Development of a Artificial Intelligence Dental Anxiety Scale (AI -CDAS) For Children: Validation And Reliability.

Assessing children's pain using patient-based pain scales can be challenging. Hence, there is a need of new version Artificial Intelligence Child Dental Anxiety Scale (AI-CDAS) to scale and test its psychometric properties (validity and reliability). This study was conducted to evaluate the validity and reliability of Artificial Intelligence version of the Child Dental Anxiety Scale (AI-CDAS) for anxiety detection scale in children using face as a response set from October 2022 to December 2023. Aim of this study was to examine the reliability and validity of Artificial Intelligence based Child Dental Anxiety Scale (AI-CDAS) using a wide range of age samples in dental clinics. A total of 100 outpatients (Age 03-09 years) from Bharati Vidyapeeth Deemed to be University Dental College and Hospital, Pune, India participated in this study. Dental anxiety was assessed using the Artificial Intelligence Child Dental Anxiety Scale (AI-CDAS) and comparing with a valid and reliable scale of Colored Version of Modified Facial Affective Scale. Reliability and validity was good and significant correlations were found between the AI-CDAS and the Colored Version of Modified Facial Affective Scale. This study suggests that the Artificial Intelligence based Child Dental Anxiety Scale (AI-CDAS) is a valid and reliable measure for assessing children's dental anxiety and may help encourage dentists to formally assess dental anxiety scale in day to day practice. Self-report measures are commonly employed in dental anxiety assessments. One advantage of self report measures is the ease of administration, taking relatively short period of time to complete. They can also assess the reaction to different aspects of the dental experience.

[Preventing dental anxiety in adults and children]. / Prévention de l'anxiété dentaire chez l'adulte et l'enfant.

PREVENTING DENTAL ANXIETY IN ADULTS AND CHILDREN. In 2014, according to INSEE, dental anxiety affected 7% of the French population. Severity of anxiety can range from minor to severe, minor anxiety manifesting for patients as physical symptoms without compromising dental care to severe anxiety by avoiding dental consultation and compromising dental care. This article explains the problems associated with dental anxiety and suggests ways in which practitioners can help their patients to come to the dentist for dental care, in particular by using cognitive-behavioural therapies.

PRÉVENTION DE L'ANXIÉTÉ DENTAIRE CHEZ L'ADULTE ET L'ENFANT. En 2014, l'anxiété dentaire touchait 7 % de la population française, selon l'Insee. La sévérité de cette anxiété peut être classée de mineure à sévère : elle peut se manifester par des symptômes physiques n'empêchant pas la consultation ou la prise en charge, ou peut mener à l'absence totale de soins, le patient choisissant alors l'évitement. Cet article rappelle les problématiques liées à l'anxiété dentaire et propose aux praticiens des clés afin de permettre à leurs patients de se présenter tout de même chez le dentiste pour bénéficier de soins dentaires, notamment en faisant appel aux thérapeutiques cognitivo comportementales.

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

BACKGROUND: Child 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. METHODS: A 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. RESULTS: The 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. CONCLUSION: In 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.

The impact of animated video cartoons as a distraction technique on anticipatory anxiety levels among children during class I GIC restoration procedures.

PURPOSE: Investigating the effect of visual distraction using animated video cartoons (AVCs) on anxiety of children during class I class I glass-ionomer cement (GIC) restoration procedures. PATIENTS AND METHODS: This randomized clinical trial, 42 children between the ages of 5-6 years were enrolled. These participants were divided into two groups: Group 1, consisting of 21 individuals (AVCs), who were exposed to a cartoon as a visual distraction tool, and Group 2, a control group with 21 participants who did not receive any form of distraction during their first visit. Both groups underwent class I GIC restoration procedures that were conducted in a consistent manner. To evaluate the anxiety levels of the children, measurements of their pulse rate (PR) were taken at the beginning and end of the treatment. Additionally, patient behavior was assessed using the Frankl behavior rating scale (FBRS) as well as validated self-reported dental anxiety scale, the Visual Analog Scale - Anxiety (VAS-A) score. RESULTS: In the control group, postoperative PR increased significantly, while the AVC group experienced a decrease compared to their preoperative PR levels. Additionally, audio-visual distraction had a notable impact on FBRS scores compared to the standard approach. Similarly, the VAS-A score displayed a significant reduction when patients received audio-visual distraction compared to the control condition. Subgroup analysis by gender showed that girls tended to be more responsive to AVCs than boys when evaluated by PR and FBRS, but such findings were not observed using VAS-A. Patients with deeper caries had higher VAS-A scores than those with shallower ones. Despite the caries depth, those who received AVC seemed to be calmer, especially to those with deeper lesions, as indicated lower postoperative VAS-A scores compared to their preoperative levels, unlike the control group. CONCLUSION: Our study suggests that the use of AVCs can be an effective method for reducing anxiety in children undergoing class I GIC restoration procedures.

Association between Dental Fear and Children's Oral Health-Related Quality of Life.

OBJECTIVES: This study aimed to examine the association between both parental dental fear and children's dental fear and its impact on the Oral Health-Related Quality of Life (OHRQoL) of Saudi children in the Eastern Province of Saudi Arabia. METHODS: Data on 93 individuals aged 7-12 years were collected using clinical examination and Arabic-validated questionnaires: the Child Oral Health Impact Profile-Short Form (COHIP-SF19), and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Negative binomial regression analysis was performed to study the association between children's fear and parental dental fear as well as the OHRQoL, while adjusting for certain confounders. RESULTS: Overall, our multivariate analyses showed that children with high dental fear (CFSS-DS ≥ 38, p = 0.027) and a higher percentage of dental caries (p = 0.013) had a significantly lower OHRQoL after adjusting for clinical and socio-demographic factors. Further, parental fear of dentists was significantly associated with children's fear of dentists (p < 0.001). CONCLUSIONS: Our findings demonstrate that children's fear and dental caries are both associated with poorer OHRQoL. Further, parental dental fear about dentists was associated with children's fear of dentists.

Novel non-pharmacological strategies for managing dentophobia in adult patients - literature review.

Dentophobia concerns a substantial portion of the adult population, often leading to avoidance of dental care and subsequent deterioration in oral health. This comprehensive review explores the multifaceted nature of odontophobia and examines various non-pharmacological strategies aimed at its management in adult patients. Factors contributing to dentophobia, including past traumatic experiences, feelings of vulnerability, and mistrust in dental professionals, are discussed, highlighting the complex interplay of psychological, physiological, and environmental influences. Novel approaches such as Virtual Reality Exposure Therapy offer promising avenues for systematically desensitising patients to their fears and enhancing treatment acceptance. Aromatherapy utilising essential oils like chamomile, orange, and lavender, as well as dog-assisted therapy, have shown potential in creating calming environments and reducing patient anxiety during dental procedures. Muscle relaxation therapy, biofeedback techniques, and process simulations provide additional tools for addressing the physiological and cognitive aspects of odontophobia. Cognitive-behavioural therapy interventions, including brief sessions focused on cognitive restructuring and exposure therapy, demonstrate efficacy in reducing fear of dentists and improving treatment outcomes. By incorporating these diverse non-pharmacological strategies into dental practice, clinicians can enhance patient experiences, increase treatment acceptance and adherence, and ultimately improve oral health outcomes. While these interventions show promising results, further research is needed to refine their implementation, optimize their effectiveness, and ensure accessibility to patients with dentophobia. By addressing the multifaceted nature of dental anxiety and adopting a patient-centred approach, clinicians can provide holistic care, fostering better oral health and overall well-being in their patients.

A cross sectional study on levels of dental anxiety, its influencing factors, and the preferred management techniques among patients in Riyadh, Saudi Arabia.

BACKGROUND: Dental anxiety is marked by intense and irrational fear of dental procedures affecting millions of individuals worldwide. The purpose of this study was to investigate the relationship between dental anxiety, its influencing factors, and the preferred management techniques among adults seeking dental care in Riyadh. METHODS: A cross-sectional questionnaire study was carried out among 1734 patients who visited dental clinics in Riyadh. A self-administered questionnaire was developed and validated, comprising 28 closed-ended questions; it demonstrated good reliability and internal consistency (Cohen's kappa coefficient = 0.90, Cronbach's alpha coefficient = 0.86), it contained pre-validated Modified Dental Anxiety Scale to quantitatively assess the level of dental anxiety. Data analysis involved descriptive analysis, Chi-square test, Pearson correlation coefficient and multiple linear regression. RESULTS: Majority (59.2%) of participants reported moderate anxiety, while 10.9% experienced high anxiety which was significantly linked to factors such as fear of pain (37.8%) and anaesthetic needles (25.8%). Topical anaesthetic gel (64.5%), pre-treatment explanations (78.9%), and conducive clinic environment (79.4%) were perceived as effective anxiety alleviators. A negative correlation existed between dental anxiety and preferred management techniques. Dental anxiety had significant association between gender (ß = 0.910) and age (ß = 0.263). CONCLUSION: This study revealed that majority of participants had moderate dental anxiety, linked significantly to influencing factors like frequency and purpose of dental visits and past dental experiences. The study also found the preferred anxiety management methods among participants which included topical anaesthetic gel, pre-treatment explanations, and a comfortable clinic environment.

Evaluation of dental behavior, anxiety, fear, and its correlation with trait emotional intelligence in 8-12-year-old children: Exploring a new frontier in behavior modification.

BACKGROUND: Children's fear and distress in dental settings often lead to anxiety and behavior issues. This study delves into why some children experience dental anxiety, whereas others do not, attributing differences to child-rearing and personality traits. Emotional intelligence (EQ), the ability to comprehend, generate, and manage emotions, is explored as a factor influencing a child's dental experience. This novel intelligence theory accommodates the intricacies of human-environment interactions. AIM: The study aimed to investigate the relationship between EQ and a child's dental anxiety, fear, and behavior in children aged 8-12 years. MATERIALS AND METHODS: The Trait Emotional Intelligence Questionnaire-Child Short Form, specifically developed for children aged between 8 and 12 years, was used among 100 participants reporting to the department outpatient department. The Frankl's Behavior Rating Scale, Modified Child Dental Anxiety Scale, and Children's Fear Survey Schedule-Dental Subscale were used to evaluate behavior, anxiety, and fear, respectively. RESULTS: Results show a positive correlation between EQ and dental behavior (P = 0.002) whereas a negative correlation between EQ and dental anxiety and fear (P < 0.001). CONCLUSION: This study sheds light on the intricate interplay between emotional intelligence, dental behavior, anxiety, and fear among children. By recognizing the impact of EQ, dental practitioners could adopt personalized strategies to alleviate anxiety and enhance cooperation, improving overall dental experiences for young patients.

Dental anxiety and dental care - a comparison between Albania and Germany.

BACKGROUND: The present study is the first in Albania on dental fear and dental anxiety and also in the field of psychosocial medicine. The purpose of this study was to find out whether there are differences in dental anxiety using the Dental Anxiety Scale, their level of psychological distress using the Brief Symptom Inventory-18 and the evaluation of oral health among Albanian and German patients. METHODS: This study was conducted in the period from December 2019 to July 2020, a sample of N = 263 patients (133 Germans, 130 Albanians) using the Dental Anxiety Scale questionnaires to determine anxiety before dental treatment and the Brief Symptom Inventory-18 to evaluate psychological distress. Moreover, the patients answered questions regarding their oral health and dental care. In Germany, there were four refusals to entrance in the study due to various reasons, in contrast to Albania, where there were no refusals at all For the purposes of this study, data on both populations aged 14 years and older were used. RESULTS: The questionnaires results were calculated for all participants. The current subjective health status of Albanian patients was assessed to be significantly worse than that of German patients (p < 0,000). Germans were more susceptible to signs of Anxiety (p < 0,000), Depression and Somatization and scored higher on the Dental Anxiety Scale and the Global Severity Index (p < 0,000) than Albanian patients. Additionally Albanian patients scored significantly lower on the preventive care index (p < 0,000). Despite an elevated DAS anxiety level, German patients reported going to the dentist more frequently than Albanian patients. CONCLUSION: The results showed that between both populations differences in dental anxiety, psychological distress and oral health exists. Patients from Germany report more psychological distress and described more dental anxiety compared to Albanian patients. Albanian patients reported not utilization on oral health care.The implementation of educational programs and preventive measures, would contribute to raising awareness about the importance of oral health and increased use of dental services.

Interdisciplinary CBT treatment for patients with odontophobia and dental anxiety related to psychological trauma experiences: a case series.

BACKGROUND: While cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample's oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach. METHODS: The study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study. RESULTS: All patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2). CONCLUSIONS: TADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes. TRIAL REGISTRATION: The study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority.

Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

Evaluation of Children's Drawings as a Measure of Dental Anxiety Before and After Oral Health Education.

BACKGROUND: Drawing is an effective tool for evaluating dental anxiety and communicating with children. AIM: The aim of this study was to evaluate children's drawings as a measure of dental anxiety with two different assessment methods and their possible relationship with age, gender, and previous dental visits before and after education. METHODS: A total of 129 children aged 4-6 years old were requested to draw a picture of the dentist and dental office perception before and after a 20-minute dental education at selected Kindergartens. Drawings were evaluated according to Child Drawing: Hospital (CD: H) and Massoni methodologies. RESULTS: The difference in drawing groups between before and after oral health education was found to be statistically significant which meant children had less anxiety after education (P = 0.001). A statistical difference was observed in the scores before and after the education in the group of children who had previous dental visits and those who did not (P = 0.001). Statistically significant differences were observed in both groups of children who had previous dental visits and those who did not (P = 0.002). CONCLUSION: Oral health education at younger ages is effective in overcoming dental anxiety and improving the positivity of dental perception. Drawing is a suitable assessment tool for learning about the child's notions and feelings.

Green light exposure in children with autism spectrum disorder: a pilot study.

Children with autism spectrum disorder (ASD) are frequently afflicted with sensory processing difficulties, which often impact their ability to cooperate with dental treatment. The objective of this pilot study was to determine the effects of green light exposure on behavior, pain, distress and anxiety in pediatric patients with ASD undergoing a dental prophylaxis. Twelve children diagnosed with ASD, aged 6-17 years, requiring a dental prophylaxis participated in this study. Participants completed two dental prophylaxes, three months apart, one in a standard white light-exposed dental operatory and one in a green light-exposed dental operatory. Behavioral cooperation, pain intensity, physiological stress and anxiety were assessed in all patients. The Wilcoxon matched-pairs signed rank test was used to estimate differences in measured outcomes according to the experimental condition. There was a trend towards reduced uncooperative behavior when children received a dental prophylaxis in the green light-exposed operatory (p = 0.06). Similar levels of heart rate variability (p = 0.41), salivary alpha amylase (p = 0.19), and salivary cortisol (p = 0.67) were observed at the start and end of each visit in both conditions. Green light exposure had no significant effect on pain intensity (p = 0.17) or behavioral anxiety (p = 0.31). These findings suggest a preliminary positive benefit of green light exposure on behavioral outcomes in pediatric patients with ASD and warrants a further, large-scale clinical trial.

Effectiveness of a dental simulation game on reducing pain and anxiety during primary molars pulpotomy compared with tell-show-do technique in pediatric patients: a randomized clinical trial.

BACKGROUND: Dental simulation games are virtual educational games that help children get familiar with different dental procedures. This study aimed to evaluate the pretreatment exposure to the "Baby Panda Dental Care" game in reducing pain and anxiety in comparison with the tell-show-do (TSD) technique during primary molars pulpotomy for patients aged 6-10 years. MATERIALS AND METHODS: It was a triple-blinded, two-arm, parallel-group, randomized, active-controlled trial. It was done on 60 patients, who were randomly divided into two groups: the control group, TSD technique (n = 30), and the experimental group, "Baby Panda Dental" Care (n = 30). For the TSD technique, children were provided with a verbal explanation followed by a demonstration of the dental treatment in a non-threatening way. The "do" phase is then initiated during performing treatment. For the "Baby Panda dental care" game, children were asked to play for 5 min before treatment, selecting root canal therapy procedures. Pulse rate and RMS pictorial scale were recorded at four time points: (1) at the baseline (t0). (2) After conditioning the child (t1). (3) During treatment (t2). (4) After finishing the treatment (t3). Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scale was recorded during treatment (t2). RESULTS: The pulse rate is higher in the control group at t1 (p = 0.012) and t2 (p = 0.015). There was a statistically significant difference in the mean RMS pictorial scale score at t1 (p < 0.001), t2 (p = 0.006), and t3 (p < 0.001), a statistically significant difference was noticed in FLACC behavioral pain assessment between the two groups (p = 0.033). CONCLUSIONS: The mobile dental game showed better results than the TSD technique, but neither technique did not reduce anxiety and pain effectively during dental treatment. TRIAL REGISTRATION: The trial was registered at the ISRCTN registry (ISRCTN30470866) on 19/04/2024.

Trauma-Informed Care in Oral Health Care: The role of dental hygienists.

Traumatic experiences can impact individuals' oral health and how they experience dental treatment in ways patients and their dental providers may or may not initially anticipate. As approximately half of children and two-thirds of adults in the United States have experienced some type of traumatic event, it is critically important for providers to be aware of patients' trauma histories and to appropriately provide trauma-informed care to their patients when needed. Individuals with a trauma history may experience significant anxiety and distress in the dental setting, even for treatment many providers and patients consider to be "simple," such as a brief intraoral examination, radiographs, or prophylaxis. Such aspects of the dental setting may trigger memories and emotions related to the original trauma and may re-traumatize patients. This short report introduces links between traumatic history, poor oral health, and dental care-related fear and anxiety. Additionally, this paper briefly describes how dental hygienists can provide compassionate trauma-informed care to their patients with the goal of providing whole-person care that considers patients' comfort, health goals, and prior experiences. Specific recommendations for providing trauma-informed care to children and adults within the scope of dental hygiene practice are provided, as is suggested wording for acknowledging a patient's prior trauma and tailoring dental care to accommodate patient experiences and concerns. As dental hygienists are often the oral health providers spending the most time with patients, they are uniquely positioned to provide compassionate effective trauma-informed care to patients with past traumatic experiences.

Dentally Anxious Patients' Perceptions of Oral Health Care.

Purpose Many adults in the United States struggle with mild, moderate, or severe dental anxiety (DA). Understanding the perspectives of patients with DA may help oral health professionals gain greater insight into their needs and learn how to provide an improved experience for these patients. The purpose of this study was to identify patients' perspectives on factors that impact anxiety in a dental practice setting.Methods A qualitative, descriptive case study design was used to identify patients' perspectives on factors impacting anxiety in a dental practice setting. Potential participants were screened using the Modified Dental Anxiety Scale (MDAS) and needed a moderate DA score to qualify for the study. An interview guide focused on obtaining information about the etiology, contributing factors, management strategies, and participant experiences of DA was used for the semi-structured virtual interviews. Responses were coded using a qualitative research analytic platform (Dedoose; Los Angeles, CA, USA). The co-investigators systematically reviewed the codes using the classic qualitative analysis strategies and journal notes to identify themes and subthemes.Results Twenty-two individuals qualified for participation in this study. Most participants reported having DA beginning in early childhood and throughout their adult life. Seven themes, including Avoidance, Supportive Behaviors, Confidence in Provider, Diversion, Enduring, Adaptations, and Benevolence emerged. Participants reported their primary method for managing DA was to avoid attending their dental appointments.Conclusion Participants in this study expressed various coping mechanisms and management strategies to alleviate the symptoms of DA. Multiple opportunities exist for increasing patient-provider trust and patient comfort to reduce DA, and ultimately improve the oral health status of individuals with DA.

A randomized clinical trial comparing the effects of music and informative videos on patient anxiety during root canal treatment and retreatment.

OBJECTIVES: This randomized clinical trial compared the effectiveness of music and informative videos as distraction tools to reduce the anxiety of patients during root canal treatment and retreatment. METHOD AND MATERIALS: A total of 90 patients were enrolled in the study. The patients were randomly allocated to three groups: Group 1 listened to music during the treatment (n = 30), Group 2 watched an informative preoperative video (n = 30), and a control group underwent treatment without a distraction method (n = 30). Prior to treatment, the Corah Dental Anxiety Scale (CDAS) and a visual analog scale for pain were used to assess anxiety and preoperative pain. Systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were recorded before the intervention (T1), after the local anesthetic (T2), following pulp extirpation or removal of root fillings (T3), and immediately following rubber dam removal (T4). One-way ANOVA, followed by post-hoc Bonferroni tests for multiple comparisons, were used to compare mean values of systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation among the groups. A P value of 5% was considered as significant. RESULTS: Listening to music reduced systolic blood pressure, heart rate (P .001), and diastolic blood pressure (P = .003) in patients undergoing root canal treatment and retreatment at T4 compared to the baseline (T1). Music (P .001) and informative video (P = .003) groups had significantly lower postoperative visual analog scale pain scores. CONCLUSION: Listening to music during root canal treatment and retreatment reduced anxiety levels in patients compared to informative preoperative videos and no distraction technique.

A cross-sectional study on dental anxiety and state anxiety related to removal of fixed partial dentures.

OBJECTIVES: This study aimed to evaluate the effect of the clinical removal of fixed partial dentures on oral health-related quality of life and the anxiety values of individuals and to determine the clinical factors of high anxiety levels. METHOD AND MATERIALS: In total, 300 participants were included in the study. Six different reasons for the clinical removal of fixed partial dentures (oral examination, denture renewal, endodontic treatment, tooth extraction, periodontal treatment, and composite filling restoration) were defined. The United Kingdom Oral Health-Related Quality-of-Life Measure (OHRQoL-UK), the Modified Dental Anxiety Scale (MDAS), and the Spielberger State-Trait Anxiety Inventory- State (STAI-S) and Trait (STAI-T) were answered. The reason groups were compared using one-way analyses of variance. Binary logistic regression analyses were performed to evaluate the risk factors for high anxiety. RESULTS: There was no significant difference in OHRQoL-UK scores (P = .279) among the reason groups, but there were significant differences in MDAS, STAI-S, and STAI-T scores (P = .004, P .001, P = .018, respectively) among the reason groups. Endodontic treatment, tooth extraction, and sex were determined to be risk factors, considering the anxiety scales. CONCLUSIONS: Females are 2.2 times more likely to have trait anxiety than men. Although the effect of the reason for the clinical removal of fixed partial dentures on oral health-related quality of life was similar among the groups, it is concluded that endodontic treatment and tooth extraction reasons for the clinical removal of fixed partial dentures could be risk factors for high anxiety regardless of fixed partial denture usage time.

Evaluation of the effect of dental anxiety on vital signs in the order of third molar extraction.

BACKGROUND: Dental anxiety is a prevalent concern affecting patients undergoing various dental procedures, particularly surgical interventions. Understanding the impact of patients' anxiety levels on their physiological responses during dental surgeries, such as third molar impaction surgery, is crucial for optimizing patient care and outcomes. Therefore, this study aimed to investigate the effect of patients' anxiety levels on vital signs during third molar teeth impaction surgery. METHODS: A cross-sectional study was conducted, including 45 randomly selected, healthy patients. Demographic information was recorded after obtaining consent from the patients prior to surgical intervention. Preoperative anxiety levels were determined using the Modified Dental Anxiety Scale (MDAS). Pupil measurements were taken from the patients before surgery, at 10 min after the surgery began, and at 10 min after the surgery ended. Systolic (SBP) and diastolic (DBP) blood pressure, pulse rate, temperature, and haemoglobin oxygen saturation (SpO2) values were recorded. RESULTS: The MDAS test results were statistically significantly higher in women compared to men (p < 0.001). Positive correlations were observed between MDAS score and both preoperative pulse rate (r = 0.344, p = 0.021) and SpO2 level during the operation (r = 0.462, p = 0.001). However, no significant correlations were found between MDAS and DBP (p = 0.575), SBP (p = 0.176), fever (p = 0.238), or pupil diameter (p = 0.338). CONCLUSIONS: Third molar impaction surgery induces anxiety in adult patients 20 years and older. Vital sign monitoring provides information about the patient's emotional state, both before and during the procedure. Since anxiety causes changes in vital signs during dental procedures, it is important to follow these findings to have an idea about the general condition of the patients.

The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study.

BACKGROUND: Identifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits. OBJECTIVES: This study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia. SUBJECTS AND METHODS: A total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents' OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant. RESULTS: Children with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20-25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001). CONCLUSION: PDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child's first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.