Effect of Recreational Intervention on the Approach of Pediatric Patients in Dental Treatment: Analysis of Salivary Cortisol

Rúbia Zen,Debora N Mário,Lilian Rigo,Emanuela Gaviolli,Luiza Paloma S Girotto

doi:10.1590/pboci.2020.036

Abstract

Objective: To verify whether recreational interaction with pediatric patient before dental care influences cortisol levels and anxiety. Material and Methods: Twelve children were selected and divided into two groups: 6 children who had not previously received recreational intervention (Group I) and 6 children who received recreational intervention before dental care (Group II). Saliva was collected with Salivettes™ kits before and soon after dental care for the measurement of cortisol. Wilcoxon test was applied to verify the difference in salivary cortisol levels before and after the dental visit in the whole sample, and the Mann-Whitney U test was used to analyze the difference between groups I and II. A significance level of 0.05 was considered . Results: Among patients from Group I, 3 had their cortisol levels increased after dental care, 2 had their cortisol levels decreased, and the other 1 patient remained constant. All participants from Group II had no significant difference in cortisol levels pre- and post-procedure. Mean salivary cortisol level was higher in Group I, pre- and post-procedure, compared to Group II . Conclusion: Pediatric patients who participated in an interactive activity prior to dental care have a lower level of anxiety according to the salivary cortisol levels obtained, compared to patients who did not participate in recreation. The techniques for the dentist to approach the child control the anxiety of the patient and make the procedure calmer and less stressful for both of them.

Highlights

Chronic and early anxiety may lead to such deleterious effects of human physiological homeostasis that some authors regard as a public mental health problem [1]
Wilcoxon test was applied to verify the difference in salivary cortisol levels before and after the dental visit in the whole sample, and the MannWhitney U test was used to analyze the difference between groups I and II
Pediatric patients who participated in an interactive activity prior to dental care have a lower level of anxiety according to the salivary cortisol levels obtained, compared to patients who did not participate in recreation

Summary

Introduction

Chronic and early anxiety may lead to such deleterious effects of human physiological homeostasis that some authors regard as a public mental health problem [1]. It is estimated that about 3–16% of adults suffer from dental phobia [2,3,4,5] These values increase substantially in studies with pediatric patients [6]. Experimental models have shown that the physiological adaptive response to stress leads to the activation of the hypothalamic-pituitary-adrenal (HPA) axis, involving serum increase of the cortisol hormone [13]. The dentist should be able to identify signs that may lead to the diagnosis of anxiety, especially in the pediatric patient, and from there on, to customize the approach of the child in order to avoid the aggravation of this feeling and future complications for their health [11]. To analyze the influence of recreational interventions on the level of anxiety of children facing dental treatment

Material and Methods

Results

Postprocedure procedure procedure procedure

Conclusion