-
Brazilian Oral Research 2022There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed...
There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed to retrieve the scientific evidence comparing the results of dental anxiety measured by salivary biomarkers with patient-reported outcomes in pediatric dental setting. The PECOS was as follows: population: pediatric patients aged ≤ 18 years; exposure: patient-reported outcome measures, such as scales and/or questionnaires; comparator: salivary biomarkers; outcome: anxiety, fear, phobia or stress during dental treatment; study design: observational studies or controlled trials. Electronic searches were conducted in PubMed, Scopus, Web of Science, and Ovid databases. Studies that compared scales/questionnaires and salivary biomarkers for the evaluation of dental anxiety, fear, and stress in children/adolescents during dental treatment were included. Certainty of evidence was assessed with GRADE. Risk of bias of the included studies was assessed with the Cochrane tool or the University of Adelaide tool. From the 314 studies identified, eight were included. Participants' age ranged from three to 13 years. The most used salivary biomarkers and instruments were cortisol and the Dental Subscale of the Children's Fear Survey Schedule, respectively. Most studies showed a weak correlation between objective and subjective measures. The main issues regarding bias were on allocation concealment, blinding of assessors, follow up, and exposure assessment. Certainty of evidence was low/very low. Evidence of salivary biomarkers and patient-reported outcome measures to investigate anxiety, fear and stress in children during in the dental environment is limited. There was no correlation between subjective and objective measures in almost all included studies.
Topics: Adolescent; Child; Humans; Child, Preschool; Dental Anxiety; Anxiety Disorders; Surveys and Questionnaires
PubMed: 36507754
DOI: 10.1590/1807-3107bor-2022.vol36.0067 -
Evidence-based Dentistry Jun 2024To establish the worldwide prevalence of paediatric dental fear and anxiety (DFA) and its associated components. (Meta-Analysis)
Meta-Analysis Review
AIMS
To establish the worldwide prevalence of paediatric dental fear and anxiety (DFA) and its associated components.
DESIGN
A systematic review and meta-analysis of 25 observational studies found on three well known English language publication databases dating from 2000. 2895 studies were identified relating to paediatric dental fear, anxiety, or phobia. 25 met the inclusion criteria and were subject to the Joanna Briggs Institute quality assessment tool and subsequently analysed using PRISMA framework. Studies exploring levels of DFA in children 2-6 years old were included. Studies were excluded if they were not published in English, included children with 'special needs' including intellectual disabilities, and studies which explored DFA intervention. Of the included studies, the following was recorded: Country of Origin, DFA prevalence, age of participants, study design, sample size, assessment method and who reported on the level of DFA of the child.
RESULTS
The pooled level of DFA of children aged 2-6 was estimated to be 30% (95% CI = 25, 36). Children with no dental experience and children with caries experience were found to have higher odds of experiencing DFA (OR = 1.37, 95% CI = 1.18, 1.59) and (OR = 1.18, 95% CI = 1.09, 1.27), respectively.
CONCLUSION
This review shows that approximately 30% of 2-6-year-old children will experience a level of dental and anxiety. Levels are expected to be higher in children who have not visited the dentist and children with dental caries.
Topics: Humans; Dental Anxiety; Child; Prevalence; Child, Preschool; Global Health
PubMed: 38762555
DOI: 10.1038/s41432-024-01016-4 -
International Journal of Nursing Studies Sep 2023To evaluate the effectiveness of a therapeutic robot, 'Paro', on anxiety, agitation, depression, apathy, medication use, total sleep time, and sociability among older... (Meta-Analysis)
Meta-Analysis Review
The effectiveness of a therapeutic robot, 'Paro', on behavioural and psychological symptoms, medication use, total sleep time and sociability in older adults with dementia: A systematic review and meta-analysis.
OBJECTIVE
To evaluate the effectiveness of a therapeutic robot, 'Paro', on anxiety, agitation, depression, apathy, medication use, total sleep time, and sociability among older adults with dementia.
DESIGN
Systematic review and meta-analysis with narrative synthesis.
SETTING AND PARTICIPANTS
Older adults aged 60 years and above with any form of dementia in the community, nursing homes, or care facilities.
METHODS
A three-step search strategy was conducted by two independent reviewers. Nine databases were searched (January 2003 to November 2022). Randomised controlled, crossover, and cluster trials on Paro for older adults with dementia published in English were included. All relevant trials were screened and assessed for risk of bias. Data were extracted using the Cochrane data collection form. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence.
RESULTS
In total, 12 articles involving 1461 participants were included. Results of the meta-analysis showed that Paro had a moderate effect on medication use (SMD: -0.63) and small effect on anxiety (SMD: -0.17), agitation (SMD: -0.27) and depression (SMD: -0.40). However, Paro exhibited negligible effect on total sleep time (SMD: -0.12). The overall quality of evidence for all outcomes were graded as low due to methodological limitations, small sample size, and wide confidence intervals. Narrative synthesis suggested that Paro reduced apathy and increase sociability.
CONCLUSION AND IMPLICATIONS
Paro could be a beneficial non-pharmacological approach to improve behavioural and psychological symptoms of dementia, reducing medication use, and increasing sociability for older adults with dementia. However, the results should be interpreted with caution as limited studies were available. Additionally, there were a variety of approaches across the studies (i.e. group and individual interventions, facilitated and non-facilitated) which made it difficult to determine which interventional approach is optimal to produce beneficial effects of Paro. Hence, more rigorous studies with a larger sample size are needed to fully understand the mechanism and effectiveness of Paro in older adults with dementia. The protocol was registered on PROSPERO (CRD42022296504).
Topics: Humans; Aged; Dementia; Sleep Duration; Robotics; Nursing Homes; Anxiety
PubMed: 37348392
DOI: 10.1016/j.ijnurstu.2023.104530 -
Odontology Jan 2023This systematic review was to compare the effects of interventions for the management of fear and anxiety for dental treatments. (Meta-Analysis)
Meta-Analysis
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.
Topics: Adolescent; Adult; Child; Humans; Anxiety; Pain; Randomized Controlled Trials as Topic; Dental Anxiety
PubMed: 35536282
DOI: 10.1007/s10266-022-00711-x -
Brazilian Oral Research 2023This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and... (Meta-Analysis)
Meta-Analysis
This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.
Topics: Child; Humans; Dental Enamel Hypoplasia; Dental Anxiety; Molar; Molar Hypomineralization; Surveys and Questionnaires; Prevalence
PubMed: 37436292
DOI: 10.1590/1807-3107bor-2023.vol37.0069 -
Medicina (Kaunas, Lithuania) Nov 2021: The COVID-19 pandemic has a negative impact on the mental health of the population in general, and in college students in particular. Dental students have seen their... (Meta-Analysis)
Meta-Analysis Review
: The COVID-19 pandemic has a negative impact on the mental health of the population in general, and in college students in particular. Dental students have seen their teaching altered and their clinical practice reduced. This study was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among dental students during the COVID-19 and estimating the pooled prevalence of depression. : Medline via PubMed and other databases were searched for studies on the prevalence of depression in dental undergraduates, published from 1 December 2019 to 1 September 2021. The pooled proportions of depression were calculated with random effects models. : We identified 13 studies from 9 countries. The pooled prevalence of depression in dental students was 37% (95% CI: 26-49%) with no variation due to gender, response rate or methodological quality. We only found a significantly higher prevalence of depression in studies from Asia compared to Europe and America. : Our results suggest that dental students are suffering from higher levels of depression compared with the general population or other college students during the COVID-19 pandemic, with differences across regions. Measures to improve mental health and wellbeing of dental students during the pandemic are needed.
Topics: Anxiety; COVID-19; Depression; Humans; Pandemics; Prevalence; SARS-CoV-2; Students, Dental
PubMed: 34833496
DOI: 10.3390/medicina57111278 -
Clinical Oral Investigations Oct 2022To perform a systematic review on the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions. (Review)
Review
OBJECTIVE
To perform a systematic review on the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions.
MATERIAL AND METHODS
A systematic review modeled according to the PRISMA guidelines was conducted. The MEDLINE/PubMed, Cochrane Library, Embase, and Scopus databases were searched for relevant reports. To be included in the study sample, the studies were required to be randomized controlled trials (RCT) on the effects of listening to music on outcomes of third molar extraction. Two reviewers independently extracted the relevant data from the reports.
RESULTS
A total of 1882 studies were retrieved after the duplicates were removed. After applying the inclusion criteria, five studies were included for qualitative analysis. In 4 studies, music was played before and during the extraction of the impacted third molars. In one study, music was played only before the procedure. The genres varied from classic piano music to rock, pop, jazz, folk, and even hymns. Overall, music listening was beneficial for patients in reducing preoperative anxiety or anxiety during the procedure compared to control. However, only one study demonstrated a statistically significant decrease in systolic blood pressure.
CONCLUSIONS
Music may be an effective non-pharmacological measure to reduce preoperative anxiety in patients scheduled for third molar extraction; however, the hemodynamic effects and the effects on pain (both perioperative and postoperative) should be further explored.
CLINICAL RELEVANCE
The side effects of certain medications may be avoided if listening to music is used in third molar extractions.
Topics: Anxiety; Humans; Molar, Third; Music; Music Therapy; Pain
PubMed: 35999384
DOI: 10.1007/s00784-022-04640-5 -
Journal of Clinical Medicine Apr 2020Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare... (Review)
Review
BACKGROUND
Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age.
METHODS
MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: "virtual reality", "distraction systems", "dental anxiety" and "pain". Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations.
RESULTS
31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies ( = 4), anxiety levels in three ( = 3) and anxiety and pain together in seven ( = 7). Our meta-analysis was based on ten studies ( = 10). The effect of VR was studied mainly in the pediatric population (for pain SMD = -0.82). In the adult population, only two studies (not significant) were considered.
CONCLUSIONS
The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.
PubMed: 32260538
DOI: 10.3390/jcm9041025 -
International Journal of Paediatric... May 2021The presence of parents during the dental appointment can affect the child's behaviour and, consequently, the success of the treatment. (Review)
Review
BACKGROUND
The presence of parents during the dental appointment can affect the child's behaviour and, consequently, the success of the treatment.
AIM
This systematic review aimed to evaluate whether parents' presence in the operatory room influences children's behaviour, anxiety and fear during dental treatment.
DESIGN
EMBASE, Cochrane Library, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, OpenGrey and ProQuest Dissertations and Theses Databases were searched. Randomized and non-randomized clinical trials in which some measure assessing children's behaviour and/or anxiety and fear during dental treatment with the presence and absence of parents were included. Two reviewers assessed studies for selection, extracted data, evaluated bias (Joanna Briggs Institute) and graded the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation). Random-effects meta-analyses using mean difference (MD) and narrative synthesis were performed.
RESULTS
A total of 2846 papers were identified, and after a 2-phase selection, sixteen studies were included (five in meta-analyses). There was no difference in children's behaviour in the presence or absence of parents (P = .23, P = .40, P = .60 and P = .89, respectively). The presence or absence of parents did not influence children's anxiety (P = .94 and P = .97) or fear (DM: -0.08; CI:-0.34-0.19, P = .24). All included studies presented a high risk of bias, and the certainty of evidence was considered to be very low.
CONCLUSION
It is concluded that parents' presence in the operation room does not influence children's (up to 12 years old) behaviour, anxiety and fear during dental treatment with very low certainty of evidence. Methodological limitations of included studies, however, suggest that better designed trials are needed to adequately understand this issue.
Topics: Anxiety; Child; Dental Anxiety; Fear; Humans; Parents
PubMed: 33258144
DOI: 10.1111/ipd.12762 -
Brain Sciences Jan 2022Hypnosis has proven a powerful method in indications such as pain control and anxiety reduction. As recently discussed, it has been yielding increased attention from... (Review)
Review
Hypnosis has proven a powerful method in indications such as pain control and anxiety reduction. As recently discussed, it has been yielding increased attention from medical/dental perspectives. This systematic review (PROSPERO-registration-ID-CRD42021259187) aimed to critically evaluate and discuss functional changes in brain activity using hypnosis by means of different imaging techniques. Randomized controlled trials, cohort, comparative, cross-sectional, evaluation and validation studies from three databases-Cochrane, Embase and Medline via PubMed from January 1979 to August 2021-were reviewed using an ad hoc prepared search string and following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 10,404 articles were identified, 1194 duplicates were removed and 9190 papers were discarded after consulting article titles/abstracts. Ultimately, 20 papers were assessed for eligibility, and 20 papers were included after a hand search ( = 40). Despite a broad heterogenicity of included studies, evidence of functional changes in brain activity using hypnosis was identified. Electromyography (EMG) startle amplitudes result in greater activity in the frontal brain area; amplitudes using Somatosensory Event-Related Potentials (SERPs) showed similar results. Electroencephalography (EEG) oscillations of θ activity are positively associated with response to hypnosis. EEG results showed greater amplitudes for highly hypnotizable subjects over the left hemisphere. Less activity during hypnosis was observed in the insula and anterior cingulate cortex (ACC).
PubMed: 35053851
DOI: 10.3390/brainsci12010108