Anxiety during the dental care of children aged 4 to 6 years over three consecutive visits

Managing the anxiety of children during dental care is a major aspect of a pediatric dentist's work. Only a sparse body of literature is available regarding anxiety during dental care over consecutive visits. The purpose of the study was to investigate anxiety over three consecutive visits for pediatric dental treatment using an electrodermal activity (EDA) device. We also investigated how patient age, gender, the type of dental care performed and previous dental experience, exerted effect on anxiety.This was an observational cohort study. Anxiety was assessed during treatment, using an EDA device. We also recorded Frankl's behavior rating, previous dental experience, behavior guidance technique, heart rate and the type of dental care. Our cohort included 30 healthy children aged 4-6 years who needed dental care over at least three visits. Frankl scale scores, EDA values and heart rate did not differ significantly between visits. Behavior and anxiety during treatment did not differ significantly according to gender and age. At the second visit, the Frankl score was higher in children who received pulp treatments and crowns than those who received restorations (p = 0.012). At the third visit, children who received pulp treatments and crowns had higher heart rates than those who received restorations (p = 0.011). Heart rate was significantly higher in children who had negative dental experiences when compared to those with positive experiences (p = 0.030). The levels of anxiety in children aged 4-6 years did not change significantly over three consecutive dental treatments. Therefore, varied and meticulous behavior management methods should be maintained throughout consecutive visits.

Parents' perceptions and concerns regarding pediatric dental care under general anesthesia in Riyadh (Saudi Arabia): a cross-sectional study

The prevalence of dental caries in Saudi children is estimated to be 80% for primary dentition and 70% for permanent dentition. Dental treatment under general anesthesia (GA) might be recommended for children with uncooperative behavior or complicated dental treatment requirements. Despite its advantages, some parents have concerns regarding this approach. Nonetheless, little is known about Saudi parents' perceptions and concerns regarding pediatric dental treatment under GA. The main objective of this study was to determine parents' concerns and perceptions on pediatric dental treatment under GA in Saudi Arabia. It is a cross-sectional survey study. The inclusion criteria were: Arabic-speaking parents of healthy children aged 1-14 years referred to GA screening for dental treatment in a hospital. The final study cohort comprised 319 participants. The first part of the questionnaire included the children's and parents' demographic and clinical input, while the second part comprised the parents' perceptions and concerns. The survey was distributed in the dental office during GA screening visits. Our findings revealed that most parents were concerned about possible GA-related complications (78%), followed by postoperative pain (51%), intravenous line and cannula (49%) and coma or death (46%). This study highlights that most Saudi parents were concerned about the use of GA in pediatric dental treatment and the need for more awareness regarding the risks, benefits and expected outcomes of pediatric dental care under GA.

Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study

Objectives and methods

Children, in the age-group of 6 to 8 years, with moderate level of anxiety, (measured with M-DAS), requiring inferior alveolar nerve block (IANB) for mandibular tooth extraction were selected. Informed consent was obtained from parents. Selected children were allocated randomly into 3 groups virtual reality (VR) distraction group, audio distraction group and Tell-show-do (TSD) group. Pre- and post- distraction anxiety level of children was measured subjectively with facial image scale and objectively with pulse rate and oxygen saturation (measured with pulse oxymeter).

Results

There was a statistically significant decrease in pulse rate after distraction (with a p < 0.01) in all the three groups. Postdistraction pulse rate was lowest in the VR distraction group when compared to other groups. While comparing postdistraction pulse rate values in the three groups, the difference in pulse rate between TSD and VR distraction group was significant. But while comparing the pulse rate between audio distraction and TSD group (p = 0.06), and audio distraction and VR distraction group (p = 0.24) was not statistically significant. Oxygen saturation increased in all the three groups which was statistically significant (p < 0.01). There was a statistically significant difference in the postdistraction oxygen (O2) saturation levels between TSD and audio distraction groups (p < 0.05) with more O2 saturation in audio distraction group. But while comparing the audio distraction with VR group and TSD with VR group, the difference was not significant. Facial image scale (FIS) scores decreased in all the three groups (p < 0.01).

Conclusion

The overall results revealed by all the parameters indicate that children were most relaxed in VR group, followed by audio group and were least relaxed in TSD group during dental visits. Hence VR distraction can be considered as a useful technique for behavior management of pediatric patients during a conventional dental treatment.

How to cite this article

SG G, George S, S A, et al. Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(S-2):S173-S178.