Perceived dental anxiety among schoolchildren treated through three caries removal approaches

Jo E. Frencken,Ece Eden,Asli Topaloglu-Ak

doi:10.1590/s1678-77572007000300015

Abstract

Objectives:The aim of the investigation was to test the differences in the perceived level of dental anxiety among children treated restoratively using the Atraumatic Restorative Treatment (ART) approach, the traditional restorative (TRA) approach and ART aided with a chemomechanical caries removal gel (ART plus).Methods:The study subjects were 6-7-year-old children. TRA was compared to ART in a clinical setting after children had seen a dentist twice (Group A), ART was compared to 'ART plus' in a clinical setting after children had seen a dentist once (Group B) and ART was applied outside the clinic on school premises (Group C). The treatments were carried out in Class II cavitated dentine lesion in primary molars. Dental anxiety was measured using the Venham Picture Test (VPT). Three-way analysis of variances and interaction was applied to test for treatment approach, gender and operator effects on the mean VPT scores.Results:There was no statistically significant difference (p=0.80) observed between the mean VPT scores for the traditional approach and those for the ART approach and between ART with and without a chemomechanical caries removal gel (p=0.07). Children in Group A had lower mean VPT scores than children in Group B (p=0.02) and Group C (p<0.00001) when treated using the ART approach by the same two operators.Conclusions:The level of dental anxiety was low. There was no difference in level of dental anxiety observed in children treated with ART in comparison to the traditional restorative approach, and between children treated with ART with and without a chemomechanical caries removal gel. The treatment environment and prepatory visits may be factors determining the level of dental anxiety in children treated through the ART approach only.

Highlights

The prevalence of dental caries has declined in many child populations in industrialized countries over the last three decades[30]
The null hypotheses of this study were that there is no difference in the perceived level of dental anxiety among children treated restoratively in primary molars in a modern dental clinic between the Atraumatic Restorative Treatment (ART) approach and 1) the traditional approach and 2) ART aided with a chemomechanical caries removal gel
The first study concerned a randomized clinical trial in which the traditional restorative treatment approach was compared to the ART approach in a dental clinic (Group A)[7]

Summary

Introduction

The prevalence of dental caries has declined in many child populations in industrialized countries over the last three decades[30]. One is believed to be the traditional way of treating cavitated dentine lesions, which is largely based on the use of rotary equipment that requires frequent administration of local anesthesia Both the bur and dental injection are considered the two main fearprovoking stimuli[17,24]. It is no surprise, that the use of traditional restorative treatment has a high potential for triggering dental anxiety in many children[2,24] and that many children with dental anxiety refuse to undergo required dental recall visits[14,15].

Methods

Results

Discussion

Conclusion