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European Journal of Paediatric Dentistry Sep 2022To synthesise knowledge on the relative efficacies of non-pharmacological strategies for managing dental fear and anxiety (DFA) in children and adolescents, specifically...
AIM
To synthesise knowledge on the relative efficacies of non-pharmacological strategies for managing dental fear and anxiety (DFA) in children and adolescents, specifically their effects on behaviour, anxiety levels and pain perception.
METHODS
An umbrella review on non-pharmacological strategies used to manage DFA in children and adolescents was conducted based the Joanna Briggs Institute methodology. Searches were performed in 5 main electronic databases and the grey-literature. Two independent reviewers selected and appraised the included studies using the AMSTAR2 tool. Disagreements were resolved by a third reviewer.
CONCLUSION
Audio-visual distraction was effective in reducing anxiety during a variety of dental procedures including those requiring local anaesthesia. A combination of techniques may be more effective in managing DFA in children and adolescents, possibly improving pain perception and cooperative behaviour.
Topics: Adolescent; Child; Dental Anxiety; Humans
PubMed: 36172904
DOI: 10.23804/ejpd.2022.23.03.11 -
Scientific Reports Feb 2023Dental anxiety causes people to postpone or refuse to go to the dentist, which further negatively impacts their quality of life and public health. Previous research has...
Dental anxiety causes people to postpone or refuse to go to the dentist, which further negatively impacts their quality of life and public health. Previous research has shown that mindfulness is inversely related to anxiety. However, little is known about the relationship between mindfulness and dental anxiety. The current research aimed to explore the relationship between mindfulness and dental anxiety and investigate the mediating role of rational thinking. Two studies were conducted. In study one, 206 Chinese participants completed questionnaires measuring trait mindfulness and dental anxiety (state, responding to a dental treatment scenario). In study two, 394 participants completed questionnaires measuring trait mindfulness, dental anxiety (trait), and rational thinking. The results for both studies showed that mindfulness is negatively correlated with dental anxiety. In study 1, each facet of mindfulness except Non-judging was negatively correlated with dental anxiety with Acting with Awareness having the strongest correlation, while in study 2, only Acting with Awareness was significantly negatively correlated with dental anxiety. Furthermore, rational thinking mediated the effect of mindfulness on dental anxiety. In conclusion, mindfulness is negatively related to both state and trait dental anxiety, and rational thinking mediates the relationship between mindfulness and dental anxiety. Implications of these findings are discussed.
Topics: Humans; Mindfulness; Quality of Life; Dental Anxiety; Anxiety; Anxiety Disorders; Surveys and Questionnaires
PubMed: 36813807
DOI: 10.1038/s41598-023-28879-4 -
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 -
BMC Psychology Nov 2021Dental anxiety is of public health importance because it leads to postponed dental treatment, which comes with health complications. The present study investigated...
BACKGROUND
Dental anxiety is of public health importance because it leads to postponed dental treatment, which comes with health complications. The present study investigated whether there is a correlation between the degree of dental anxiety and other kinds of anxiety and whether there are prognostic factors for the different kinds of anxiety.
METHOD
In the sample (N = 156) from a dental practice in a large German city, 62% of patients received a check-examination and 38% received dental surgery. The target variables were recorded with validated questionnaires: dental anxiety (IDAF-4c+), subclinical anxiety (SubA), anxiety of negative evaluation (SANB-5), current general anxiety (STAI state), loneliness (LS-S) and self-efficacy (GSW-6). The applied statistics were: t-tests for 31 variables, correlation matrix and multivariate and bivariate regression analyses.
RESULTS
The dental surgery patients displayed more dental anxiety and more dental interventions than the check-examination group. The main result was a positive correlation of all kinds of anxiety with each other, a positive correlation of loneliness and neuroticism with all forms of anxiety and a negative correlation between all forms of anxiety and self-efficacy. Especially dental anxiety is positively associated with other kinds of anxiety. In multivariate regression models only neuroticism is associated with dental anxiety, but feelings of loneliness are positively associated with with the other kinds of anxiety assessed in this study. The higher the self-efficacy, the lower the level of general anxiety.
CONCLUSIONS
In dentistry, anxiety from negative experiences with buccal interventions should be distinguished from anxiety caused by personality traits. Self-efficacy tends to protect against anxiety, while loneliness and neuroticism are direct or indirect risk factors for anxiety in this urban dentistry sample. Dental anxiety seems to be independent from biographical strains but not from neuroticism. In practice, more attention must be paid to anxiety control, self-management and efforts to improve the confidence of patients with emotional lability, less self-confidence and propensity to shame.
Topics: Anxiety Disorders; Cross-Sectional Studies; Dental Anxiety; Humans; Loneliness; Neuroticism
PubMed: 34819158
DOI: 10.1186/s40359-021-00684-6 -
International Journal of Environmental... Mar 2023Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA)...
Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children's demographic information and their dental treatment experiences. The children's DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children's DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children's DFA after SDF therapy ( > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting.
Topics: Child, Preschool; Humans; Male; Cariostatic Agents; Cross-Sectional Studies; Dental Anxiety; Dental Caries; Dental Caries Susceptibility; East Asian People; Quaternary Ammonium Compounds; Female
PubMed: 36901476
DOI: 10.3390/ijerph20054467 -
BMC Oral Health Oct 2023People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing... (Meta-Analysis)
Meta-Analysis
Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses.
BACKGROUND
People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety.
METHODS
This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software.
RESULTS
A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p = < 0.001) in reducing psychophysiological responses of dental anxiety.
CONCLUSION
Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD.
TRIAL REGISTRATION
The title of this review was registered with PROSPERO (CRD42022322083).
Topics: Child; Humans; Young Adult; Dental Anxiety; Developmental Disabilities; Oral Health; Psychophysiology; Risk Factors
PubMed: 37858057
DOI: 10.1186/s12903-023-03445-6 -
The Journal of Clinical Pediatric... 2018The aim of this study was to differentiate anxious from nonanxious adolescents and evaluate gender differences in anxiety with respect to previous negative dental and... (Comparative Study)
Comparative Study
OBJECTIVES
The aim of this study was to differentiate anxious from nonanxious adolescents and evaluate gender differences in anxiety with respect to previous negative dental and medical experiences. The purpose was also to evaluate a causative relationship between child medical fear and dental anxiety.
STUDY DESIGN
This study sampled 113 Croatian adolescents from 15 to18 years of age. Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used for the assessment of child dental anxiety regarding visits to the dentist and receiving dental treatment. A modified version of Child Medical Fear Questionnaire (CMFQ-M) was used for evaluation of child medical fear related to medical treatment and doctors in general.
RESULTS AND CONCLUSION
The results showed significantly higher dental anxiety (CFSS-DS) and medical fear (CMFQ-M) in adolscent girls (p<0,001) as compared to adolescent boys. A significantly strong correlation between medical fear and dental anxiety in adolescent girls was proved by Pearson's correlation coefficient (p < 0,01). In this study, CMFQ-M and CFSS-DS questionnaires were standardized in the Croatian adolescent population and proved reliable in the estimation of anxious behaviour with respect to specific medical and dental situations.
Topics: Adolescent; Croatia; Dental Anxiety; Fear; Female; Humans; Male; Sex Distribution; Sex Factors
PubMed: 29698137
DOI: 10.17796/1053-4628-42.3.3 -
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 -
Acta Bio-medica : Atenei Parmensis Jan 2022The anxiolytic effects of music have been studied during the past twenty years in different medical therapies. The aim of this study is to evaluate the effect of music... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND AIM
The anxiolytic effects of music have been studied during the past twenty years in different medical therapies. The aim of this study is to evaluate the effect of music therapy on patients' dental anxiety, salivary cortisol, heart rate, blood pressure and body temperature during dental treatment.
METHODS
In this randomized control study, 46 patients were randomly selected from the Urgent Care dental clinic who needed urgent endodontic treatment (endodontic access and pulp extirpation). Participants were divided into two groups: intervention group (N=23) which was exposed to slow rhythm melody music and had no lyrics throughout the entire procedure and a control group (N=23) who undergoes the same dental procedure without being exposed to music. Participants' blood pressure, heart rate, body temperature and salivary cortisol were measured before and after the treatment for both groups.
RESULTS
Patients in the intervention group showed lower salivary cortisol, blood pressure, heart rate and body temperature compared to those in the control group, however, the differences did not reach to statistical significance.
CONCLUSION
-Despite the change in the dental anxiety and stress during treatment with music, the findings of this study could not establish evidence of the effect of music in reducing dental anxiety and lowering physiological stressors. Therefore, further studies with larger sample size may be needed. (www.actabiomedica.it).
Topics: Blood Pressure; Dental Anxiety; Heart Rate; Humans; Hydrocortisone; Music; Music Therapy
PubMed: 35075079
DOI: 10.23750/abm.v92i6.11668 -
The Journal of Clinical Pediatric... Dec 2020Dental student's dental anxiety may negatively affect patient's attitude towards dental treatment. We evaluated dental anxiety among dental students in different...
PURPOSE
Dental student's dental anxiety may negatively affect patient's attitude towards dental treatment. We evaluated dental anxiety among dental students in different clinical stage of their studies. We assessed the student's anxiety prior to treating patients.
STUDY DESIGN
A cross-sectional study. Fourth to sixth-year dental students completed questionnaires containing: 1) Dental Anxiety Scale (DAS); 2) Dental Fear Survey (DFS); and 3) visual analogue scale questions relating to the student's anxiety when performing dental treatments in children and adults.
RESULTS
124 dental students completed the questionnaires (mean age, 26.4±3.1 years, 59.7% women). Average DAS in the study population was 7.55±2.15 with similar scores observed across the years. Average DFS score was highest among fourth-year students (1.62±0.65) and lowest among sixth year students (1.36±0.32). DFS scores decreased as the students progressed through the clinical years (p=0.059). The students' average anxiety scores prior to treating children were significantly higher than the anxiety scores prior to treating adults (3.82±2.42 vs. 2.67±1.9, p<0.001). Fifth-year students had significantly higher anxiety scores prior to treating children and adults compared to fourth and sixth-year students.
CONCLUSION
Dental anxiety among dental students is relatively low and decreases gradually as they progress through the clinical years. Anxiety prior to treating patients, particularly children, is at its highest just before starting to treat patients for the first time. As dental students are future healthcare providers, it is important that they learn techniques to help them manage their own dental anxiety and fear as well as deal with anxiety related to treating patients.
Topics: Adult; Attitude; Child; Cross-Sectional Studies; Dental Anxiety; Fear; Female; Humans; Male; Students, Dental; Young Adult
PubMed: 33378462
DOI: 10.17796/1053-4625-44.6.3