Dental Anxiety Research Articles

Virtual reality in specialized dentistry: employing virtual reality for the alleviation of pain and anxiety in hereditary angioedema patients.

Following an episode of hereditary angioedema (HAE), dental anxiety commonly arises, and many patients find it challenging to access proper care. While the use of virtual reality (VR) for pain and anxiety management in dentistry is on the rise, its application in individuals with angioedema remains largely unexplored. In a case series conducted at a specialized dental clinic, three patients with a history of acute angioedema attacks and dental anxiety engaged with 360° VR videos while seated in the dental chair, utilizing a virtual reality device. Three patients with hereditary angioedema were treated by subjecting them to virtual immersion using VR glasses. Intraoperative reactions were analyzed using VAS scales in order to report the patients' level of anxiety and pain. The outcomes, evaluated through a standard observation tool, surveys, and interviews, encompass the assessment of patient anxiety and pain, responses to VR, and the evaluation of system usability along with its impact on the dental team's workflow Three individuals underwent examination, from which three reliable questionnaires were obtained, demonstrating a success rate of 99.9%. The group included one male and two females, with their ages spanning from 6 to 58 years. The findings revealed an average anxiety score of 1.80 with a standard deviation of 0.6 points, and an average pain score of 1.98 with a standard deviation of 0.3, thus validating full immersion in distraction. Statistical analysis using independent-sample t-tests and ANOVA indicated no significant differences in anxiety levels among the patients based on gender. Both patients wore the VR device throughout the procedure, expressing that it was comfortable, diverting, and held the potential to alleviate anxiety and pain. The dentist noted a positive influence on patient anxiety levels and procedure completion times, expressing an intention to continue employing VR with other angioedema patients and across diverse clinical populations. Virtual reality can be an excellent distraction tool in patients with hereditary angioedema who present at least one acute attack per year.

Color perception and its relation to dental anxiety in children.

One of the major causes of dental anxiety in children is their first impression of the dental environment. Even minor details, such as the choice of color in a dental setting and the color of dental equipment, can positively influence a child's behavior. The aim of the study was to assess the relationship between the emotions in children and color combinations in a pediatric setting. The study involved 200 children (99 boys and 101 girls) aged between 6 and 12 years who visited the dental clinics at the College of Dentistry, Jazan University, for the first time between November 2017 and January 2018. The participants were divided into 2 groups based on age. The younger children group included participants aged from 6 to 9 years, while the older children group included participants aged from 10 to 12 years. Anxiety levels were recorded using the Modified Dental Anxiety Scale. Colored pencils and images of emoticons were provided to all children, who were instructed to color the negative and positive emoticons with their preferred colors. The analysis of anxiety levels among children in both groups revealed statistically significant differences across sexes in the younger age group, with girls being more anxious than boys (p = 0.003). Additionally, a statistically significant difference was observed in the choice of colors by children of both sexes in 2 age groups (p = 0.001). Most children were inclined towards bright colors and used them to express their emotions. The incorporation of colors in a dental setting could invoke positive emotions in children. Hence, the use of colors in the workplace has the potential to ease anxiety.

Impact of Dental Treatment Simulation App on Anxiety of Pediatric Dental Patients: An Observational Study

ABSTRACT Aim: The study aimed to investigate the effect of a dental treatment simulation app on the anxiety levels of pediatric dental patients. Materials and Methods: Forty children, aged 4–8 years and with no prior dental experience, were randomly assigned to either the control group (group I) or the dental app group (group II). The children’s anxiety levels were measured before and after undergoing restorative dental treatment, using the Chota Bheem Chutki pictorial scale. Results: The initial anxiety levels were similar across both groups. Post treatment, the dental app group exhibited a significant reduction in anxiety compared to the control group. This suggests that the simulation app has a beneficial effect in lowering dental anxiety in children. Conclusion: The dental treatment simulation app can effectively reduce pre and postoperative anxiety in pediatric patients, potentially enhancing their overall dental experience.

Assessment of the Knowledge, Attitudes, and Practices for Optimal Oral Health among Adults in Benin City, Nigeria: A Cross-sectional Study

Introduction: Oral health is crucial for overall well-being, involving the maintenance of good oral hygiene to prevent diseases. Despite global progress, gaps persist in developing countries, leading to higher oral disease prevalence. Factors such as awareness, access, cultural beliefs, and dental phobia significantly impact oral health. Knowledge, attitudes, and practices also play critical roles. Objective: To assess the knowledge, attitudes, and practices related to the oral health of adults in Benin City, Edo State. Methods: This cross-sectional study included 198 adults attending a dental outreach program in three local government areas (Ikpoba-Okha, Oredo, and Egor) in Benin City, Edo State. A sample size of 200 was determined using the Cochrane formula. A researcher-administered proforma was used for data collection, assessing socio-demographics, oral health knowledge, attitudes, and practices. A validated questionnaire was used for knowledge assessment, and a Likert scale was employed for attitude measurement. The Simplified Oral Hygiene Index (OHI-S) and the Decayed, Missing, and Filled Teeth (DMFT) index were used for clinical examination. Data were analyzed using IBM® SPSS® Statistics version 25. Results: The mean oral health knowledge, attitudes, and practices among respondents were 57.5%, 83.1%, and 55.0%, respectively. Conclusion: The study revealed fair knowledge and practices but good attitudes among respondents. Notable gaps exist in oral hygiene knowledge and practices, although the positive attitudes observed may support effective oral health promotion efforts. Update Dent. Coll. j: 2024; 14(2): 3-8

Anxiolytic Effect of Jasmine Aromatherapy in Pediatric Dental Procedures: A Single-Blinded Randomized Placebo-Controlled Trial

Objectives: The aim of the present investigation was to evaluate the possible anxiolytic effect of jasmine aromatherapy in pediatric dental procedures. Materials and Methods: A parallel randomized single-blinded placebo-controlled clinical trial was designed and conducted from February 19 until April 19, 2020, on children aged 7 to 12 years-old requiring class 1 restorative treatment of primary or permanent tooth with infiltration anesthesia. Interventions were defined as 15 minutes of aromatherapy using 2mL of jasmine extract for the intervention group, and with water for the control group. Outcomes were defined as child’s anxiety and pain perception, measured by modified child dental anxiety scale (MCDAS), visual analogue scale (VAS) and changes of vital signs. After the patients received interventions based on their groups, their data was collected and analyzed. We used parametric tests and linear regression for outcome comparisons. Results: 56 patients were randomized and allocated in two groups, 28 to each. The groups did not differ significantly regarding age, sex, heart rate and O2 saturation before, during, and after procedures. Based on multivariable regression, the intervention group showed a significantly reduced MCDAS (B (95% CI)=-2.11 (-4.09, -0.13), P=0.04) and VAS (B (95% CI)=-2.30 (-3.50, -1.10), P<0.001) scores. Conclusion: Jasmine aromatherapy showed to be effective in reducing children’s anxiety and pain perception during dental procedures and therefore, can be suggested as a cheap and practical complementary method in dental practice.

Exploring Patient Experiences with Dental Anxiety Management Techniques in Dentistry

Dental anxiety is a prevalent issue affecting patients and dental healthcare providers alike, leading to avoidance of treatment and poor oral health outcomes. This study investigates dental anxiety management techniques and their effectiveness in promoting patient comfort, improving oral behavior, and increasing satisfaction during dental care. The research was conducted in Davao City, Philippines, utilizing a qualitative, descriptive phenomenological approach through in-depth interviews with eight participants who experienced dental anxiety. Key findings reveal that dental anxiety stems from unfamiliarity with procedures, negative experiences, and anticipation of pain. Patients reported heightened anxiety due to the sight and sound of dental tools and past negative encounters, often leading to long-term avoidance of care. Effective management strategies, such as deep breathing and distraction techniques, significantly improved patient satisfaction and oral health behavior, fostering better engagement with dental care. The study underscores the importance of patient-centered communication and personalized care in addressing dental anxiety, calling for enhanced integration of mental health considerations in dental practices.

Photobiomodulation therapy on puncture-associated pain: A controlled randomized double-blind clinical trial.

Dental fear and phobia are prevalent worldwide, with local anesthesia being the most feared procedure. This study aimed to determine whether photobiomodulation therapy (PBMT), used as a pre-anesthetic, could modulate puncture pain and enhance the effectiveness of local anesthesia. In this controlled, randomized, double-blind study, 49 participants were divided into an experimental group (n = 24), which received infrared laser therapy (100 mW, at 808 nm, 8 J, 80 s at a single point) immediately before standard anesthesia; and control group (n = 25), which received the standard anesthetic technique and sham laser. Pain levels were measured using the visual analog scale, and anesthetic efficacy was assessed through electrical tests (latency), percentage of failures, and cartridge usage. Anxiety levels were evaluated using the Beck Anxiety Inventory. Cardiovascular parameters were evaluated through blood pressure, oxygen levels, and heart rate. This randomized, double-blind study found no difference between groups in these experimental conditions. The bias toward a positive PBMT result was sufficiently removed. Autonomic responses of the PBMT group were maintained stable during the procedure.

The impact of children’s dental anxiety on dentists

INTRODUCTION. According to statistics, medical workers and, in particular, dentists are exposed to stressful factors in the workplace on a daily basis. Due to the specifics of their daily activities, pediatric dentists experience a great emotional burden, especially when treating children who are not adapted to dental care, which leads to the development of an emotional burnout syndrome among specialists. AIM. To determine the effect of children’s dental anxiety on emotional stability during admission and psychoemotional status after admission by dentists with emotional burnout syndrome.MATERIALS AND METHODS. The study involved 76 pediatric dentists and 68 patients aged 6–7 years. The psychoemotional state of dentists was assessed using the Maslach Burnout Questionnaire and a Visual Analog Scale. The behavior of children at the dental appointment was recorded according to the evaluation scale of the behavioral profile of the Melamed.RESULTS. According to the results of the Maslach questionnaire, burnout syndrome of varying severity was detected in all specialists. Deterioration of the psychoemotional state after receiving a patient who was not adapted to dental treatment was observed in 16%.CONCLUSIONS. The study shows that in order to prevent burnout syndrome in pediatric dentists, it is necessary to reduce professional stress through methods of adapting children to treatment, correcting patient behavior and reducing dental anxiety.

Dental Fear in Children with Cleft Lip and Palate and their Correlation to Salivary Cortisol Levels

Dental Fear in Children with Cleft Lip and Palate and their Correlation to Salivary Cortisol Levels

Comparative evaluation of three different behavior management techniques among children aged 6-12 years in dental practice: A single-center, double-blind, randomized controlled trial.

Dental anxiety is characterized by distress in anticipation of dental visits, which may result in a child's refusal to undergo treatment and, ultimately, lead to parents' reluctance towards dental care. The aim of this study was to evaluate and compare the effectiveness of the tell-show-do technique, modeling technique and yogic relaxation technique in the reduction of dental anxiety among children aged 6-12 years. The study was an interventional, parallel-group, single-center, double-blind, randomized controlled trial conducted on 120 children who required restorative treatment without the use of local anesthesia. The participants were selected based on specific inclusion and exclusion criteria and were randomly divided into 3 groups: group 1 - tell-show-do technique; group 2 - modeling technique; group 3 - yogic relaxation technique. The dental anxiety levels were evaluated 4 times using both physiological (oxygen saturation and pulse rate) and behavioral parameters (facial image scale (FIS) and the Face, Legs, Activity, Cry, and Consolability scale (FLACC)). The data was assessed by 2 blinded and calibrated specialists. Statistically significant differences were observed in all 4 parameters among the 3 groups. During both the intraoperative and postoperative periods, the oxygen saturation levels were significantly higher in the yogic relaxation technique group. Moreover, the yogic relaxation technique group exhibited lower pulse rates, FIS and FLACC scores compared to the tell-show-do and modeling technique groups. The practice of yoga has a positive influence on the general health of the individual. Consequently, it can be considered one of the alternative behavioral modification techniques for the reduction of dental anxiety in children.

Transient bradycardia during local anaesthesia to the oral cavity under intravenous sedation and its associate factors: a prospective observational study

BackgroundLocal anaesthesia in dental procedures is generally safe, although the occurrence of transient bradycardia (TB) has occasionally been reported. TB is often associated with two reflexes, the trigeminal cardiac reflex (TCR) and the vasovagal reflex (VVR) and is characterised by a rapid decrease in heart rate (HR) and blood pressure (BP). The prevalence of TCR is considered low, and its predictors have not been thoroughly investigated, although an association with the gag reflex has been suggested in recent years.MethodsThis prospective study assessed TB occurrence during local anaesthesia and its potential associated factors. A comprehensive questionnaire was used to categorise discomforts during dental treatment, and various anxiety scales were used to measure patients’ anxiety levels. We investigated HR variability during local anaesthesia administration under sedation and the association between the incidence of TB and gag reflex. Subsequently, logistic regression analysis was performed to assess factors associated with TB occurrence.ResultsThe prospective analysis included 188 patients of 234 initial patients. The analysis revealed a high TB incidence rate of 41% during local anaesthesia administration under sedation. No severe hypotensive events occurred, indicating a relatively benign nature of TB during local anaesthesia. TB occurrence was significantly higher in the group of patients with the gag reflex. Further analysis revealed that both gag reflex and trait anxiety were significantly associated with TB occurrence, whereas dental phobia did not directly correlate with TB.ConclusionThis study highlights the prominent occurrence of TB during local anaesthesia in dental treatment, which is primarily attributed to TCR activation. The identification of gag reflex and trait anxiety as independent factors associated with TB development may pave the way for TB prevention measures. Further research is required to clarify the mechanisms of TCR and perform safer dental procedures under sedation. Future studies should also aim to elucidate the precise mechanisms underlying TB during local anaesthesia through direct measurements of neural activity. A better understanding of TB in dentistry is crucial for improving patient safety and optimising dental practice protocols.

Dental fear and anxiety of preschools Ha'il city children

Dental fear and anxiety of preschools Ha'il city children

Dentistry Students' Oral Health Awareness and Dental Fear Levels

Dentistry Students' Oral Health Awareness and Dental Fear Levels

Enhancing Pediatric Dental Care: The Influence of Virtual Reality.

The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children. The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB. The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety. This study concluded that VR reduced pain and anxiety levels in its passive and active forms.

Reduction of Dental Anxiety in Children Using Virtual Reality: A Randomised Controlled Trial.

The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods. The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children's Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05. VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

Understanding and addressing pediatric dental Anxiety: A contemporary overview.

Understanding and addressing pediatric dental Anxiety: A contemporary overview.

The relationship of dental anxiety with periodontal health

The relationship of dental anxiety with periodontal health

Assessment of dental anxiety in children using different methods

Assessment of dental anxiety in children using different methods

Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: a network meta-analysis

BackgroundChild dental anxiety is a prevalent issue in the field of pediatric dentistry. At present, several non-pharmacological interventions are employed to mitigate anxiety during dental treatments for children. The objective of this study is to assess the effectiveness of diverse non-pharmacological interventions in reducing dental anxiety, as well as enhancing heart rate during pediatric dental treatments. To achieve this, we conducted a systematic review and a network meta-analysis (NMA) to compare the efficacy of various outcome indicators.MethodsA thorough search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, Scopus, APA PsycInfo, CINAHL, and AMED to identify all eligible randomized controlled trials (RCTs) from the beginning of the databases up to August 1, 2024. The quality assessment was carried out using the Cochrane Collaboration’s bias risk tool. The two outcome measures under consideration were dental anxiety and heart rate. Network graphs, league tables and SUCRA were constructed using R 4.2.3 software and Stata 16 software. This study is registered in PROSPERO under the registration number CRD42023467610.ResultsThe study examined 12 different non-pharmacological approaches, drawing from a pool of 61 research studies involving 6,113 participants aged 4 to 16 years. The results of the network meta-analysis revealed that music (SUCRAs: 93.60%) proved to be the most effective measure in mitigating dental anxiety, followed by aromatherapy (SUCRAs: 78.58%) and game (SUCRAs: 70.99%). Moreover, hypnosis (SUCRAs: 98.80%), music (SUCRAs: 79.58%), and relaxation (SUCRAs: 72.41%) were identified as the top three interventions for decreasing heart rate.ConclusionIn this NMA, when contemplating dental anxiety outcomes, music is recommended as a priority. For heart rate outcomes, hypnosis may be a preferred measure. However, owing to the limited number of articles, the conclusion of this study still requires additional confirmation or correction through more high-quality primary studies in the future.

Recent Developments in the Non-Pharmacological Management of Children's Behavior Based on Distraction Techniques: A Concise Review.

Oral diseases and conditions affect children's oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological behavior management strategies, such as distraction techniques, are commonly adopted to manage children's behaviors. Distraction techniques have been developed rapidly in recent years and are widely accepted by both health professionals and parents due to their noninvasive and low-cost nature. This concise review aims to summarize current distraction techniques applied during dental treatments, especially for children. The most commonly reported techniques for children are audio distraction, audio-visual distraction, tactile distraction, olfactory distraction, and gustatory distraction. Audio distraction techniques involving music and storytelling help children relax. Audio-visual distraction techniques help to divert children's attention from the dental treatment. Tactile stimuli can reduce the transmission of pain signals. Olfactory stimuli can help children feel comfortable and relaxed. Gustatory distraction involving sweet substances can create a positive environment. These distraction techniques effectively reduce DFA in children and improve their satisfaction with dental procedures. As technology continues to develop, further research is needed to provide more robust, evidence-based guidance for dentists using distraction techniques.