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Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children.

ABSTRACT: Background:Children with high level of preoperative anxiety during their visit to dental office are more likely to develop maladaptive behavior postoperatively. First dental experience is always critical in molding child's attitude toward dentistry. Various behavior management methods are being employed during dental treatment to complete anticipated treatment in children. Aim:The aim of the study was to evaluate the effectiveness of cognitive behavioral play therapy and audiovisual distraction for management of preoperative anxiety in children. Materials and methods:A total of 45 children of age 6-10 years with moderate-to-severe anxiety were allocated into three groups: group I-cognitive behavioral play therapy (CBT), group II-audiovisual (AV) distraction, and group III-tell-show-do technique (control group). Children in the CBT group were allowed to play with building blocks, asked to draw a picture and then showed a modeling video of co-operative child undergoing dental treatment. Children in group II were subjected to passive distraction with audiovisual aids, whereas group III (control) children were managed with the conventional TSD technique. Baseline and postintervention objective and subjective anxiety scores were measured with a pulse oximeter and facial image scale (FIS), respectively. Results:A statistically significant reduction in the subjective and objective anxiety scores is observed in all the three groups (p = 0.001) in both intragroup and intergroup comparisons. On intergroup comparison, the reduction in subjective and objective anxiety scores was higher in CBT (p = 0.0) than in AV distraction and TSD groups (p = 0.05). Conclusion:Active distraction with cognitive behavioral play therapy is found to be more effective in reducing the preoperative anxiety in children compared to audiovisual distraction and tell-show-do technique. Clinical significance:Identification and management of preoperative anxiety in children is most critical for successful dental treatment. Active distraction is an effective psychological approach for behavior management in anxious children. How to cite this article:Rajeswari SR, Chandrasekhar R, Vinay C, et al. Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children. Int J Clin Pediatr Dent 2019;12(5):419-422.

SUBMITTER: Rajeswari SR

PROVIDER: S-EPMC7229371 | biostudies-literature | 2019 Sep-Oct

REPOSITORIES: biostudies-literature

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Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children.

Rajeswari Sandaka Raja SR Chandrasekhar Rayala R Vinay C C Uloopi K S KS RojaRamya Kakarla Sri KS Ramesh Manumanthu Venkata MV

International journal of clinical pediatric dentistry 20190901 5

<h4>Background</h4>Children with high level of preoperative anxiety during their visit to dental office are more likely to develop maladaptive behavior postoperatively. First dental experience is always critical in molding child's attitude toward dentistry. Various behavior management methods are being employed during dental treatment to complete anticipated treatment in children.<h4>Aim</h4>The aim of the study was to evaluate the effectiveness of cognitive behavioral play therapy and audiovisu ...[more]

PMID: 32440048

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Project description:Dental anxiety affects approximately 9% of children and is associated with poor oral health, pain, and psychosocial problems. The objective of this study was to investigate the efficacy of cognitive behavioral therapy (CBT) for children with dental anxiety in specialist pediatric dentistry. The study used a parallel-group superiority randomized controlled trial design. The primary outcome measure was the behavioral avoidance test; assessors were blind to treatment allocation. Participants were 8 boys and 22 girls 7 to 18 y old (mean ± SD, 10 ± 3.1). Children fulfilling the diagnostic criteria for dental anxiety were randomized to CBT (n = 13) or treatment as usual (n = 17), such as various sedation methods. Psychologists provided 10 h of CBT based on a treatment manual. Treatments were conducted in a naturalistic real-world clinical setting. Assessments were conducted before the treatment, 3 mo after the start of treatment, and at 1-y follow-up. The analyses of the primary outcome measure by repeated-measures analysis of variance and independent t test showed that children receiving CBT made superior, statistically significant improvements at follow-up (16.8 ± 2.4) compared with treatment as usual (11.4 ± 3.1, P < 0.01). A large between-group effect size (Cohen's d = 1.9) was found. Following treatment, 73% of those in the CBT group managed all stages of the dental procedures included in the behavioral avoidance test compared with 13% in the treatment-as-usual group. Furthermore, 91% in the CBT group compared with 25% in the treatment-as-usual group no longer met the diagnostic criteria for dental anxiety at the 1-y follow-up according to the secondary outcome measure. Measures of dental anxiety and self-efficacy showed larger improvements in the CBT group compared with controls. We conclude that CBT is an efficacious treatment for children and adolescents with dental anxiety and should be made accessible in pediatric dentistry (ClinicalTrials.gov: NCT01798355). Knowledge transfer statement: The results of this study can be used by decision makers and clinicians when planning to implement evidence-based treatment in pediatric dentistry and give children and adolescents access to methods for treating dental anxiety. The results can also be used by parents of children with dental anxiety when asking dentists to cooperate with psychologists using cognitive behavioral therapy.

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Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children.

Publications

Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children.

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