Assessment of Dental Anxiety during Pulp Therapy, Restorations & Extraction in 6- to 9-year-old Children Using Drawings and Questionnaire – A cross sectional study.

Abstract

Background: Childhood dental fear and anxiety are prevalent from an early age through adolescence, posing a significant challenge in pediatric dental care. Understanding children's emotions during dental procedures is crucial for pediatric dentists to anticipate and address behavioral responses in future visits. Utilizing drawings and questionnaires can effectively gauge an individual's self-concept, anxiety, attitude, or conflicts. Aim: This study aimed to assess children's drawings and questionnaires as means to measure dental anxiety related to dental treatment. Methodology: Forty children aged 6-9 years participated in this study. During the initial therapeutic session, all participants underwent pulp therapy and restorative treatment with local anesthesia administration. Objective assessment of distress during treatment was conducted using the Sound, Eye, Motor (SEM), and Frankl Scales. Subsequently, children were provided with a predetermined set of questions before the treatment, and their responses were recorded. Following the interview, children were asked to draw a picture of their surroundings. Pediatric dentists and psychologists scored the children's drawings using the Child Drawing: Hospital (CD: H) scale. The findings were compared with Frankl and SEM Scores. Results: A statistically significant association was observed between Frankl score and SEM Score (p<0.001*). A strong positive correlation was found between CD:H Scores Examiner 1 and CD:H Scores Examiner 2 (p<0.001*; r=0.760). Conclusion: Assessing dental anxiety through children's drawings, which reflect their inner feelings, offers an alternative to self-report techniques for pediatric dentists. Drawing, being both easier and enjoyable, emerges as a valuable tool for measuring children’s levels of dental anxiety.