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BMC Oral Health Dec 2023Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive...
BACKGROUND
Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry.
METHODS
A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed.
RESULTS
A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction.
CONCLUSIONS
VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.
Topics: Child; Humans; Pediatric Dentistry; Pain; Anxiety; Pain Management; Virtual Reality
PubMed: 38087294
DOI: 10.1186/s12903-023-03595-7 -
Oral Diseases May 2021To evaluate the efficacy of aromatherapy on dental anxiety. (Review)
Review
OBJECTIVES
To evaluate the efficacy of aromatherapy on dental anxiety.
METHODS
A detailed protocol was registered a priori (PROSPERO: CRD42019141093). PubMed, EMBASE, CDSR, CENTRAL, CNKI and grey literature databases were searched from inception to 10 January 2020. Randomised controlled trials (RCTs) and quasi-randomised controlled trials (CCTs) that examined the effects of aromatherapy on dental anxiety, compare to either negative control (i.e. no aromatherapy) or other positive control approaches (e.g. music), were included. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration's tool and ROBINS-I, while the certainty of evidence was assessed using GRADE. A narrative synthesis was performed, rather than meta-analysis, due to the high level of heterogeneity across studies.
RESULTS
Eleven RCTs and six CCTs were included. The risk of bias was identified as either high or unclear in RCTs, and moderate to serious in CCTs. Performance bias and detection bias were the most prevalent in RCTs, followed by selection bias and reporting bias. As to CCTs, greater risk of bias was found in the selection of participants into the study and in the measurement of outcomes. Based on the selected studies, the most commonly used aromatherapy for dental anxiety management was lavender fragrance, followed by orange. Compared to the negative control condition, aromatherapy might reduce the anxiety-related physiological parameters and psychometric rating, pain, and mood, alertness, and calmness compared to the negative control condition; and there might be no intergroup difference in such outcomes between aromatherapy and music. However, GRADEs of the relevant evidence were judged as low to very low.
CONCLUSIONS
Compared to the negative control condition, aromatherapy is more effective to reduce dental anxiety and has comparable effects on dental anxiety compared to music intervention; however, the certainty of evidence is relatively limited. Further high-quality randomised trials with robust study design and large sample size are warranted to confirm our findings and to confirm the role of aromatherapy in relieving dental anxiety.
Topics: Aromatherapy; Dental Anxiety; Humans; Pain; Randomized Controlled Trials as Topic
PubMed: 32267044
DOI: 10.1111/odi.13346 -
Medicina (Kaunas, Lithuania) Jan 2023To evaluate the effectiveness of music therapy for dental anxiety disorders. In order to gather clinical randomized controlled trials comparing the effectiveness of... (Meta-Analysis)
Meta-Analysis Review
To evaluate the effectiveness of music therapy for dental anxiety disorders. In order to gather clinical randomized controlled trials comparing the effectiveness of music interventions to traditional oral manipulation in patients with dental anxiety disorders, computer searches of the electronic databases of Wanfang, CNKI, VIP, PubMed, Web of Science, ScienceDirect, Cochrane library, Scopus, and CINAHL were conducted. The search period covered from 23 December 2022, through to the development of the database. The Cochrane Handbook was used to assess the quality of the included literature, and two researchers independently conducted the literature screening and data extraction. Stata 17.0 and RevMan 5.3 were used to conduct the meta-analysis. The preoperative baseline levels of the music intervention group were similar to those of the control group ( > 0.05), according to the meta-analysis, and music intervention significantly decreased heart rate (I = 81.2%, WMD (95% CI): -7.33 (-10.07, -4.58), < 0.0001), systolic blood pressure fluctuations (I = 85.6%, WMD (95% CI): -6.10(-9.25, 2.95), < 0.0001), diastolic blood pressure (I = 79.7%, WMD (95% CI): -4.29(-6.57, -2.02), < 0.0001) fluctuations, anxiety scores (I = 19.6%, WMD (95% CI): -9.04(-11.45, 6.63), < 0.0001), and pain scores (I = 32.7%, WMD (95% CI): -7.64(-9.43, -5.85), < 0.0001), as well as significantly lowered anxiety and pain levels and raised patients' cooperation rates (I = 0%, OR (95% CI): 3.03(1.24, 7.40), = 0.02). Music interventions are effective for dental anxiety disorders, but given the limitations of the study, more multicenter, large-sample, high-quality randomized controlled trials are needed to further validate the findings and obtain more objective and reliable clinical evidence.
Topics: Humans; Music; Music Therapy; Anxiety; Anxiety Disorders; Pain; Multicenter Studies as Topic
PubMed: 36837411
DOI: 10.3390/medicina59020209 -
Anesthesia Progress 2017Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used... (Meta-Analysis)
Meta-Analysis Review
Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used individually, the combination of the two is also commonly used. Four clinical trials were identified that compared the combination technique with the individual use of the drugs. The standardized mean difference (SMD) for each outcome measure was considered for final analysis. Three studies with 534 participants were included in the final meta-analysis, and the SMD [95% CI] was obtained as -0.15 [-0.32, 0.03] and was not statistically significant for cooperation scores. Two studies reported the dose of midazolam required for inducing sedation in 450 participants, and the pooled estimate of SMD [95% CI] was obtained as -0.29 [-0.48, -0.10] and was significant. Two studies with 450 participants reported the time taken to recover from sedation, and the pooled estimate of SMD [95% CI] was obtained as -0.20 [-0.39, -0.01] and favored the combination technique. To conclude, the combination technique combines the pros and cons of both drugs in causing fewer adverse effects due to midazolam by reducing the total dose and also helps to provide better acceptance of nitrous oxide inhalation.
Topics: Anesthesia, Dental; Conscious Sedation; Humans; Hypnotics and Sedatives; Midazolam; Nitrous Oxide; Outcome Assessment, Health Care
PubMed: 28604098
DOI: 10.2344/anpr-63-03-06 -
Currents in Pharmacy Teaching & Learning Dec 2020Test anxiety is well studied in higher education, but studies primarily concern traditional assessments, such as written examinations. As use of objective structured... (Review)
Review
INTRODUCTION
Test anxiety is well studied in higher education, but studies primarily concern traditional assessments, such as written examinations. As use of objective structured clinical examination (OSCE) in pharmacy education increases, a closer examination of non-cognitive factors such as test anxiety is warranted. The purpose of this review was to determine the association between OSCE-associated test anxiety with OSCE performance in health professional students.
METHODS
A literature search was conducted to identify peer-reviewed literature concerning test anxiety in health professional students associated with OSCE. Investigators searched for a combination of OSCE-related terms with anxiety-related terms using PubMed. Articles were included if they assessed OSCE-related anxiety by quantitative or qualitative methods. Data extracted from eligible articles included demographic data, type of the anxiety survey, associations between OSCE-related anxiety and performance, and other student-factors associated with OSCE-related anxiety.
RESULTS
The literature search yielded 339 articles. Nine articles met eligibility criteria and were included in the review. Results included students from medical, pharmacy, dental, and nursing professional programs. Anxiety was assessed via multiple scales. Six out of the eight studies assessing the relationship OSCE-related anxiety and OSCE performance found no association between the two measures. Contrary to literature concerning test anxiety in higher education, female gender was not associated with OSCE-related anxiety.
CONCLUSION
OSCE-related anxiety appears to have minimal to no influence on student performance. Future studies should utilize standardized anxiety assessments and should seek to understand anxiety's effects on student wellbeing and burnout.
Topics: Anxiety; Clinical Competence; Educational Measurement; Female; Humans; Physical Examination; Students
PubMed: 33092780
DOI: 10.1016/j.cptl.2020.07.007 -
Journal of Dental Anesthesia and Pain... Aug 2021The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited... (Review)
Review
The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited evidence regarding its efficacy. The present meta-analysis is an attempt to assess the association between the use of aromatherapy and anxiety levels among dental patients. A comprehensive search was conducted across Medline, Scopus, Web of Science, EBSCO host, Cochrane databases, and Google Scholar for studies evaluating aromatherapy and anxiety level among dental patients. PRISMA guidelines were followed for the meta-analysis. Randomized and cluster-randomized trials comparing aromatherapy with controls were included. The random-effects model was used to assess the mean differences in anxiety levels of patients visiting dental OPD. The significance value was set at P < 0.05. Six studies were identified that met the requirements for inclusion. Aromatherapy was significantly associated with reduction in patient anxiety levels during dental treatment (pooled mean difference: -3.36 [95% CI, -3.77 - -2.95, P = 0.00001). Low heterogeneity was noted between studies (I = 1%, P = 0.41) analyzed in the meta-analysis. High certainty of the evidence was obtained from the association between the use of aromatherapy and dental anxiety. This meta-analysis suggests that aromatherapy is effective in reducing dental anxiety. When used judiciously, the results of this work should encourage the use of aromatherapy to reduce patient anxiety levels during dental procedures.
PubMed: 34395898
DOI: 10.17245/jdapm.2021.21.4.311 -
Factors determining tooth extraction anxiety and fear in adult dental patients: a systematic review.International Journal of Oral and... Dec 2016The aim of this study was to review previous studies and to identify reliable factors determining anxiety in adult patients undergoing tooth extraction procedures. An... (Review)
Review
The aim of this study was to review previous studies and to identify reliable factors determining anxiety in adult patients undergoing tooth extraction procedures. An electronic literature search was conducted of the MEDLINE, ScienceDirect, SpringerLink, and Wiley Online Library databases covering the period January 2005 to May 2015. Sequential screening was performed at the title/abstract and full-text level. The review included all human prospective and retrospective follow-up studies and clinical trials, cohort studies, case-control studies, and case series that demonstrated at least one factor determining tooth extraction anxiety and/or fear and used specific scales for measurement. The search identified 16 articles meeting the inclusion criteria. Factors related to tooth extraction in patients were assessed: propensity to anxiety (P<0.05), pain experience or expectations (P<0.05), level of disturbance during the procedure (P<0.001), difficulty of the procedure (P=0.034), marital status (P=0.003), social class (P=0.012), and type of local anaesthesia (P=0.008). Using a video as the method of providing information (P<0.05) and having had a previous negative dental experience (P<0.05) led to an increase in patient anxiety level. Due to disagreements between studies, further investigations into the other factors are required to clarify the results. However, the absence of a single and appropriate scale that includes both the patient's evaluation and that of the doctor, hinders the rating of patient anxiety.
Topics: Adult; Dental Anxiety; Fear; Humans; Prospective Studies; Retrospective Studies; Tooth Extraction
PubMed: 27436789
DOI: 10.1016/j.ijom.2016.06.019 -
International Journal of Paediatric... Mar 2021Dental anxiety (DA) negatively impacts oral health-related quality of life, and patients with DA usually require more dental treatment time. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dental anxiety (DA) negatively impacts oral health-related quality of life, and patients with DA usually require more dental treatment time.
AIM
To describe the global prevalence of DA in children and adolescents and to examine the influence of individual factors (age, sex, and caries experience) and variables related to DA measurement on pooled prevalence.
DESIGN
Systematic review with meta-analyses of observational studies published between 1985 and 2020 (PROSPERO CRD42014013879).
RESULTS
Searches yielded 1207 unique records; 224 full-text articles were screened, and 50 studies were used in the qualitative and quantitative synthesis. No study was considered as having high methodological quality according to 'The Joanna Briggs Institute assessment tool'. Overall pooled DA prevalence was 23.9% (95% CI 20.4, 27.3). Pooled prevalence in preschoolers, schoolchildren, and adolescents was as follows: 36.5% (95% CI 23.8, 49.2), 25.8% (95% CI 19.5, 32.1), and 13.3% (95% CI 9.5, 17.0), respectively. DA was significantly more prevalent in preschool children (one study) and schoolchildren (two studies) with caries experience and in female adolescents (one study). The scale used for DA assessment was shown to influence pooled prevalence in preschoolers and adolescents.
CONCLUSION
DA is a frequent problem in 3- to 18-year-olds worldwide, more prevalent in schoolchildren and preschool children than in adolescents.
Topics: Adolescent; Child; Child, Preschool; Dental Anxiety; Dental Caries; Female; Humans; Prevalence; Quality of Life
PubMed: 33245591
DOI: 10.1111/ipd.12712 -
Global prevalence of early childhood dental fear and anxiety: A systematic review and meta-analysis.Journal of Dentistry Mar 2024The objective of this review is to determine the global prevalence of dental fear and anxiety (DFA) in early childhood and identify its related factors. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this review is to determine the global prevalence of dental fear and anxiety (DFA) in early childhood and identify its related factors.
METHODS
The systematic review utilized three common English-language databases (PubMed, EMBASE, and Web of Science). Two independent researchers performed a systematic search to include observational studies on young children published from 2000 to 2023. They extracted information on prevalence of DFA, assessment tools used, study sites, respondents, and children's dental visit experiences.
RESULTS
A total of 2,895 studies were identified, and 25 studies met the inclusion criteria for analysis. The pooled prevalence of DFA among 2- to 6- year-old children was estimated to be 30 % (95 % CI=25, 36). Children without dental visit experience (OR=1.37, 95 % CI=1.18, 1.59) and children with caries experiences (OR=1.18, 95 % CI=1.09, 1.27) had higher odds of experiencing DFA compared to those with dental visit experience or caries-free status. The most commonly used assessment tools in the included studies were the Frankl Behaviour Rating Scale (32 %, 8/25), Children's Fear Survey Schedule-Dental Subscale (20 %, 5/25), and Dental Anxiety Question (20 %, 5/25).
CONCLUSIONS
This systematic review reveals that approximately one-third of young children globally experience DFA. Children who lack dental visit experience or have caries experiences are at increased risk of DFA. Clinicians can use this information to make informed decisions regarding dental care provision for young children.
CLINICAL SIGNIFICANCE
This study provides comprehensive information on the global prevalence of dental fear and anxiety and its associated factors in early childhood. The findings can assist clinicians in understanding and addressing DFA in their dental care approach for young children.
REGISTRATION
PROSPERO (CRD42023446464).
Topics: Child; Child, Preschool; Humans; Anxiety Disorders; Dental Anxiety; Dental Caries; Prevalence; Observational Studies as Topic
PubMed: 38246307
DOI: 10.1016/j.jdent.2024.104841 -
Journal of Dentistry May 2023To analyse the effectiveness of virtual reality (VR) distraction intervention for the management of dental anxiety in paediatric patients. (Meta-Analysis)
Meta-Analysis Review
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.
Topics: Child; Humans; Dental Anxiety; Pain; Anxiety; Bias; Virtual Reality
PubMed: 36842625
DOI: 10.1016/j.jdent.2023.104455