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Patient Education and Counseling Oct 2011To review the literature, of the past 30 years, on the effects of dental staff behaviour on the anxiety and behaviour of child dental patients; especially to determine... (Review)
Review
OBJECTIVES
To review the literature, of the past 30 years, on the effects of dental staff behaviour on the anxiety and behaviour of child dental patients; especially to determine staff behaviours that reduce anxiety and encourage cooperation of children.
METHODS
A systematic literature review was conducted using PubMed, Web of Science, The Cochrane Library, PsycINFO, Embase and CINAHL.
RESULTS
Initial search returned 31 publications of which 11 fulfilled the criteria for review. Among seven studies that measured anxiety, four used validated measures. Five observational studies coded behaviour using Weinstein et al.'s (1982) coding scheme [1]. An empathic working style and appropriate level of physical contact accompanied by verbal reassurance was found to reduce fear-related behaviours in children. Findings regarding positive reinforcement and dentists' experience increasing cooperative behaviour were inconsistent.
CONCLUSIONS
Measures for anxiety and behaviour varied across studies. Relationships between certain dental staff behaviours and child anxiety/behaviour were reported. However, limited work was identified and research using improved sampling, measurement and statistical approach is required.
PRACTICE IMPLICATIONS
Understanding what routine clinical behaviour of dental staff affects children's dental anxiety/behaviour will inform investigators of how children comply and help staff be aware the significance of their daily behaviour on treatment success.
Topics: Child; Child Behavior; Child, Preschool; Dental Anxiety; Dental Auxiliaries; Dental Care for Children; Dentist-Patient Relations; Humans; Patient Compliance; Professional-Patient Relations
PubMed: 20807676
DOI: 10.1016/j.pec.2010.08.002 -
The Journal of Clinical Pediatric... Mar 2022Dentists have a wide variety of techniques available to them such as tell -show-do, relaxation, distraction, systematic desensitisation, modelling, audio analgesia,... (Meta-Analysis)
Meta-Analysis
Effectiveness of Audio and Audio-Visual Distraction Aids for Management of Pain and Anxiety in Children and Adults Undergoing Dental Treatment- A Systematic Review And Meta-Analysis.
UNLABELLED
Dentists have a wide variety of techniques available to them such as tell -show-do, relaxation, distraction, systematic desensitisation, modelling, audio analgesia, hypnosis, and behaviour rehearsal. There is no concrete research as systematic review and meta-analysis indicating which explains the most effective distraction technique.
AIM
To summarize effectiveness of audio and audio-visual (AV) distraction aids for management of pain and anxiety in children undergoing dental treatment.
STUDY DESIGN
Literature search: PubMed/MEDLINE, DOAJ, Science Direct from June - July 2020 with randomized control clinical trials conducted on children with audio and AV distraction aids as intervention and those which had anxiety and pain as outcomes were searched. Fifty articles were identified and relevance was determined. 14 studies were included for qualitative synthesis and 05 were eligible for meta-analysis. Cochrane handbook used to assess the risk of bias. The meta analysis conducted using review manager 5.3 software.
RESULTS
Meta-analysis, cumulative mean difference for audio and AV distraction techniques was calculated with main outcomes as pulse rate, O2 level, Vehman's picture and clinical test. These findings showed significant difference favoring the intervention (audio and AV) group when compared with control but indicating more effectiveness of AV distractions.
CONCLUSION
Different audio-visual aids assist in reducing pain and anxiety in children but using audio distraction aids when audio-visual aids are not available could be acceptable way for distracting and treating children.
Topics: Adult; Anxiety; Audiovisual Aids; Child; Dental Anxiety; Dental Care; Humans; Pain; Pain Management
PubMed: 35533223
DOI: 10.17796/1053-4625-46.2.2 -
Community Dentistry and Oral... Apr 2013The reliable assessment of children's dental anxiety can have many benefits for the dental team, service providers and dental public health practitioners. This study... (Review)
Review
The reliable assessment of children's dental anxiety can have many benefits for the dental team, service providers and dental public health practitioners. This study aimed to identify and evaluate self-report measures, which are available to assess children's dental anxiety. Systematic searches of the literature between 1998 and 2011 were conducted to identify relevant studies. The properties of each measure (reliability and validity) were assessed, and measures were evaluated against a theoretical framework of dental anxiety. Executing the search strategy generated 498 articles and of these 60 studies met all of the inclusion criteria. Seven 'trait' and two 'state' measures of dental anxiety had been employed to assess children's dental anxiety over the past decade. Reliability and validity estimates for the most widely used measures were good; however, many questionnaires had a limited focus in the aspects of anxiety they assessed. The paper summarizes the measures of children's dental anxiety which may be most useful for a number of different purposes and populations.
Topics: Child; Dental Anxiety; Humans; Reproducibility of Results; Self Report; Surveys and Questionnaires
PubMed: 22970833
DOI: 10.1111/j.1600-0528.2012.00740.x -
European Journal of Oral Sciences Jun 2013The aim was to investigate the efficacy of behavioural interventions as treatment of dental anxiety/phobia in adults, by conducting a systematic review of randomized... (Review)
Review
The aim was to investigate the efficacy of behavioural interventions as treatment of dental anxiety/phobia in adults, by conducting a systematic review of randomized controlled trials (RCTs). The inclusion criteria were defined according to the Patients, Interventions, Controls, Outcome (PICO) methodology. The study samples had documented dental anxiety, measured using validated scales [the Dental Anxiety Scale (DAS) or the Dental Fear Survey (DFS)], or fulfilled the psychiatric criteria for dental phobia. Behavioural interventions included were based on cognitive behavioural therapy (CBT)/behavioural therapy (BT), and control conditions were defined as information, sedation, general anaesthesia, and placebo/no treatment. The outcome variables were level of dental anxiety, acceptance of conventional dental treatment, dental treatability ratings, quality of life and oral health-related quality of life, and complications. This systematic review identified 10 RCT publications. Cognitive behavioural therapy/behavioural therapy resulted in a significant reduction in dental anxiety, as measured using the DAS (mean difference = -2.7), but the results were based on low quality of evidence. There was also some support that CBT/BT improves the patients' acceptance of dental treatment more than general anaesthesia does (low quality of evidence). Thus, there is evidence that behavioural interventions can help adults with dental anxiety/phobia; however, it is clear that more well-designed studies on the subject are needed.
Topics: Adult; Dental Anxiety; Humans; Psychotherapy; Young Adult
PubMed: 23659254
DOI: 10.1111/eos.12032 -
International Journal of Paediatric... Mar 2023Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings.
AIM
To investigate whether the use of AAT helps to reduce anxiety during dental care in children and adolescents.
DESIGN
Systematic review that included randomized and nonrandomized clinical trials with children up to 18-years of age undergoing dental appointments. The databases Embase, Cochrane, Pubmed/Medline, LILACS, PsycInfo, Scopus, and Web of Science were searched including gray literature. Random-effects meta-analyses using mean difference (MD) and narrative synthesis (vote counting) were implemented. Risk of bias was assessed using RoB2 for randomized clinical trials. The certainty of the evidence was performed using GRADE.
RESULTS
A total of 1103 references were identified, and after a two-phase selection, three studies were included. Anxiety, behavior, and pain were the outcomes. A meta-analysis with 146 participants was performed for anxiety at three time points: before treatment (MD -0.40, CI: -1.06 to 0.26; I = 0%; p = .24), during treatment (MD -3.64, CI: -11.18 to 3.91; I = 94%; p = .34), and after treatment (MD -5.97, CI: -17.08 to 5.14; I = 98% p = .29). There was no difference during dental treatment with or without ATT (dogs), as well as for narrative analysis for any outcome. The risk of bias was high mainly because of the randomization and outcome measurement.
CONCLUSION
There is no evidence to support or refute that the presence of AAT during dental care can help reduce anxiety in children (5-11 years). Studies with larger samples are suggested. Protocol registration (CRD42021293593).
Topics: Animals; Dogs; Humans; Animal Assisted Therapy; Anxiety; Dental Care; Pain
PubMed: 36208050
DOI: 10.1111/ipd.13033 -
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 -
Quintessence International (Berlin,... Mar 2021Objectives: The prevalence of "dental anxiety" (DA) is often underestimated and numerous diagnostic methods are available for dental practitioners. It is difficult to...
Objectives: The prevalence of "dental anxiety" (DA) is often underestimated and numerous diagnostic methods are available for dental practitioners. It is difficult to differentiate between a dental phobia requiring an interdisciplinary approach and DA, which can be managed by dental practitioners alone. The appropriate use of diagnostic tools is key for the successful management of highly anxious and/or phobic patients. The aim was to provide a guideline to recognize dental fear and to differentiate DA from patients who are highly anxious or even have a phobia. Data sources: In total, 8,929 articles that were selected for the development of the German guidelines for "Dental anxiety in adults" in PubMed, Web of Science, Embase, and MedPilot were filtered for diagnosis of DA disorder. The focus for this review was on the use of scales to measure DA levels. The methods and tools used in the 51 reviewed articles to assess DA levels were evaluated in terms of their practicability and suitability in daily practice to differentiate between phobia (ie, DA disorder) and nonpathologic anxiety. In addition, the internal consistency (Cronbach alpha) of the questionnaires/tools was determined. Conclusion: All identified DA questionnaires validated in the German language had an acceptable to excellent internal consistency (0.7 to 0.986). The only validated questionnaire-free method was galvanic skin reaction measurement. For the assessment of DA and diagnosis of a DA disorder in adults, the survey by means of any suitable questionnaire or even several questionnaires in combination with a behavioral observation of the patient is currently the method of choice.
Topics: Adult; Dental Anxiety; Dentists; Humans; Language; Phobic Disorders; Professional Role; Surveys and Questionnaires
PubMed: 33491392
DOI: 10.3290/j.qi.a45603 -
Journal of Oral and Maxillofacial... Apr 2022The aim of this study is to assess whether the use of computerized devices to deliver local anesthesia results in less pain and anxiety compared to traditional... (Review)
Review
PURPOSE
The aim of this study is to assess whether the use of computerized devices to deliver local anesthesia results in less pain and anxiety compared to traditional anesthesia in adult dental procedures.
METHODS
This review was registered at PROSPERO (CRD 42021265046), based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was structured according to the PICO strategy. The studies were selected based on eligibility criteria, and data were collected by 1 author and reviewed by another.
RESULTS
Nine of the 10 studies included were randomized controlled trials. Differences related to pain and anxiety were observed, which favored computerized techniques; however, caution should be exercised when interpreting these results due to differences in assessment methods. The studies used different local anesthetics, including 2% lidocaine, 4% articaine, or 3% mepivacaine with epinephrine diluted 1:80,000 to 1:200,000. A total of 560 patients were evaluated.
CONCLUSIONS
Computerized anesthesia devices yielded better results than conventionally delivered anesthesia after qualitative evaluation. Nevertheless, conventional anesthesia is widely used, safe, and effective. Due to the heterogeneity among the included studies, it is strongly recommended that new randomized clinical trials using well-defined methodologies be performed to improve the quality of evidence regarding this topic.
Topics: Adult; Anesthesia, Dental; Anesthesia, Local; Anesthetics, Local; Anxiety; Carticaine; Humans; Lidocaine; Pain
PubMed: 34942152
DOI: 10.1016/j.joms.2021.11.018 -
Scientific Reports Dec 2019A systematic review and network-meta analysis (NMA) were performed to estimate significance of the anxiolytic effect of lavender essential oil taken as silexan capsules... (Comparative Study)
Comparative Study
A systematic review and network-meta analysis (NMA) were performed to estimate significance of the anxiolytic effect of lavender essential oil taken as silexan capsules versus other comparators (i.e., placebo/paroxetine/lorazepam). The outcome of interest was Hamilton Anxiety Scale (HAMA). Weighted mean differences (WMD) were calculated to estimate the treatment effect at the confidence interval of 95%. League tables were generated using treatment effect, for all pairwise comparisons, where WMD < 0 favors the column-defining treatment. Five studies were identified with a total of 524 participants receiving treatment with silexan 80 mg and 121 participants taking silexan 160 mg. The NMA results indicated that consumption of silexan 160 mg resulted in higher decline of HAMA score [WMD -1.14 (-1.10, 3.39)] in comparison to silexan 80 mg, placebo [-2.20 (-4.64, 0.24)] and paroxetine [-1.24 (-5.34, 2.85)]. The effect of silexan 80 mg was observed to be same as that of paroxetine. Overall, silexan 160 mg was noticed to be a more efficient treatment giving significant decline in HAMA score across other comparators. However, no improvements in HAMA score was observed for the group receiving lorazepam 0.5 mg when compared to silexan 160 mg, silexan 80 mg, paroxetine 20 mg, and placebo.
Topics: Anti-Anxiety Agents; Anxiety Disorders; Capsules; Humans; Lavandula; Lorazepam; Network Meta-Analysis; Oils, Volatile; Paroxetine; Personality Assessment; Plant Oils; Treatment Outcome
PubMed: 31792285
DOI: 10.1038/s41598-019-54529-9 -
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