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Journal of Anxiety Disorders Jun 2024This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental... (Review)
Review
This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.
PubMed: 38945067
DOI: 10.1016/j.janxdis.2024.102891 -
Medical Education Online Dec 2024Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve... (Meta-Analysis)
Meta-Analysis Review
Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, < 0.0001). Lastly, the results also showed a significant (z = -2.52, = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.
Topics: Yoga; Humans; Blood Pressure; Heart Rate; Stress, Psychological; Anxiety; Education, Medical; Depression; Students, Medical; Respiratory Function Tests
PubMed: 38861675
DOI: 10.1080/10872981.2024.2364486 -
Journal of Dental Anesthesia and Pain... Jun 2024Dental injections are routinely performed and can result in pain and anxiety in patients. This systematic review aimed to evaluate the efficacy of photobiomodulation... (Review)
Review
Dental injections are routinely performed and can result in pain and anxiety in patients. This systematic review aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) in dental injections for pain management in patients undergoing dental treatment. Indexed databases, including PubMed, EMBASE, Scopus, ISI Web of Knowledge, and Cochrane Library, were electronically searched without a time limit up to February 2024. A risk of bias evaluation was performed using the Cochrane tool. A preliminary investigation using electronic and manual methods yielded 4,920,881 manuscripts. Based on the eligibility requirements, 13 randomized control trials (RCTs) were included. Self-assessed pain was determined using the visual analog scale, Face, Legs, Activity, Cry, Controllability scale, or Wong-Baker face pain scale. Eight RCTs demonstrated a notable decrease in needle pain in patients undergoing dental needle injections using PBMT. Based on current evidence, PBMT may help reduce needle pain related to dental anesthesia. Further standardized studies are needed to assess the significance of PBMT for postoperative pain in patients undergoing dental injections.
PubMed: 38840646
DOI: 10.17245/jdapm.2024.24.3.145 -
Oral and Maxillofacial Surgery Jun 2024This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar... (Review)
Review
This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar surgeries. Clinical trials evaluating patients who used virtual reality (VR) compared with no VR in the management of pain or anxiety after third molar extractions were included. A literature search was conducted in five electronic databases to identify relevant articles: Medline (PubMed interface), Web of Science, Virtual Health Library, Embase, and Scopus. There were no restrictions on the time or language of publication. The risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB 2.0). A total of six studies were included in the qualitative analysis and three in the quantitative analysis. The results of the meta-analyses on anxiety revealed that patients in the intervention group before VR already showed less anxiety compared to those in the control group (-0.28 [-0.44 to -0.13, 95%CI] I²=24.51%. In the post-intervention evaluation, the group that received VR remained with a lower level of anxiety and a slight reduction compared to the pre-intervention. (-0.34 [-0.49 to -0.19, 95%CI] I²=36.61%. Virtual reality can be a clinical resource in dental care because it seems to cause a small reduction in anxiety, and with still uncertain results in the reduction of postoperative pain in extractions of third molars.
PubMed: 38834821
DOI: 10.1007/s10006-024-01265-8 -
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 -
Special Care in Dentistry : Official... Apr 2024Children with autism exhibit a higher general and dental anxiety, due to altered sensory sensibilities. (Review)
Review
Effect of Sensory Adapted Dental Environment (SADE) on physiological and behavioral parameters related to stress and anxiety in children with Autism Spectrum Disorder (ASD) undergoing dental treatment: A systematic review and meta-analysis.
BACKGROUND
Children with autism exhibit a higher general and dental anxiety, due to altered sensory sensibilities.
AIM
This current systematic review aims to evaluate the effectiveness of Sensory adapted dental environment (SADE) over regular dental environment (RDE) on behavioral, physiological stress and overt anxiety in children with autism spectrum disorders (ASDs).
MATERIALS AND METHODS
Prospero registered (CRD42024508336). PubMed, Cochrane, Scopus databases are searched from years January 1, 1980-January 1, 2024 using pre-defined search strategy.
RESULTS
A total of 269 titles, were obtained from the included databases after application of filters, exclusion of duplicates and reviews and irrelevant articles led to the final inclusion of 12 articles for full text screening from which, three studies sustained the targeted PICO search.
CONCLUSION
Skin conductance level (parameter indicating physiological stress) is lower in SADE environment in children with ASD, other behavior stress related parameters there is no significant difference between SADE and RDE environments.
PubMed: 38689539
DOI: 10.1111/scd.13003 -
Community Dentistry and Oral... Apr 2024Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can... (Review)
Review
BACKGROUND
Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences.
AIM
To explore and synthesize qualitative literature related to patient experience of dental behaviour support.
METHODS
A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified.
RESULTS
Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision.
CONCLUSION
Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.
PubMed: 38680013
DOI: 10.1111/cdoe.12969 -
Cureus Mar 2024Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This... (Review)
Review
Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This systematic review aims to comprehensively assess the effectiveness of non-invasive treatment modalities for TMJ dysfunction, prioritizing a definitive protocol to ensure patient safety and enhance quality of life. Employing the PRISMA guidelines, we meticulously analyzed 20 studies from a pool of 1,417 articles sourced from databases such as PubMed, Google Scholar, ScienceDirect, and Medline. These studies underscore the multifarious nature of TMD and the varied responses to treatments such as physical therapy, laser therapy, ultrasound and electrical stimulation, splint therapy, injections, and arthrocentesis. Notably, the review highlights the paramount importance of precise diagnosis, often through surface electromyography, followed by a tailored treatment approach integrating manual therapy, counseling, and splint therapy. The systematic analysis revealed that while certain treatments such as transcutaneous electrical nerve stimulation and low-level laser therapy showed limited efficacy, combination therapies, especially those involving manual therapy, counseling, and splint therapy, demonstrated substantial improvement in reducing pain, depression, and anxiety. The findings advocate for a non-invasive, patient-centric approach, emphasizing education and symptom management before considering more invasive procedures such as injections and arthrocentesis. The review identifies the need for more comprehensive, longitudinal studies to establish a standardized, evidence-based treatment protocol for TMJ dysfunction, aiming to improve patient outcomes holistically.
PubMed: 38646388
DOI: 10.7759/cureus.56713 -
Journal of Oral Rehabilitation Jul 2024Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective.
MATERIALS AND METHODS
An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE.
RESULTS
The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD.
CONCLUSION
This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.
Topics: Humans; Temporomandibular Joint Disorders; Facial Pain; Treatment Outcome; Pain Measurement; Randomized Controlled Trials as Topic; Cognitive Behavioral Therapy; Psychotherapy
PubMed: 38616535
DOI: 10.1111/joor.13693 -
Soa--ch'ongsonyon Chongsin Uihak =... Apr 2024This study aims to extract and summarize the literature on the mental health status of patients with monkeypox. (Review)
Review
OBJECTIVES
This study aims to extract and summarize the literature on the mental health status of patients with monkeypox.
METHODS
This review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using different databases and publishers such as Scopus, Sage, ScienceDirect, PubMed, BMJ, Wiley Online Library, Wolters Kluwer OVID-SP, and Google Scholar. The literature review was based on monkeypox and mental health. The year of publication was 2021-2023, during the monkeypox disease period. Data were extracted from opinions, editorials, empirical studies, and surveys.
RESULTS
Based on the literature related to the mental status of patients with monkeypox, the following themes and subthemes were identified: anxiety and depression, self-harm and suicidal tendencies, neuropsychiatric symptoms, mental health, social stigma, sex workers, vaccination, and stress-related diseases.
CONCLUSION
A review of monkeypox virus infection studies reveals that 25%-50% of patients experience anxiety and depression due to isolation, boredom, and loneliness. Factors such as infected people, a lack of competence among healthcare professionals, and shame over physical symptoms exacerbate mental insults. The implications of society include increased self-harm, suicide, low productivity, fear of stigmatization, and transmission of infection.
PubMed: 38601106
DOI: 10.5765/jkacap.230064