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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 -
Clinical Oral Investigations Feb 2022We present this systematic review and meta-analyses to evaluate current evidence on the prevalence of depression, anxiety, and stress in patients with oral lichen planus... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We present this systematic review and meta-analyses to evaluate current evidence on the prevalence of depression, anxiety, and stress in patients with oral lichen planus and their magnitude of association.
MATERIAL AND METHODS
We searched PubMed, Embase, Web of Science, Scopus, PsycInfo, and Google Scholar for studies published before January 2021. We evaluated the quality of studies using a specific method for systematic reviews addressing prevalence questions, designed by the Joanna Briggs Institute. We carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.
RESULTS
Fifty-one studies (which recruited 6,815 patients) met the inclusion criteria. Our results reveal a high prevalence of depression (31.19%), anxiety (54.76%), and stress (41.10%) in oral lichen planus. Furthermore, OLP patients presented a significantly higher relative frequency than control group without OLP for depression (OR = 6.15, 95% CI = 2.73-13.89, p < 0.001), anxiety (OR = 3.51, 95% CI = 2.10-5.85, p < 0.001), and stress (OR = 3.64, 95% CI = 1.48-8.94, p = 0.005), showing large effect sizes. Subgroups meta-analyses showed the relevance of the participation of psychologists and psychiatrists in the diagnosis of depression, anxiety, and stress in patients with OLP. Multivariable meta-regression analysis showed the importance of the comorbidity of depression-anxiety in patients with OLP.
CONCLUSIONS
Our systematic review and meta-analysis show that patients with OLP suffer a higher prevalence of depression, anxiety, and stress, being more frequent than in general population. Clinical relevance In the dental clinic, especially dentists should be aware of depression, anxiety, and stress in OLP patients to achieve a correct referral.
Topics: Anxiety; Depression; Humans; Lichen Planus, Oral; Prevalence
PubMed: 34460001
DOI: 10.1007/s00784-021-04114-0 -
Clinical Psychology Review Nov 2020Anxiety disorders and related traits have become increasingly relevant to the study of physical health and health behaviors over the years. One important health behavior...
Anxiety disorders and related traits have become increasingly relevant to the study of physical health and health behaviors over the years. One important health behavior is healthcare utilization, and both over- and under-use have important implications within both personal and public health domains. Anxiety disorders are associated with reassurance-seeking, avoidance behaviors, and other characteristics and traits that may impact patterns of healthcare utilization. The current paper reviews the literature on the known associations between anxiety disorders and healthcare utilization, including studies (N = 70) that examined the association of healthcare utilization with generalized anxiety disorder, social anxiety disorder, panic disorder and agoraphobia, dental and blood-injection-injury phobias, and illness anxiety disorder/health anxiety. Overall, the majority of the studies reviewed indicate that anxiety disorders and health anxiety are associated with increased healthcare utilization across multiple care settings. In addition, there is preliminary but limited evidence that, in some cases, anxiety can be associated with delayed, irregular, or inconsistent use of healthcare services. More work is needed to fine-tune our understanding of the impact of anxiety disorders in healthcare settings.
Topics: Adult; Aged; Anxiety Disorders; Female; Humans; Male; Middle Aged; Panic Disorder; Patient Acceptance of Health Care; Phobia, Social; Phobic Disorders
PubMed: 32818687
DOI: 10.1016/j.cpr.2020.101894 -
Journal of Oral Rehabilitation Oct 2021Problem-orientated dental attenders account for around one-third of the UK population, these being patients who do not seek regular dental care, instead only attending... (Review)
Review
BACKGROUND
Problem-orientated dental attenders account for around one-third of the UK population, these being patients who do not seek regular dental care, instead only attending with dental pain. In order to develop intervention(s) to encourage regular dental attendance in these patients, any previous intervention development should be identified to aid idea generation or retrofitting of interventions.
OBJECTIVE
To identify previous interventions which have been developed targeted at problem-orientated dental attenders to facilitate the development and co-design of a new intervention.
METHODS
Eight electronic databases were searched for studies which included an intervention targeted at adult problem-orientated or irregular dental attenders to encourage regular dental attendance. Data on the intervention design mapped to the theoretical domains framework were extracted, alongside effectiveness and patient views where available.
RESULTS
Three studies fitted the inclusion criteria for the review. Interventions identified were attendance at a dental anxiety clinic, and a large advertising campaign promoting a free dental update where members of the public could visit local dental practices to look around and meet the dentists. One study looked at the effect of policy change by introducing free dental check-ups in Scotland. Interventions were poorly reported, with significant omissions in their description and a lack of clear identification of what composed the intervention.
CONCLUSION
There are very few interventions developed targeted at problem-orientated dental attendance, but important areas to consider in future intervention development include the following: dentist communication; dentist-patient relationship; increasing the awareness of need; the effect of free dental check-ups.
Topics: Adult; Anxiety; Humans
PubMed: 34398460
DOI: 10.1111/joor.13244 -
Pain Management Nursing : Official... Oct 2022The purpose of this systematic review is to examine the delivery and clinical efficacy of virtual reality (VR) therapeutics for acute pain management in adults and... (Review)
Review
OBJECTIVES
The purpose of this systematic review is to examine the delivery and clinical efficacy of virtual reality (VR) therapeutics for acute pain management in adults and identify practical considerations of VR deployment, as well as current gaps in the literature.
DESIGN
A systematic review.
DATA SOURCES
A search of PubMed, CINAHL, PsychINFO, Embase, Compendex, and Inspec was completed using Medical Subject Headings (MeSH) and keyword search terms related to acute pain and VR.
REVIEW/ANALYSIS METHODS
A systematic review of all pertinent articles published between January 1, 2000, and August 1, 2020, was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.
RESULTS
Twenty-three articles met final inclusion criteria and were included in this review. Studies utilized VR in a variety of settings for wound care, procedure-induced pain, physical or occupational therapy, dental treatment or generalized acute pain. A likely mechanism by which VR promoted analgesia in these studies is distraction. Of the reviewed studies, 19 (83%) reported decreases in pain intensity while using VR compared with no VR use or with a non-VR group.
CONCLUSIONS
This systematic review found VR to be an effective tool for acute pain management. Findings from this review also underscore the importance of addressing the patient's sense of presence and levels of immersion, interaction, and interest when deploying VR. Future VR studies should consider incorporation of anxiety, presence, and VR side effect measures in addition to acute pain metrics.
Topics: Adult; Humans; Pain Management; Acute Pain; Virtual Reality; Pain Measurement; Pain, Procedural
PubMed: 35868974
DOI: 10.1016/j.pmn.2022.05.004 -
Journal of Dental Education Jul 2020Dental anxiety is common and can propagate a vicious cycle of dental neglect and anxiety-provoking treatment. Patient, procedural, and operator factors are important...
PURPOSE/OBJECTIVES
Dental anxiety is common and can propagate a vicious cycle of dental neglect and anxiety-provoking treatment. Patient, procedural, and operator factors are important contributions. This review aims to explore risk factors for dental anxiety in adult patients treated by dental students, in order to improve awareness of relevant factors and aid patient management.
METHODS
Systematic searching of PubMed and Scopus databases was performed. Inclusion criteria were: studies assessing at least 1 risk factor for dental anxiety in patients aged 18 years and above treated by dental students, with use of a specific measurement scale for dental anxiety. Exclusion criteria were: duplicates, non-English publications, non-full-text publications, studies with a pediatric sample.
RESULTS
Nine hundred thirty-one articles were identified. Eight eligible articles representing 1702 patients were included. Seven studies had a cross-sectional design and 1 study had a pretreatment/posttreatment design. Sixteen factors for dental anxiety were assessed. A significant correlation (P < 0.05) was found for: age (younger), gender (female), general/waiting room anxiety, irregular dental attendance, invasive treatment, poor emotional well-being, postponement of dental visit due to anxiety, previous negative dental experience and village residence. No significant correlation was found for: education, employment, income, perceived oral health, presence of a previous dental visit, symptom duration and time since last dental visit.
CONCLUSIONS
These findings provide a good foundation for future research, but clinical generalization is limited by the heterogeneity among included studies. A well-structured comparison of risk factors for dental anxiety between patients treated by dental students and dentists is required.
Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Dental Anxiety; Female; Humans; Oral Health; Risk Factors; Students, Dental
PubMed: 32400046
DOI: 10.1002/jdd.12173 -
BMC Oral Health Oct 2023People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing... (Meta-Analysis)
Meta-Analysis
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.
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).
Topics: Child; Humans; Young Adult; Dental Anxiety; Developmental Disabilities; Oral Health; Psychophysiology; Risk Factors
PubMed: 37858057
DOI: 10.1186/s12903-023-03445-6 -
Clinical Oral Investigations Oct 2023To evaluate the influence of dental anxiety on the perception of pain before and during endodontic treatments. (Review)
Review
OBJECTIVE
To evaluate the influence of dental anxiety on the perception of pain before and during endodontic treatments.
MATERIALS AND METHODS
The PRISMA checklist was followed. A search was conducted in Scopus, Medline/PubMed, The Cochrane Library, and Web of Science databases. Based on PECOS criteria, the first outcome was a possible association between pre-operative pain and anxiety. The second outcome was a possible association between intraoperative pain and anxiety. The type of studies was observational. The JBI Critical Appraisal Checklist was used to evaluate the methodological quality of articles. The certainty of the evidence was analyzed using the GRADE approach.
RESULTS
Four articles were included with a total of 471 patients. Two studies found a positive association between pain and pre-endodontic treatment anxiety. Three studies investigated the relationship between anxiety and intraoperative pain; two identified an extremely significant positive association. One article noted that anxiety influences pain expectancy. The studies were of good quality as assessed by the JBI Critical Appraisal Checklist for cross-sectional studies. However, the certainty of the evidence was considered low and very low.
CONCLUSIONS
Dental anxiety can be directly associated with pre- and intraoperative pain during endodontic procedures.
CLINICAL RELEVANCE
It is necessary to identify patients with dental anxiety to employ therapies to bring their anxiety under control, avoiding the increase of endodontic infections, and the postponement and evasion of endodontic treatments.
PubMed: 37526740
DOI: 10.1007/s00784-023-05181-1