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The Cochrane Database of Systematic... Jun 2017Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children,... (Review)
Review
BACKGROUND
Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children, such us: 'tell, show & do', positive reinforcement, modelling and hypnosis. The use of hypnosis is generally an overlooked area, hence the need for this review.
OBJECTIVES
This systematic review attempted to answer the question: What is the effectiveness of hypnosis (with or without sedation) for behaviour management of children who are receiving dental care in order to allow successful completion of treatment?Null hypothesis: Hypnosis has no effect on the outcome of dental treatment of children.
SEARCH METHODS
We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE (OVID), EMBASE (OVID), and PsycINFO. Electronic and manual searches were performed using controlled vocabulary and free text terms with no language restrictions. Date of last search: 11th June 2010.
SELECTION CRITERIA
All children and adolescents aged up to 16 years of age. Children having any dental treatment, such as: simple restorative treatment with or without local anaesthetic, simple extractions or management of dental trauma.
DATA COLLECTION AND ANALYSIS
Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors of trials were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The methodological quality of randomised controlled trials (RCTs) was assessed using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2.
MAIN RESULTS
Only three RCTs (with 69 participants) fulfilled the inclusion criteria. Statistical analysis and meta-analysis were not possible due to insufficient number of studies.
AUTHORS' CONCLUSIONS
Although there are a considerable number of anecdotal accounts indicating the benefits of using hypnosis in paediatric dentistry, on the basis of the three studies meeting the inclusion criteria for this review there is not yet enough evidence to suggest its beneficial effects.
Topics: Adolescent; Child; Child, Preschool; Dental Anxiety; Dental Care; Humans; Hypnosis; Randomized Controlled Trials as Topic
PubMed: 28632910
DOI: 10.1002/14651858.CD007154.pub3 -
The Journal of Clinical Pediatric... Sep 2023Dental Anxiety constitutes a series of signs of sympathetic hyperfunction that arises during a dental visit. Orthodontic pain is a common reaction in children and adults... (Review)
Review
Dental Anxiety constitutes a series of signs of sympathetic hyperfunction that arises during a dental visit. Orthodontic pain is a common reaction in children and adults that can increase dental anxiety and affect orthodontic outcomes. Both malocclusion and orthodontic pain negatively affect quality of life. Dental anxiety and orthodontic pain have different contributing factors, and the prevalence of malocclusion and dental anxiety varies. Different methods have been proposed for the classification of the dental anxiety scales and orthodontic pain as a first approach in the treatment process. The objective of this literature review was to discuss the effect of orthodontic pain on dental anxietyand to explore ways to address dental anxietyin children and adultsto reduce negative effects on quality of life. This review not only analyses the prevalence and etiology of dental anxiety, the characteristics and influencing factors of orthodontic pain; but also introduces how dental anxiety and orthodontic pain are diagnosed, and proposes some treatment options. The occurrence of malocclusion has recently risen in children and adults, and the negative effects of orthodontic pain and dental anxiety have been explored in literature. Therefore, this review attempts to provide a critical analysis of dental anxiety and orthodontic pain, to attract the attention of orthodontists and provide a framework for further exploration of effective treatment solutions.
Topics: Adult; Child; Humans; Dental Anxiety; Quality of Life; Malocclusion; Pain
PubMed: 37732433
DOI: 10.22514/jocpd.2023.051 -
Community Dentistry and Oral... Jun 2020To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience...
OBJECTIVE
To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners.
METHOD
A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (scoring 0) questions: 'ever taken (illegal) drugs', 'injecting drugs' and 'ever participated in a rehabilitation programme'. Participants had an oral examination to determine dental caries experience (missing [MT] and untreated decay [D T]) in all four quadrants. Latent variable path analysis was conducted to test the mediation model.
RESULTS
A total of 342 prisoners participated, of which 298 yielded a complete data set. Depression was associated with missing teeth and untreated decay (D T) through an indirect pathway (Total standardized indirect effects = 0.11, P < .01) via drug use and dental anxiety (X [71] = 89.8, P = .07; Root Mean Square Error of Approximation: 0.03; Comparative Fit Index: 0.994 and Tucker-Lewis index: 0.992). Twenty-two percent of the variance in untreated decay and missing teeth was explained by both drug use and dental anxiety; however, the strongest predictor was drug use (total standardized direct effects = 0.45, P < .001).
CONCLUSION
A relatively simple model to assist understanding dental decay experience of people in prison has been proposed. The data collected were consistent with our specified model. Drug use acted as the primary mediator and dental anxiety as a secondary mediator between depression and dental decay experience. Given the co-morbidity between mental health and drug use and dental decay experience, an integrated or shared approach is proposed. We recommend that future research should concentrate on building a firmer picture by replicating and extending the framework presented.
Topics: Cross-Sectional Studies; Dental Anxiety; Dental Caries; Depression; Humans; Pharmaceutical Preparations; Prisons; Scotland
PubMed: 32043284
DOI: 10.1111/cdoe.12522 -
BMJ Open Apr 2021Dental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of...
OBJECTIVES
Dental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of the study was to explore the trend of children's dental anxiety over time and potential risk factors.
DESIGN
Longitudinal study.
METHODS
Children aged between 5 and 12 years were investigated with the Chinese version of face version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankl Behavior Rating scale from 2008 to 2017, and influential factors were explored.
RESULTS
Clinical data were available from 1061 children, including 533 (50.2%) male participants and 528 (49.8%) female participants. The total CFSS-DS scores ranged from 16 to 66, with a mean of 24.8±10.3. The prevalence of dental anxiety is 11.59%. No significant differences in total CFSS-DS scores between girls and boys were found. According to the Frankl scale, 238 children were allocated to the uncooperative group and the remaining 823 children were allocated to the cooperative group. Scores of CFSS-DS were negatively correlated with the clinical behaviour level of Frankl. Children aged 11-12 years old had significantly decreased scores compared with other age groups, and there was a decline in the scores of the group aged 8-10 years old over time. The factor analysis divided 15 items of CFSS-DS into four factors, and the total scores of 'less invasive oral procedures' items belonging to factor III decreased significantly over time in the group aged 8-10 years old.
CONCLUSIONS
Age is a significant determinant for children's dental anxiety, and dental anxiety outcomes have improved for Chinese children aged 8-10 years. This study is one of the few reports on changes of children's dental anxiety in a new era of information, but the results may be extrapolated to other populations with caution.
Topics: Adult; Child; Child Behavior; Child, Preschool; China; Dental Anxiety; Female; Humans; Longitudinal Studies; Male; Prevalence; Quality of Life; Risk Factors; Surveys and Questionnaires
PubMed: 33863714
DOI: 10.1136/bmjopen-2020-043647 -
Acta Odontologica Scandinavica Jul 2023There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.
INTRODUCTION AND OBJECTIVE
There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.
MATERIALS AND METHODS
Eleven semi-structured interviews were conducted with dental clinicians from the public dental service of Östergötland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis.
RESULTS
The core category was identified as; 'the clinical eye', clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: , , , and . Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patient's normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor.
CONCLUSIONS
Clinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor.
Topics: Humans; Dental Anxiety; Grounded Theory; Anxiety Disorders; Sweden
PubMed: 36519282
DOI: 10.1080/00016357.2022.2154263 -
Journal of Applied Oral Science :... 2009Atraumatic Restorative Treatment (ART) is considered to be well accepted, both by children and by adult patients. The objective of this review is to present and discuss... (Review)
Review
UNLABELLED
Atraumatic Restorative Treatment (ART) is considered to be well accepted, both by children and by adult patients. The objective of this review is to present and discuss the evidence regarding the acceptability of ART, from the patient's perspective. Aspects related to dental anxiety/fear and pain/discomfort have been highlighted, to facilitate better understanding and use of the information available in the literature.
CONCLUSIONS
The ART approach has been shown to cause less discomfort than other conventional approaches and is, therefore, considered a very promising "atraumatic" management approach for cavitated carious lesions in children, anxious adults and possibly, for dental-phobic patients.
Topics: Dental Anxiety; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Cavity Preparation; Dental Restoration, Permanent; Humans; Pain; Patient Satisfaction
PubMed: 21499661
DOI: 10.1590/s1678-77572009000700015 -
International Dental Journal Feb 2019To evaluate the effects of the patient-dentist relationship on dental anxiety among young adult Sudanese patients.
OBJECTIVE
To evaluate the effects of the patient-dentist relationship on dental anxiety among young adult Sudanese patients.
MATERIALS AND METHODS
In this cross-sectional study, 864 patients attending outpatient dental clinics of the governmental dental hospitals in Khartoum, Sudan were recruited; 51.2% were males and 48.8% were females, with an age range of 18-24 years. The questionnaire used evaluated the socio-demographics, education levels, economic status, patient experience, and also included the Dental Anxiety Scale, Corah (J Dent Res 1969 48: 596).
RESULTS
High dental anxiety was reported by 22.2%, 29.5% reported moderate dental anxiety, and 48.3% reported low or no dental anxiety. There were statistically significant associations between dental anxiety and gender, time lapse since the previous dental visit (P < 0.004) and the reason for the previous visit (P < 0.001). In addition, the dental clinic environment (P < 0.002), the time waiting before seeing the dentist (P < 0.001) and the overhearing of pain expressed by other patients (P < 0.001) were also statistically significant. Negative comments by the treating dentist also had a statistically significant impact (P < 0.032). In contrast, a clear explanation of related dental care (P < 0.008), as well as the allowance of adequate time to discuss oral health (P < 0.006), had significantly positive effects.
CONCLUSION
The study showed that the patient-dentist relationship had a significant association with dental anxiety, and may be an important target for improving the delivery and standards of oral health in dentally anxious patients in this region.
Topics: Adolescent; Cross-Sectional Studies; Dental Anxiety; Dental Clinics; Dentist-Patient Relations; Economic Status; Educational Status; Female; Humans; Male; Sex Factors; Sudan; Time Factors; Young Adult
PubMed: 29992551
DOI: 10.1111/idj.12409 -
BMC Oral Health Sep 2023Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction.
METHODS
Four electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA.
RESULTS
A total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis.
CONCLUSIONS
Relaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.
Topics: Humans; Dental Anxiety; Music; Music Therapy; Network Meta-Analysis; Tooth Extraction
PubMed: 37735362
DOI: 10.1186/s12903-023-03407-y -
Brazilian Oral Research 2022This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A...
This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.
Topics: Child; Child Behavior; Cross-Sectional Studies; Dental Anxiety; Dental Care; Dental Caries; Female; Humans; Male; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 35946734
DOI: 10.1590/1807-3107bor-2022.vol36.0106 -
International Journal of Environmental... Feb 2021(1) Background: Dental anxiety with disease value usually leads to avoidance of dental treatment. For the initial diagnosis of the level of anxiety, questionnaires such...
(1) Background: Dental anxiety with disease value usually leads to avoidance of dental treatment. For the initial diagnosis of the level of anxiety, questionnaires such as the Hierarchical Anxiety Questionnaire (HAQ) are suitable. The construct of sensory processing sensitivity (SPS) describes a general trait in which people with a higher degree of SPS perceive information more strongly and process it more thoroughly. (2) Methods: This cross-sectional study evaluated the relationship between dental anxiety and higher levels of SPS in 116 soldiers referred with different stages of periodontitis for mandatory dental fitness before military deployment. (3) Results: The proportion of patients with periodontitis in stage III + IV was 39% and in stage I + II was 27%. The mean cumulative values of the questionnaires were 20.9 ± 10.6 for HAQ and 27.7 ± 16.0 for SPS. Eleven moderately anxious patients had a SPS value of 37.4 ± 13.5 and 10 highly anxious patients had a value of 36.3 ± 14.1. Patients diagnosed with stage III + IV periodontitis showed significantly higher values on the SPS subscale Low Sensory Threshold (LST), which describes overstimulation by external sensory stimuli, compared to patients with stage I + II periodontitis. Dental anxiety showed moderately significant correlations with the SPS subscale Ease of Excitation (EOE), which measures emotional reactivity to physiological stimuli. (4) Conclusions: Due to the frequency of dental anxiety and higher sensitivity in patients with severe periodontitis, it is useful to record said frequency.
Topics: Cross-Sectional Studies; Dental Anxiety; Humans; Military Personnel; Periodontal Diseases; Sensation; Surveys and Questionnaires
PubMed: 33567560
DOI: 10.3390/ijerph18041584