Can galvanic skin conductance be used as an objective indicator of children's anxiety in the dental setting?

E Najafpour,N Asl-Aminabadi,S Nuroloyuni,Z Jamali,S Shirazi

doi:10.4317/jced.53419

Abstract

BackgroundAssessment of procedural distress is essential at assisting children during invasive dental treatments. This study aimed to determine the validity and reliability of galvanic skin response as a measure for assessment of dental anxiety in children.Material and Methods151 children, aged 5-7 years, participated in this study. Similar dental treatments were rendered to all subjects. At the beginning and end of the session, modified child dental anxiety scale (MCDAS), clinical anxiety rating scale (CARS) and galvanic skin response (GSR) were used to determine children’s anxiety.ResultsGSR was significantly correlated with both MCDAS (rs=0.62, p=0.02) and CARS (rs=0.44, p=0.032). The correlation between MCDAS and CARS was also significant (rs = 0.9, P<0.001). Anxiety decreased during the session in both GSR (rs=0.52, p=0.001) and MCDAS scales (rs=0.77, p=0.001). CARS also showed a reduction between the initial and second assessment, but it was not statistically significant (rs=0.12, P=0.36).ConclusionsThe findings suggest that GSR is a reliable and valid measure for assessment of children’s dental anxiety in the clinical context. GSR may help to identify clinically anxious children before dental treatment to provide appropriate interventions. Key words:Dental anxiety, reliability, validity, galvanic skin response.

Highlights

Despite the ever growing body of medical research, there is a paucity of relevant and comprehensive measurement tools for pediatric distress
This study aimed at evaluating the correlation between galvanic skin response (GSR) and two well-established anxiety assessment tools namely the Modified Child Dental Anxiety Scale (MCDAS), and the Clinical Anxiety Rating Scale (CARS) to provide evidence of the validity and reliability of the GSR in pediatric dental patients
According to the pilot study conducted on 20 patients and considering α equal to 0.05 and prevalence of dental anxiety equal to 20% with maximum marginal error of 8% [3,17], and assuming 80% sensitivity between the GSR and CARS, 126 samples were needed for this study which were increased to 151 to improve the validity and power of study

Summary

Introduction

Despite the ever growing body of medical research, there is a paucity of relevant and comprehensive measurement tools for pediatric distress. The results of the studies by Tiwari et al confirmed the physiological changes in the body as a result of the anxiety and stress during dental treatment [9] Measurement of these physiological variables is possible in children, there are several difficulties including the paucity of norm measurements, the inconvenience and expense of the necessary sophisticated equipment, and the necessity of child’s cooperation in some procedures [4,8]. To overcome these shortcomings, several investigators have used psycho-physiological measurements such as galvanic skin response (GSR) to quantitate levels of anxiety in patients [10]. This study aimed to determine the validity and reliability of galvanic skin response as a measure for assessment of dental anxiety in children

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