and improve their behaviour during dental treatment. MATERIALS AND METHODS Two hundred children (98 boys, 102 girls; mean age: 6.5 ± 1.66 years) appointed for first time for dental caries were included and randomly divided into two groups [N = 100 for each group; RG: Robot Group (accompanied by the robot), CG: Control Group (without robot accompaniment)]. Half of the children were treated under local anaesthesia (infiltration anaesthesia) (n = 50 within each group) and half of the children were treated without any local anaesthesia (n = 50 within each group) within each group. The success rate of the new robotic distraction technique was evaluated by using Parental Corah Dental Anxiety Scale, Facial Image Scale (FIS), physiological pulse rate and Frankl Behaviour Rating Scale (FBRS). RESULT Pulse rates, which measured during treatment and after treatment, were statistically higher in CG than in RG (p < .05). After dental treatment, the FIS score was significantly higher in CG than RG (p < .05). 88.3% of the children in RG stated that they wanted the robot to be with them at the next treatment session. CONCLUSIONS Robotic technology can successfully help in coping with dental anxiety and stress, and helps children to behave better in dental office.
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Affiliation(s)
- Yelda Kasimoglu
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Simin Kocaaydin
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Emine Karsli
- Department of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Merve Esen
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Irmak Bektas
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Gökhan Ince
- Department of Computer Engineering, Istanbul Technical University, Istanbul, Turkey
| | - Elif Bahar Tuna
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Arslan I, Aydinoglu S, Karan NB. Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial. Eur J Pediatr 2020; 179:985-992. [PMID: 32030454 DOI: 10.1007/s00431-020-03595-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.
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Affiliation(s)
- Ipek Arslan
- Faculty of Dentistry, Department of Pediatric Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Sema Aydinoglu
- Faculty of Dentistry, Department of Pediatric Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Nazife Begüm Karan
- Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Recep Tayyip Erdoğan University, Rize, Turkey
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Silva AM, Nogueira BR, Leal TAC, Prado Júnior RR, Mendes RF. Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Cademartori MG, Cara G, Pinto GDS, da Costa VPP. Validity of the Brazilian version of the Dental Subscale of Children's Fear Survey Schedule. Int J Paediatr Dent 2019; 29:736-747. [PMID: 31144393 DOI: 10.1111/ipd.12543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) is a tool widely used to assess dental fear in children. AIM To translate and to verify the psychometric properties, including factor analyses of the Brazilian version of the CFSS-DS (B-CFSS-DS) in two settings. DESIGN The CFFS-DS was translated into the Portuguese language. In the first cross-sectional study (dental setting), 128 children (age: 4-12 years) participated. Mothers were interviewed; children's dental fear was assessed through the CFSS-DS and the Venham picture test; and child behaviour was assessed using the Frankl Scale. The second was a longitudinal study, with 103 schoolchildren (age: 4-12 years). Two receiver operating characteristic curves were drawn to establish the cut-off points. RESULTS The B-CFSS-DS version showed good internal consistency in dental and school settings (Cronbach's α = 0.88 and 0.77 respectively) and a good test-retest reliability (Weighted Kappa = 0.767), as well as good criterion and discriminant validities. Factor analyses showed four factors. CONCLUSION The Brazilian version of the CFSS-DS is a valid tool for dental fear assessment in children aged 4-12 years. Further studies with representative samples should be performed to strengthen the findings of this study, especially in the school setting.
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Affiliation(s)
| | - Gleidi Cara
- School of Dentistry, Specialized Faculty in the Health area of Rio Grande do Sul (Fasurgs), Passo Fundo, Brazil
| | - Gabriela Dos Santos Pinto
- School of Dentistry, Specialized Faculty in the Health area of Rio Grande do Sul (Fasurgs), Passo Fundo, Brazil
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Jakubovics N, Richman J. JDR Historical Highlights #10. J Dent Res 2019; 98:1063-1065. [DOI: 10.1177/0022034519864885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Birang E, Yaghini J, Birang R, Zohary M. Effect of Virtual Reality During Periodontal Treatment of Patients with Anxiety. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2019. [DOI: 10.29252/jrdms.4.1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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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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