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Cureus Jul 2023Dental anxiety is one of the main problems dentists may face during the treatment of pediatric dental patients; therefore, clinicians tend to perform different behavior... (Review)
Review
Dental anxiety is one of the main problems dentists may face during the treatment of pediatric dental patients; therefore, clinicians tend to perform different behavior management techniques to reduce dental anxiety in children. This review aimed to systematically compare and evaluate the published literature regarding the effects of distraction techniques on anxiety, pain perception, and patient experience during dental practice. A detailed electronic search was conducted on 3 databases including PubMed, Google Scholar, and Cochrane Library. The databases were searched for articles published in the English language between 2015 and 2022. Among 102 studies, 27 studies fulfilled the criteria of eligibility and were included in this study to be analyzed. Numerous approaches have been proposed for the reduction of dental anxiety, out of which the use of audio-visual aids and instruments, active distraction such as tablets, smartphones, and virtual reality glasses showed governance in decreasing the children's anxiety followed by cognitive and behavioral methods.
PubMed: 37621781
DOI: 10.7759/cureus.42366 -
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 -
Special Care in Dentistry : Official... 2024This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive... (Meta-Analysis)
Meta-Analysis
AIM
This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs.
METHODS
Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted.
RESULTS
Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05).
CONCLUSION
MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
Topics: Adult; Humans; Aged; Quality of Life; Reproducibility of Results; Cognitive Dysfunction; Anxiety
PubMed: 37515496
DOI: 10.1111/scd.12906 -
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 -
Pediatric Dentistry May 2023To assess the effectiveness of nonpharmacological behavior guidance interventions used for a child undergoing preventive dental visits.
PURPOSE
To assess the effectiveness of nonpharmacological behavior guidance interventions used for a child undergoing preventive dental visits.
METHODS
Databases: Ovid MEDLINE, PsycINFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a pre- ventive visit including examination, prophylaxis, fluoride application and radiographs. Workgroup (WG) identified moderate-to-high quality system- atic reviews (SRs) published on hypnosis, audiovisual distraction, and parental presence/ absence; and decided to exclude these interventions from current SR to avoid duplication. The primary outcome measures for the studied interventions included reduction in anxiety, fear, pain, and improve- ment in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bias. Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done.
RESULTS
Fifteen articles qualified for analysis from 219 screened articles. WG found studies evaluating effectiveness of pre- visit preparation and in-office strategies rendered pre- or during treatment such as positive imagery, communication, modeling, tell-show-do, magic tricks, mobile applications, positive reinforcement, and sensory adapted dental environment. The certainty of evidence ranged from Very low to Moderate and the magnitude of effect varied from trivial to a large change in the desired outcomes.
CONCLUSIONS
Most basic nonpharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with mobile application and modeling showing large effects in reduction of anxiety based on some rating scales. Systematic Review Registration Number: PROSPERO: CRD42022314723.
Topics: Child; Humans; Communication; Behavior Therapy; Fluorides
PubMed: 37381126
DOI: No ID Found -
Pediatric Dentistry May 2023To assess the effectiveness of nonpharmacological behavior guidance interventions used for children and youth with special health care needs (CYSHCN) during preventive...
PURPOSE
To assess the effectiveness of nonpharmacological behavior guidance interventions used for children and youth with special health care needs (CYSHCN) during preventive and dental treatment visits.
METHODS
Databases: Ovid MEDLINE, PsycINFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a preventive visit (exam, fluoride application, radiographs, and prophylaxis) or a treat- ment visit (simple surgical treatment, sealants, restorative care with or with local anesthesia) with control or other interventions. The primary outcome measures for the studied interventions were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included Randomized Controlled Trials (RCTs), performed data extraction, and assessed the risk of bias (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done.
RESULTS
Eleven articles qualified for analysis from 219 screened articles. Included studies evaluate the effectiveness of in office strategies such as modeling, audio-visual distraction, sensory adapted dental environment, and picture exchange communication system. The certainty of evidence ranged from Very low to Low and the magnitude of effect varied from trivial to large change in the desired outcomes.
CONCLUSIONS
Most basic non-pharmacological behavior guidance techniques showed some trivial to small reduction in self-reported anxiety and/ or improvement in behavior, with audiovisual distraction, Sensory Adapted Dental Environment, and Picture Exchange Communication System showing large reduction in anxiety based on some rating scales. Systematic Review Registration Number: PROSPERO: CRD42022314723.
Topics: Adolescent; Child; Humans; Behavior Therapy; Anesthesia, Local; Dental Materials; Fluorides; Delivery of Health Care
PubMed: 37381125
DOI: No ID Found -
Pediatric Dentistry May 2023'Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for children undergoing dental treatment visits. (Meta-Analysis)
Meta-Analysis
UNLABELLED
'Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for children undergoing dental treatment visits.
METHODS
Databases: Ovid MEDLINE, PsycINFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a dental treatment visit including sealants, restorative care, dental local anesthesia, and simple surgical procedures. The primary outcome measures were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bias (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommenda- tions Assessment, Development and Evaluation approach were done.
RESULTS
Forty articles qualified for analysis from 219 screened articles. Included studies evaluated the effectiveness of pre-visit preparation and in office strategies rendered pre-/post- or during treatment such as positive imagery, direct observation/modeling, desensitization, tell-show-do and its modifications, voice control, positive reinforcement, memory restructuring, bio- feedback and breathing relaxation, animal assisted therapy, combined therapies, and cognitive behavior therapy. The certainty of evidence ranged from Very low to high and the magnitude of effect varied from trivial to large change in the desired outcomes.
CONCLUSIONS
Most of the basic non- pharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with modeling, positive reinforcement, biofeedback relaxation, breathing relaxation, animal assisted therapy, combined tell-show-do and audiovisual distraction, and cognitive behavior therapy showing large effects in reduction of anxiety based on some scales.
Topics: Animals; Humans; Behavior Therapy; Anesthesia, Local; Animal Assisted Therapy; Dental Materials; Dental Care
PubMed: 37381122
DOI: No ID Found -
European Journal of Oral Sciences Aug 2023This systematic review aimed to investigate whether root canal treatment caused greater stress than other dental treatments for patients and dentists. All peer-reviewed... (Meta-Analysis)
Meta-Analysis Review
This systematic review aimed to investigate whether root canal treatment caused greater stress than other dental treatments for patients and dentists. All peer-reviewed literature published in English between January 1990 and January 2023 was included. This included randomized/non-randomized control trials, cohort studies, case-control studies, and cross-sectional studies. An electronic search used PubMed, Scopus, Medline, Cochrane Collaboration, and Embase. Hand searching supplemented the screening pool. Studies examining physiological or psychological stress measures within patients or providers of dental treatment (dentists, dental specialists, and dental students) were eligible. The study must have reported on the stress outcome for root canal treatment and at least one other dental procedure. After screening 3639 eligible records, there were 23 studies included, varying from very-low to low certainty of evidence. This review found that root canal treatment was more psychologically stressful for patients than routine restorative or cleaning procedures. However, the stress of root canal treatment relative to other dental procedures, especially extractions, was inconclusive for both dental patients and providers. Since patients regard root canal treatment as more stress-evoking than other routine dental procedures, providers should endeavour to minimise their own bias toward root canal treatment when providing adequate information for an informed treatment choice.
Topics: Humans; Cross-Sectional Studies; Dental Pulp Cavity; Root Canal Therapy; Dentists; Case-Control Studies
PubMed: 37357152
DOI: 10.1111/eos.12941 -
Journal of Orthodontic Science 2023Coronavirus disease of 2019 (COVID-19), which has affected almost all medical professions, has had a significant negative influence on dental care. Additionally,... (Review)
Review
Coronavirus disease of 2019 (COVID-19), which has affected almost all medical professions, has had a significant negative influence on dental care. Additionally, non-urgent dental procedures were stopped during the epidemic in a number of countries. The purpose of this systematic review was to examine the impact of COVID-19 on individuals who had undergone or are currently having orthodontic treatment in any capacity during/after the pandemic's occurrence. After a thorough search of the online journals, a total of 634 documents were found, and 416 of the papers were initially chosen. The removal of 362 similar or duplicate publications that followed led to the initial availability of 54 separate papers. The final selection consisted of 23 documents, mostly in vitro investigations, cross-sectional studies, and comparative evaluations, which satisfied the necessary inclusion and exclusion criteria. COVID-19 had a significant impact on nearly every sphere of the patients' lives who were undergoing orthodontic treatment. However, people who are currently availing of various orthodontic treatment modalities did not experience the same issues as the ones faced by patients earlier. Teleorthodontics emerged as a viable option to access treatment during the lockdown period caused due to the pandemic. COVID-19 also had an overall negative impact on the psyche and morale of orthodontists around the world. .
PubMed: 37351409
DOI: 10.4103/jos.jos_118_22 -
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