Development of the first Arabic cognitive dental anxiety scale for children and young adults

Are technological contributions in behavior guidance techniques superior to conventional methods?: Effects on dental anxiety and pain perception

BACKGROUND

To evaluate the effects of three different behavior guidance methods on children's dental anxiety levels and pain perception.

METHODS

This study included 63 children aged 6-8 years who required pulpotomy and were divided into three groups: tell-show-do (TSD; Group 1), TSD with video modeling (Group 2), and TSD with mobile phone application (Group 3). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and hemoglobin oxygen saturation (SPO2) of the participants were recorded before the procedure, after local anesthesia, after pulpotomy, and after the end of the procedure. Faces Version of the Modified Child Dental Anxiety (MCDASf), Wong-Baker Faces Pain Rating Scale (WBFPRS), and Face, Legs, Activity, Cry, Consolability (FLACC) pain scales were applied. Chi-squared test, one-way ANOVA, Kruskal-Wallis test, Friedman's test, and repeated measurement analysis statistical tests were used.

RESULTS

No significant difference was found between the steps in terms of BP, HR, and SPO2 within the groups (p > 0.05). When comparing the groups, there were significant differences in SBP (p = 0.040) and DBP (p = 0.027) measured at the beginning and end of the procedure, and between MCDASf (p = 0.041) and WBFPRS (p = 0.013) scores. These values ​​were lower in Group 3.

CONCLUSION

Dental anxiety and pain perception scores were lowest when using TSD with mobile phone application (Group 3). In line with developing technology, the use of mobile phone applications in pediatric dentistry can contribute to more harmonious treatment management in children.

TRIAL REGISTRATION

The trial protocol was retrospectively registered ID NCT06912789 ( https://clinicaltrials.gov/ ); 2025-03-26.

White vs. colored coats: Which reduces dental anxiety better?

BACKGROUNDS

To evaluate the effect of colored vs. white coat wear on dental anxiety in children using psychometric, projective, and physiological methods.

METHODS

The participants were divided into two groups by the pediatric dentist based on the participants' coat color (white vs. colored), and procedures were performed during two separate appointments for both groups: dental examination (DE) and preventive dental treatments (PDT). The blood pressure, pulse rate, and saturation were recorded before and after each appointment. Anxiety was assessed using the Modified Child Dental Anxiety Scale Faces Version (MCDASf) before and after the appointments and the Child Drawing: Hospital (CD: H). Chi-Square, Mann-Whitney U test, Wilcoxon Signed-Rank test, and t-test were used for analysis. The statistical significance level was evaluated as P < 0.05.

RESULTS

Compared to the colored coat group, MCDASf values ​​recorded before both appointments were higher in the white coat group (P = 0.019; P = 0.034). Also, it was observed that the CD: H values of the colored coat group were significantly lower after PDT (P = 0.037). According to the coat groups, there was a significant difference between pulse rates measured before and after both appointments (P = 0.026; P = 0.017; P = 0.008; P = 0.004).

CONCLUSIONS

The clinician's coat color selection impacts children's dental anxiety. The findings suggest that colored coats are more effective than white coats in relieving dental anxiety.

The relationship between Body Mass Index and dental anxiety among pediatric patients in Jeddah, Saudi Arabia: a cross-sectional study

BACKGROUND

Studies suggested a relationship between anxiety and Body Mass Index (BMI). However, dental anxiety and BMI was not previously investigated. This cross-sectional study aimed to assess the impact of BMI levels on dental anxiety and behavior among pediatric patients.

METHODS

Children 6-11 years attending four-referral centers in Jeddah, Saudi Arabia and their parents were interrogated. The BMI level scores, child's behavior (Frankel's classification) and dental-anxiety (Abeer Dental Anxiety Scale (ACDAS)) were evaluated.

RESULTS

Out of 952 children participated in this study, 496 (52.1%) had normal BMI, 264 (27.7%) had high BMI (overweight), and 192 (20.2%) had low BMI (underweight). Regression analysis found that overweight was significantly associated with an increased adjusted odds ratio (AOR) of dental anxiety (AOR = 3.018) and uncooperative dental behavior (AOR = 8.714) with p < 0.001. Also, statistically significant increase in the odds ratio (OR) of the child feeling shy in the clinic (P = 0.002; OR:2.113) and parents/operators reporting child behaving scared (P = 0.004; OR:1.985 and p < 0.001; OR:3.03, respectively) when overweight compared to normal-weight.

CONCLUSIONS

This study highlights the impact of overweight on the emotional and behavioral dimensions of the child's dental experience as they significantly increased the probability of dental anxiety and uncooperative behavior by three and eight times, respectively.

Retrospective Study Regarding the Correlation between Dental Anxiety and Color Preferences in Children with Severe Early Childhood Caries

BACKGROUND

Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries index DMFT are more likely to develop high levels of dental anxiety, which will influence the degree of cooperation during dental procedures. Emotions play an important role in the psychosomatic development of children, and all the factors that contribute to the modeling of these emotional states must be known and taken into consideration.

AIM

The aim of this study was to assess the association between dental anxiety in children with S-ECC and the color preferences for the components of the dental environment to reduce the levels of dental anxiety during medical visits.

MATERIAL AND METHOD

For this study, 91 children between 3 and 6 years of age diagnosed with S-ECC were selected from the Pediatric Dentistry Department of UMFST from Targu Mures and from a private dental office. The level of dental anxiety was determined by measuring the pulse rate, and a questionnaire was completed to establish the color preferences for the dental office environment and the dentist's attire. For this purpose, six different colors and their variants with three shades less intensity were chosen by using RGB (Red, Green, and Blue) identification codes for each color.

RESULT

The results showed that there was a statistically significant difference between the age of the subjects and dental anxiety levels, but there was no significant correlation between the DMFT score and dental anxiety. Also, the results showed that there was no significant difference between girls and boys when choosing the colors preferred by them for the dental office, but when comparing the colors that represented happiness, significant statistical difference was found between the girls' and boys' groups (p = 0.0039). For all the subjects, the colors associated with happiness were light yellow and pink, while the colors associated with anxiety were red and dark blue.

CONCLUSION

The data obtained showed that dental anxiety is strongly influenced by age, and an important role in inducing positive emotions is played by the dental environment if dressed in specific colors in order to reduce dental anxiety and create familiar conditions, especially for young children with S-ECC.

The Abeer Children Dental Anxiety Scale (ACDAS) cross-cultural adaptation and validity of self-report measures in the Malaysian Children Context (MY-ACDAS)

BACKGROUND

The Abeer Children Dental Anxiety Scale (ACDAS) source language was developed and validated in an English-speaking country in the UK to measure dental anxiety among children. The ACDAS also included the child's cognitive assessment, as well as feedback from the parent or the legal guardian and a dental health professional (DHP). This is the first study to validate the application of the ACDAS in Malay or Bahasa Melayu for children aged 6-16 years.

AIM

To assess the Malay-translated version of the ACDAS, postadaptation into the local context and validation by the content and construct experts.

DESIGN

The English ACDAS was translated into Malay first through forward translation and then through backward translation. The prefinal translated version of the instrument was designed, with the participation of 61 children and 61 parents or legal guardians. Subsequently, a final cross-cultural adaptation of the instrument was then made for another group of participants and evaluated for validity and test-retest reliability among 144 children and 144 parents or legal guardians participating in the self-report feedback process at the Paediatric Dental Clinic, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia. The cross-cultural adaptation of the instrument considered translating to Malaysian national language and adapting to its culture.

RESULTS

The Malay-translated ACDAS consisted of 19 items. The translated version of Malaysian-ACDAS (MY-ACDAS) achieved an acceptable agreement between six expert committee members with an internal consistency (Cronbach's alpha value, αconsistency) of 0.839. The test-retest reliability results of all participants support semantic and conceptual equivalence as an accepted construct validity between the children, parents and DHPs across the multicultural Malaysian population.

CONCLUSION

The MY-ACDAS is a valid and reliable scale for measuring dental anxiety among Malaysian children.

Comparisons Between Preclinical and Clinical Dental Students' Perceptions of the Educational Climate at the College of Dentistry, Jazan University

PURPOSE

The aim of this study was to compare the preclinical and clinical undergraduate dental students' perceptions of their educational climate (EC). In addition it will be compared with other local and international studies.

MATERIALS AND METHODS

Students enrolled in their third and fourth years (preclinical phase) and students in their fifth and sixth years (clinical phase) of the Bachelor of Dental Science at the University of Jazan, Saudi Arabia, were invited to complete a WhatsApp media survey, which included demographics and the Dundee Ready Education Environment Measure (DREEM). This scale measured students' overall perceptions of the EC in five domains: learning, teaching, academic self-perception, atmosphere, and social self-perception. Data were analyzed with Student's t-tests and ANOVA to compare between and within groups.

RESULTS

A total of 272 participants, 140 (51.5%) preclinical and 132 (48.5%) clinical students,took part in the study. Students were generally positive about their learning climate, with overall DREEM scores of 125.19 and 126.21 (preclinical) to 124.10 (clinical) out of a possible score of 200 phases. Student's perceptions of teaching (26.18±3.24/72.72%) and atmosphere (28.08±5.29/63.82%) were the highest and lowest scores, respectively, and both scores were positive.

CONCLUSION

No differences between the preclinical and clinical phases of the curriculum point to the structure of learning, teaching, academic, social self-perception in health professional degrees. Further research should investigate the weak points in the social and atmospheric climate.

The Evaluation of Dental Anxiety in Primary School Children: A Cross-Sectional Study from Romania

Current data report that high levels of dental anxiety in children have a negative impact on oral health. The aim of this study was to measure dental anxiety, based on the Abeer Children Dental Anxiety Scale (ACDAS) used as a self-reported measure and to correlate its values with the salivary cortisol levels. The study was conducted in 2019 and included 389 children aged 6-9 years old; evaluation of dental anxiety and saliva sampling were performed. The influence of gender on the presence of dental anxiety was analyzed using Fisher's exact test, the salivary cortisol level was compared between anxious and non-anxious children and was further correlated with the ACDAS score (p < 0.05). Girls had higher odds of experiencing dental anxiety (odds ratio: 1.533, p = 0.041). Salivary cortisol levels were higher in anxious compared to non-anxious children (median 1.251 vs. 1.091 ng/mL, p < 0.001) and showed a positive moderate correlation with the ACDAS score (r = 0.411, p < 0.001). Children aged 6-9 years have a high prevalence of dental anxiety, with girls being more susceptible to this condition. Salivary cortisol levels are higher in anxious children and correlate positively with the ACDAS score, proving that ACDAS can be used for the detection of dental anxiety.

Assessing dental anxiety in young girls in KSA

Objective

To evaluate the potential causative factors of dental anxiety in girls aged 6–14 years in Almadinah Almunawwarah, KSA.

Methods

A cross-sectional study was conducted with a random sample of school girls aged 6–14 years. The participants' perceptions were captured using the self-administered Abeer Children Dental Anxiety Scale.

Results

There were 118 respondents and the results showed 47.6% prevalence of dental anxiety. Dental extraction was reported as the most common cause for dental anxiety (18.6%), followed by the feeling of numbness after the application of dental anaesthesia (17.8%). There was no significant relationship between dental anxiety and cognition. The highest score of dental anxiety was found in children aged 7–9 years, of which 35.6% (42/118) had previously never visited a dentist. A negative correlation between dental anxiety scores and age was reported with a Pearson correlation coefficient of −0.026.

Conclusions

Dental extraction, anaesthesia, and numbness were the most frequent causative factors of dental anxiety that appear to decrease in frequency as the child gets older. However, the highest score of dental anxiety was reported in 7- to 9-year-old girls.