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Experiential learning for children's dental anxiety: a cluster randomized trial.

ABSTRACT: BACKGROUND:Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children's oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA. METHODS:In September 2018, we recruited 988 children aged 7-8?years from 24 classes to participate in a cluster-randomized trial. Classes were randomly assigned to EL (in which children received a lively presentation on oral health and participated in a role play in a simulated dental clinic in the classroom) or the Tell-Show-Do (TSD) group (in which children received a conventional TSD behavior management). The primary outcome was the prevalence of high DA after the procedure of pit and fissure sealant (PFS), assessed by a modified Children's Fear Survey Schedule-Dental Subscale. Secondary outcomes were changes in blood pressures (BP) and pulse rates (PR) before and after the PFS procedure. The intervention effects were estimated by means of mixed effect models, which included covariates of gender and school (and baseline value for BP and PR only), and a random cluster effect. RESULTS:In 396 children of the EL group who received the PFS treatment, the prevalence of high DA (score???38) was 18.5%, compared with 24.3% in 391 children of the TSD group (OR?=?0.65; 95% confidence interval, 0.46-0.93; P?=?0.019). The increases in BP and PR after the PFS were also significantly less in the EL group. CONCLUSION:School-based experiential learning intervention before a dental visit is feasible and effective in reducing children's dental anxiety during PFS. TRIAL REGISTRATION:The trial was registered in Chinese Clinical Trial Registry on 5 January 2020 (No.: ChiCTR2000028878 , retrospectively registered).

SUBMITTER: Zhu M

PROVIDER: S-EPMC7395402 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Experiential learning for children's dental anxiety: a cluster randomized trial.

Zhu Minmin M Yu Hongbing H Xie Bo B Li Hongwen H He Qian Q Li Huimin H Su Jing J Li Xueqi X

BMC oral health 20200731 1

<h4>Background</h4>Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children's oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA.<h4>Methods</h4>In September 2018, we recruited 988 children aged 7-8 years from 24 classes to participate in a cluster-randomized trial. Classes were randoml ...[more]

PMID: 32736555

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Project description:BackgroundA change in how a dentist looks may affect the child's anxiety in the dental office. This study compared the effect of conventional facial PPE versus extra PPE as reusable respirators; on the preoperative child's anxiety in the dental office.MethodsFifty two children were randomly allocated into 4 groups, (1) goggles + surgical mask, and (2) face shield + surgical mask versus (3) half-face respirator and (4) full-face respirator. Each child was communicated with and clinically examined by a dentist wearing the assigned PPE, and then his anxiety was assessed using CFSS-DS. Shapiro-Wilk's test was used to analyse normality. Kruskal-Wallis test followed by Dunn's post hoc test with Bonferroni correction test, were used to analyse non-parametric anxiety score data. Correlations between different factors and anxiety scores were analysed using Spearman's rank-order correlation coefficient.ResultsThere were no statistically significant differences in the number of anxious children in each group, boys had significantly higher scores than girls (p < 0.001) For the "Goggles and surgical mask" group and "overall". There was no significant correlation between age and anxiety scores. Children who didn't have a previous dental visit had statistically significant higher scores than children with previous experience for "Goggles and surgical mask", "Face shield and surgical mask "groups and "overall".ConclusionsHalf-face and full-face respirators have not affected the child's preoperative anxiety in the dental office when compared to the conventionally used PPE. Overall, there is an association between gender and previous dental visits, and dental anxiety, however; there is no correlation between child's age and dental anxiety. Dentists dealing with children should feel free to use reusable respirators, without the risk of affecting children's anxiety in the dental office. Trial Registration This study was registered on www.Clinicaltrialsgov , ID: NCT05371561 on 12/05/2022.

Project description:BackgroundPromising results from a trauma reactivation study on post-traumatic stress disorder suggest that propranolol is capable of attenuating symptoms of traumatically induced mental disorders by blocking memory reconsolidation.MethodsA randomized, parallel, placebo-controlled, quadruple-blind trial was designed to determine the effectiveness of perioperative propranolol during exposure to dental extractions in reducing dental anxiety in patients with dental anxiety or dental phobia. Between November 2014 and December 2018, 52 patients with high levels of fear in anticipation of dental extractions who were referred to a department of oral and maxillofacial surgery for at least two tooth and/or molar removals with 1 month in between were included. On the first visit participants received either 120 mg of perioperative oral propranolol (n = 19) or placebo (n = 17), and a core fear memory was reactivated 1 h preoperatively. The primary outcome was change in severity of dental anxiety from baseline to 1-month follow-up, as indexed by the short version of the dental anxiety inventory (S-DAI). Secondary outcome measures were change in intra-operative state anxiety and specific phobia diagnoses.ResultsLinear mixed model (LMM) yielded no statistically significant difference in change of dental trait anxiety from baseline to 1-month follow-up between propranolol and placebo groups (Cohen's d = 0.23). S-DAI scores decreased in both study arms from baseline to follow-up (propranolol arm: from 32.1 [SD = 7.3] to 29.1 [SD = 8.8]; placebo arm: from 31.6 [SD = 7.5] to 27.1 [SD = 6.5]). Also, administering propranolol was not associated with a significant difference in change of intra-operative state anxiety or phobia diagnoses between groups over time.ConclusionsThe results do not concur with earlier findings regarding post-traumatic stress disorder, and suggest that individuals with traumatically induced fears or phobias do not benefit from the application of perioperative propranolol.

Project description:INTRODUCTION:Dental anxiety is common and causes symptomatic use of oral health services. OBJECTIVES:The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. METHODS:A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. RESULTS:Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (? = -0.75, P < .001, for MDAS total score; ? = -0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (? = -1.08, P < .001) and treatment-related dental anxiety (? = -0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (? = -0.217, P < .026) and women (? = -0.498, P < .001). CONCLUSION:Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). KNOWLEDGE TRANSFER STATEMENT:Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.

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.

Dataset Information

Experiential learning for children's dental anxiety: a cluster randomized trial.

Publications

Experiential learning for children's dental anxiety: a cluster randomized trial.

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