Storytelling using self-designed image-based storybook as tools for reducing dental anxiety in 5 to 12-years-old children: a narrative therapy

Background: Children commonly experience dental anxiety, marked by a general feeling of fear when they have not encountered the situation before. By incorporating positive dental information through storytelling or engaging dental activity books, children can be effectively reassured and mentally prepared for their initial dental appointments. Storytelling and storybooks in healthcare serves multiple functions such as educating patients and their families, promoting specific qualities, and enhancing behaviors.Methods: A randomized clinical study involving 240 children aged 5 to 12 years was conducted. The children were randomly assigned to three groups of 80 each: group 1 (received storytelling with image-based storybook), group 2 (received only storytelling), and the control group (received neither). Pulse rate and anxiety assessment using animated emoji scale measurements were taken at the start of the appointment, after the intervention before treatment, and after dental treatment.Results: The interventional groups 1 and 2 showed a significant difference compared to the control group for pulse rate and animated emoji scale. Group 1 exhibited the highest reduction in anxiety as measured using the animated emoji scale and pulse rate.Conclusions: In conclusion, providing children with a dental storybook before dental treatment can decrease dental anxiety and improve their behavior during the dental treatment.

Chromotherapy: a useful tool for managing anxiety in children

Background: Dental anxiety is a type of fear developed due to threatening stimuli. Assessing the child's level of dental anxiety is very important to successfully carry out many treatment procedures in dentistry. Needles in general can cause dental anxiety. Chromotherapy is an ancient alternative medicine practice that uses the energy of the visible spectrum of electromagnetic radiation (i.e., coloured light) to induce changes in the human body. The objective of this study was to clinically evaluate and compare the effect of chromotherapy on the level of anxiety in patients treated with infiltration under local anaesthesia.Methods: This is a randomized control trial where anxiety was assessed using heart rate and animated emoji scale (AES) in children aged 4-14 years requiring infiltration injection of local anaesthesia. Patients were divided into 4 groups: group-1 blue, group-2 pink and group-3 yellow, group 4-control. Evaluation of all parameters was carried out at three levels, i.e., pre-operative, post-chromotherapy session and infiltration after local anaesthesia.Results: This study demonstrated that patients subjected to blue, pink and yellow colour therapy had a statistically significant reduction in anxiety compared to the control group after chromotherapy.Conclusions: Chromotherapy plays an important role in managing dental anxiety in children and can be effectively incorporated into routine practice.

Translation and cultural adaptation of the Children's Experiences of Dental Anxiety Measure (CEDAM) to Brazilian Portuguese / Tradução, adaptação cultural e análise das propriedades psicométricas da "Children's Experiences of Dental Anxiety Measure" para uso em crianças brasileiras

Objetivo: A escala Children's Experiences of Dental Anxiety Measure (CEDAM) foi originalmente desenvolvida em Inglês para avaliar importantes aspectos da ansiedade odontológica em crianças. Os objetivos do estudo foram traduzir e realizar a adaptação cultural da CEDAM para o Português Brasileiro. Material e Métodos: A CEDAM consiste de 14 itens, medidos por escala Likert de 3 pontos, que indica a intensidade da ansiedade odontológica. O questionário foi traduzido para o Português Brasileiro, retraduzido para o Inglês, revisado por um Comitê de Especialistas e pré-testado em 10 escolares de oito a doze anos. Resultados: O Comitê Revisor de Especialistas comparou as versões original, traduzida (T1, T2) e retraduzida (BT1, BT2) e recomendou algumas mudanças a fim de obter uma boa compreensão dos itens. No pré-teste, somente a questão 8 não foi compreendida por uma criança, isto é, a versão traduzida foi bem compreendida por mais de 85% dos participantes. Conclusão: A versão brasileira da CEDAM foi culturalmente adaptada para a população avaliada de crianças.(AU)

Objective: The Children's Experiences of Dental Anxiety Measure (CEDAM) was originally developed in English to assess important aspects of dental anxiety for children. The aims of the study were to translate and perform the cultural adaptation of the CEDAM to Brazilian Portuguese. Material and Methods: The CEDAM consists of 14 items, measured by a Likert scale of 3 points, that indicates the intensity of dental anxiety. The questionnaire was translated to Brazilian Portuguese, back-translated to English, reviewed by an Expert Committee and pretested in 10 eight- to twelve-year-old schoolchildren. Results: The Expert Committee Review compared the original, translated (T1, T2) and back-translated (BT1, BT2) versions and recommended some changes in order to achieve good understanding of the items. In the pretest, only question 8 was misunderstood by one child, i.e., the translated version was well-understood by more than 85% of the participants. Conclusion: The Brazilian CEDAM was culturally adapted for the evaluated population of children(AU)

Pain, anxiety, and catastrophizing among pregnant women with dental pain, undergoing root canal treatment

Abstract This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.

Which Dental Procedures Lead to Greater Distress During Children's Dental Treatment? A Cohort Study

ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3-10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment.

O método computadorizado de anestesia odontológica é mais efetivo que o método convencional em crianças e adolescentes? Uma revisão sistemática da literatura / Is the computerized dental anesthesia method more effective than the conventional method in children and adolescents? A systematic literature review

Objetivo:Revisar sistematicamente a literatura sobre a efetividade do método computadorizado de anestesia odontológica em relação àdor, comportamento não colaborador e o medo/ansiedade em crianças e adolescentes em comparação com o método convencional. Materiais e métodos:Uma buscaeletrônica foi realizada em cinco base de dados (Biblioteca Virtual em Saúde, Scopus, Embase, Pubmed e Web of Science)e que incluiu ensaios clínicos randomizados. A busca foi realizada em outubro de 2020 eatualizada em maio de 2021 e, não houve restrição de data ou idioma. A avaliação de risco de viés foi realizada usando aRoB 2 e, tambémfoi realizada uma análise qualitativa. Resultados:Foram encontrados 3.518 estudos, e após a remoção das duplicatas, análise do título e resumo e,leitura completa, restaram 26 estudos incluídos. Destes,cinco avaliaram ansiedade/medo, doze avaliaram o comportamento durante a anestesia, e vinte e dois avaliaram a percepção de dor. Não foi observadodiferença significativa na maioria dos estudos entreo uso do método computadorizado em comparação ao método tradicionalpara todos os desfechos analisados. Discussão:Apesar de não parecer haver diferença significativa na percepção de dor, no relato de medo/ansiedade e no comportamento entre o uso do método computadorizado emcomparação ao método tradicional, é fundamentalavaliar o comportamento da criança durante o atendimento odontológico pois suas expressões podem indicar algum desconforto e dor. Esses achados devem ser interpretados com cautela, considerando que quase três quartos dos estudos incluídos apresentaram alto risco de viés. Conclusão:Mesmo com a ausência de diferença, os dispositivos eletrônicos são promissores, visto que promovem uma administração lenta e controlada e resultam em uma anestesia segura e eficaz que coloca-se como alternativa a prática clínica.

Aim:To systematically review the literature on the effectiveness of the computerized method of dental anesthesia in relation to pain, non-collaborative behavior and fear/anxiety in children and adolescents compared to the conventional method. Materials and methods:An electronic search was performed in five databases (Virtual Health Library, Scopus, Embase, Pubmed and Web of Science)that included randomized clinicaltrials. The search was performed in October 2020 and updated in May 2021. The risk of bias assessment was performed using the RoB 2 andaqualitative analysis was also performed. Results:A total of 3,518 studieswere found, and after removing duplicates, analyzing the title and abstract, and completereading, 26 studies remainedincluded. Of these, five assessed anxiety/fear, twelve assessed behavior during anesthesia, and twenty-two assessed pain perception. No significant difference was observed in most studies between the use of the computerized method compared to the traditional method for all outcomesanalyzed. Discussion:Although there does not seem tobe a significant difference in pain perception, fear/anxiety reports and behavior between the use of the computerized method and the traditional method, it is fundamental to evaluate the child's behavior during dental care, as their expressions may indicate some discomfort and pain. These findings should be interpreted with caution, considering that nearly three-quarters of the included studies were at high risk of bias. Conclusion:Even with the absence of difference, electronic devices are promising, as they promote slow and controlled administration and result in safe and effective anesthesia, which is an alternative to clinical practice.

Playing it down - effectiveness of clay therapy, origami and building blocks in the management of dental anxiety among children aged 6-10 years

Background: Children experience dental anxiety during their first dental visit, which affects the quality of dental treatment and gives rise to behaviour management problems. Clay, origami and building blocks have been effective in alleviating hospitalization anxiety in pediatric patients. These successful techniques in hospitalized pediatric patients have seldom been used in the dental set up. Therefore, the aim of this study is to assess and compare the efficacy of clay therapy, origami and building blocks in the management of dental anxiety in children aged 6-10 years.

Methods: Sixty children aged 6-10 years, with no previous dentist exposure, with Frankl抯 behaviour rating 2 or 3 having dental caries with international caries detection and assessment system (ICDAS) score 3 requiring restorations without local anesthesia were selected and divided into four groups. Group 1 � clay therapy; group 2 - building blocks; group 3 � origami; and group 4 � tell show do. Pulse rate, facial image scale (FIS) and face, leg, activity, cry, consolability (FLACC) behaviour scales were used to quantify anxious behaviour. Operator compliance and parent acceptance was rated on the Likert scale.

Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, and better operator compliance and parental acceptance in clay therapy, origami and building blocks groups than in the conventional tell-show-do group. The most significant reduction in all the parameters was seen in the clay therapy group.

Conclusions: Clay therapy, origami and building blocks can be used as an effective means to reduce dental anxiety in children.

Indicações e eficácia do tratamento restaurador atraumático / Indications and effectiveness of atraumatic restorative treatment

A fobia odontológica afeta considerável parcela da população, a ansiedade e medo frente ao tratamento dentário induzem pacientes ao cancelamento ou adiamento de tratamentos essenciais, agravando assim o seu quadro clínico. As abordagens restauradoras minimamente invasivas preconizam maior preservação dos tecidos dentários, diminuindo o desconforto e dor durante as intervenções. Sob esta ótica o Tratamento Restaurador Atraumático (ART) dispensa o uso das turbinas rotatórias, da anestesia local, do isolamento absoluto e utiliza o Cimento de Ionômero de Vidro de alta viscosidade nas restaurações. A relevância do ART no panorama odontológico e sua ampla utilização nos serviços públicos e privados de assistência bucal justificam a realização desta revisão narrativa de literatura, realizada a partir de artigos publicados nos últimos dois anos, acessados nas bases de dados online Scientific Eletronic Library On-line (SciELO), MEDLINE e LILACS. Esta pesquisa tem como objetivo reconhecer a fobia odontológica e associá-la à indicação do ART assim como definir a efetividade desta proposta de intervenção, colaborando para seu uso de forma criteriosa e adequada.

Dental phobia affects a considerable portion of the population, anxiety and fear regarding dental treatment induce patients to cancel or postpone essential treatments, thus aggravating their clinical condition. Minimally invasive restorative approaches advocate greater preservation of dental tissue, reducing discomfort and pain during interventions. From this perspective, the Atraumatic Restorative Treatment (ART) dispenses with the use of rotating turbines, local anesthesia, absolute isolation and uses high viscosity Glass Ionomer Cement in restorations. The relevance of ART in the dental panorama and its wide use in public and private oral care services justify this narrative literature review, based on articles published in the last two years, accessed in the online databases Scientific Electronic Library On- line (SciELO), MEDLINE and LILACS. This research aims to recognize dental phobia and associate it with the indication of ART, as well as to define the effectiveness of this intervention proposal, contributing to its judicious and appropriate use.

Sinicization of the Index of Dental Anxiety and Fear Scale and the test of reliability and validity / 中国实用护理杂志

Objective:To sinicize the Index of Dental Anxiety and Fear (IDAF-4C +), and to test its reliability and validity. Methods:According to the Brislin translation model, the literal translation, back translation, cultural adjustment and pre-investigation of the scale were carried out to form the Chinese version of the IDAF-4C + Scale, and the convenience sampling method was used to investigate the outpatients of the Affiliated Stomatological Hospital of Nanchang University from October 2021 to January 2022 to verify the reliability and validity of the scale. Results:The Chinese version of the IDAF-4C + Scale consisted of three modules (core anxiety module, fear module and stress module), with a total of 23 items, of which the core anxiety module included cognitive, physiological, behavioral and emotional dimensions. The content validity index of each item was 0.8-1.0, and the content validity index of the total scale was 0.913; the construct validity was 0.903, and a common factor was extracted by exploratory factor analysis of anxiety module. The contribution rate of cumulative variance was 72.037%. The results of confirmatory factor analysis showed that the model fitted well and all the adaptation indexes were up to the standard. Using the Modified Dental Anxiety Scale (MDAS) as the criterion, the correlation coefficient between IDAF-4C module and MDAS was 0.66, the Cronbach α coefficient of the scale was 0.913, and the test-retest reliability was 0.923. Conclusions:The Chinese version of the IDAF-4C + Scale has good reliability and validity and can be used as a tool to measure and evaluate the level of dental anxiety and fear in oral patients.

Factors Influencing Anxiety Levels During Dental Radiographic Examination Among Dental Students

@#Introduction: : Dental anxiety was found to be related to the radiographic procedure and can be influenced by sociodemographic characteristics of patients such as age, gender, level of education, and provoking factors such as past dental examination experience. Evaluating the anxiety regarding dental radiographic examination could be beneficial in ensuring the procedure’s continuance. This study aimed to measure the radiology knowledge among dental students and its association with anxiety due to dental radiographic examination. Methods: A cross-sectional study was conducted to collect the data using a questionnaire packet that included a knowledge and anxiety questionnaire, demographic data, and information about the experience of dental radiographic examination. A total sampling of 1st and 2nd year undergraduate and clerkship dental students at the Faculty of Dentistry, Universitas Gadjah Mada, Indonesia was selected based on inclusion and exclusion criteria. Anxiety-related factors were assessed using descriptive statistics and multiple linear regression conducted with STATA 15.1. Results: Results showed that knowledge and anxiety were negatively correlated but the correlation was not statistically significant. Gender, radiographic technique, and presence/absence of a companion during the examination were not correlated with anxiety. Meanwhile, the anxiety level was negatively and significantly correlated with age and examination frequency (p < 0.05). Multiple linear regression results showed strong evidence that age and examination frequency were the main factors for predicting anxiety. Conclusion: Although age, radiographic examination frequency, and educational level are significant bivariate predictors of anxiety, subsequent regression analysis indicated that only age and radiographic examination frequency influence anxiety.

Knowledge, Dental Anxiety, and Patient Expectations During the COVID-19 Pandemic

Abstract Objective: To assess the knowledge, dental anxiety, and expectations regarding dental services during the COVID-19 pandemic. Material and Methods: The respondents were Indonesian citizens above 18 years old. An online Google survey was administered using a structured questionnaire with a snowball sampling technique. Survey items comprised knowledge related to COVID-19, dental anxiety assessed using the modified DAS (Dental Anxiety Scale) and expectations regarding dental services using four dimensions of dental service quality. All questionnaires were tested for reliability and indicated acceptable and good agreement. The data were analyzed descriptively. Results: A total of 553 responses were analysed. Most respondents were female (72.9%), 76.7% knew of recommendations to postpone dentist visits and 86.8% knew methods of preventing COVID-19 transmission. More than 70% of respondents knew the precaution procedures in the dental office during COVID-19, and only 27.9% had moderate-severe anxiety. Most respondents' expectations regarding dental services during the pandemic era were related to the quality domain of reliability and responsiveness. Conclusion: Respondents knew about COVID-19 transmission and prevention, emergency conditions warranting a visit to the dentist and the procedures used at the dental office. Most respondents stated that they were not anxious about visiting a dentist during the pandemic. The respondents expect the dentist to provide sufficient information to improve oral health and treatment plan.

Nitrous oxide or midazolam to tooth extraction? a systematic review / Óxido nitroso ou midazolam para extracção dentária? uma revisão sistemática / ¿Óxido nitroso o midazolam para la extracción dental? una revisión sistemática

Aim: This systematic review aimed to evaluate the use of midazolam and nitrous oxide in conscious sedation for dental extraction procedures. Methods: A search was conducted in electronic searches Medline/PubMed, Embase, Cochrane Library, Web of Science, grey literature, and the main scientific journals in the area, following PRISMA. Booleans operators were used for the combinations of terms and the search strategy was adapted to each of the databases, ("tooth extraction" OR "molar, third" OR "tooth, impacted" OR "surgery, oral" OR "exodontics" OR "wisdom tooth" AND "nitrous oxide" OR "anesthetics, inhalation" OR "conscious sedation" OR "laughing gas" OR "moderate sedation" AND "midazolam" OR "benzodiazepines" OR "hypnotics and sedatives" OR "sedative effect"). Study Selection and Data Extraction: The inclusion criteria were parallel and crossover RCTs involving patients of any age submitted to tooth extraction at a dental office under local anesthesia. No language restrictions have been imposed until 2023. The exclusion criteria were studies involving patients submitted to extraction in the hospital setting, studies that did not measure anxiety or sedation and studies for which the full text was not available. Results: Where within the eight articles that met the eligibility criteria, no significant differences were found between the methods, in relation to sedation or anxiety. Conclusion: In conclusion, nitrous oxide and midazolam safely ensure good levels of sedation and anxiety control, being pharmacological approaches possible to be used in dental care, even in those more invasive such as, tooth extraction.

Objetivo: Esta revisão sistemática visava avaliar a utilização de midazolam e óxido nitroso na sedação consciente para procedimentos de extração dentária. Métodos: Foi realizada uma pesquisa nas pesquisas electrónicas Medline/PubMed, Embase, Cochrane Library, Web of Science, literatura cinzenta, e nas principais revistas científicas da área, seguindo o PRISMA. Foram utilizados operadores booleanos para as combinações de termos e a estratégia de pesquisa foi adaptada a cada uma das bases de dados, ("extração dentária" OU "molar, terceiro" OU "dente, impactado" OU "cirurgia, oral" OU "exodontia" OU "dente do siso" OU "óxido nitroso" OU "anestésico, inalação" OU "sedação consciente" OU "gás do riso" OU "sedação moderada" OU "midazolam" OU "benzodiazepinas" OU "hipnóticos e sedativos" OU "efeito sedativo"). Seleção do estudo e extração de dados: Os critérios de inclusão foram RCTs paralelos e cruzados envolvendo pacientes de qualquer idade submetidos a extração dentária num consultório dentário sob anestesia local. Não foram impostas restrições linguísticas até 2023. Os critérios de exclusão eram estudos que envolviam pacientes submetidos a extração no ambiente hospitalar, estudos que não mediam ansiedade ou sedação e estudos para os quais o texto completo não estava disponível. Resultados: Nos oito artigos que preenchiam os critérios de elegibilidade, não foram encontradas diferenças significativas entre os métodos, em relação à sedação ou ansiedade. Conclusão: Em conclusão, o óxido nitroso e o midazolam garantem, com segurança, bons níveis de sedação e controle de ansiedade, sendo abordagens farmacológicas possíveis de serem usadas nos cuidados odontológicos, mesmo naqueles mais invasivos como, a extração dentária.

Objetivo: Esta revisión sistemática pretendía evaluar el uso de midazolam y óxido nitroso en la sedación consciente para procedimientos de extracción dental. Métodos: Se realizó una búsqueda en las bases de datos electrónicas Medline/PubMed, Embase, Cochrane Library, Web of Science, literatura gris y en las principales revistas científicas del área, siguiendo PRISMA. Se utilizaron operadores booleanos para las combinaciones de términos y se adaptó la estrategia de búsqueda a cada una de las bases de datos, ("tooth extraction" OR "molar, third" OR "tooth, impacted" OR "surgery, oral" OR "exodontia" OR "wisdom tooth" OR "nitrous oxide" OR "anaesthetic, inhalation" OR "conscious sedation" OR "laughing gas" OR "moderate sedation" OR "midazolam" OR "benzodiazepines" OR "hypnotics and sedatives" OR "sedative effect"). Selección de estudios y extracción de datos: Los criterios de inclusión fueron ECA paralelos y cruzados que incluyeran pacientes de cualquier edad sometidos a extracción dental en un consultorio dental bajo anestesia local. No se impusieron restricciones de idioma hasta 2023. Los criterios de exclusión fueron estudios que incluyeran pacientes sometidos a extracción en el ámbito hospitalario, estudios que no midieran la ansiedad o la sedación y estudios para los que no estuviera disponible el texto completo. Resultados: En los ocho artículos que cumplían los criterios de elegibilidad, no se encontraron diferencias significativas entre los métodos con respecto a la sedación o la ansiedad. Conclusión: En conclusión, el óxido nitroso y el midazolam garantizan con seguridad buenos niveles de sedación y control de la ansiedad, siendo abordajes farmacológicos posibles de ser utilizados en la atención odontológica, incluso en aquellas más invasivas como, la extracción dentaria.

Do patients with molar incisor hypomineralization have more dental anxiety and behavior management problems? A systematic review with meta-analysis

Abstract This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.

Técnicas no-farmacológicas en el manejo del comportamiento ante el tratamiento odontológico del niño

Introducción: Muchas veces la experiencia del niño encuentra la manera de responder ante un problema de una forma más verosímil, siendo más real que se concentre la atención en la clínica del niño. Objetivo: Determinar la efectividad de esas técnicas en el control de la ansiedad en niños ante el tratamiento estomatológico. Métodos: La investigación fue de carácter experimental y cuantitativo, se tomó una población muestral de 16 niños de 6-11 años de edad. Los cuales fueron hechos para la intervención con técnicas no farmacológicas. Resultados: Después de realizado en análisis, se utilizó la prueba t de Student, que constituyó el 56,25 % de los niños del grupo experimental y el 50 % del grupo control se encontraron en el rango de edad de 8-9 años, 31,25 % y 37,5 % entre 6-7 años y el 12,50 % en ambos grupos de 10-11 años respectivamente; a diferencia del grupo control que el 75 % de los niños, presentaban alta ansiedad, y el 68,75 % estaban en una ansiedad moderada. Conclusiones: Las técnicas no farmacológicas son efectivas en el manejo de los comportamientos en la consulta odontológica, a diferencia en niños del grupo control sin esta intervención disminuyen a nivel moderado.

Introduction: Many times the experience of the child finds a way to respond to a problem in a more credible way, being more real than the attention of the child's clinic is combined. Objective: To determine the effectiveness of these techniques in the control of anxiety in children before dental treatment. Methods: It was an experimental and quantitative subject; a sample population of 16 children from 6 to 11 years of age was taken. Which were made for intervention with non-pharmacological techniques. Results: After the analysis, the t-Student test was used, which is 56.25 % of the children of the experimental group and 50 % of the control group are in the age range of 8 to 9 years, 31.25% and 37.5% between 6 to 7 years and 12.50 % in both groups from 10 to 11 years respectively; unlike the control group, 75 % of the children before the care presented high anxiety, after which 68.75 % presented moderate anxiety. Conclusions: Non-pharmacological techniques are effective in managing behaviors in the dental office, unlike children in the control group without this intervention, they decrease to a moderate level.

Associations between maternal mental health, child dental anxiety, and oral health of 6- to 12-year-olds in Nigeria

Abstract Maternal mental health affects their children's oral health. This study assessed the associations between maternal mental health and dental anxiety level, dental caries experience, oral hygiene, and gingival status among 6- to 12-year-old children in Nigeria. This was a cross-sectional study that recruited mother-child dyad participants through a household survey conducted in Ile-Ife, Nigeria. Data collected included the independent (maternal mental health risk, depressive symptoms, and child's dental anxiety), and dependent (caries experience, oral hygiene status, and gingival health status) variables. Multivariate logistic regression analysis was conducted to determine the associations between dependent and independent variables after adjusting for confounders (mothers' age, child's age, sex, and socioeconomic status). Statistical significance was set at p < 0.05. Of the 1411 mothers recruited, 1248 (88.4%) had low mental health risk, and 896 (63.5%) had mild depressive symptoms. As for the children, 53 (3.8%) had caries, 745 (52.8%) had moderate to high dental anxiety, 953 (63.0%) had gingivitis and 36 (2.6%) had poor oral hygiene. The maternal mental health risk was not significantly associated with the child's caries experience (AOR: 1.012; 95%CI: 0.860-1.190; p = 0.886), poor oral hygiene (AOR:1.037; 95%CI: 0.975-1.104; p=0.250), and moderate/severe gingivitis (AOR:0.887; 95%CI: 0.764-1.030; p = 0.115). Maternal depression status was not significantly associated with the child's caries experience (AOR: 0.910; 95%CI: 0.802-1.033; p = 0.145), poor oral hygiene (AOR: 1.016; 95%CI: 0.976-1.057; p = 0.439), and moderate/severe gingivitis (AOR: 0.963; 95%CI: 0.861-1.077; p = 0.509). Maternal mental health risk and depression do not seem to be risk factors for schoolchildren's oral health in Nigeria. Further studies are needed to understand these findings.

Prevalence of Dental Fear and its Association with Painful Oral Conditions in Adolescents

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System - ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear.

Child Stress and Behaviour During Restorative Treatment under Non-Pharmacological Techniques and Sedation: A Case Series

ABSTRACT Objective: To evaluate the behaviour and stress of children undergoing restorative treatment with and without sedation. Material and Methods: Participants were 14 healthy children aged between 2.5 and 6 years and with a history of dental behavioural management problems. In the dental treatment visit, the child was treated with non-pharmacological techniques, and in the second, moderate sedation was added. The child received the same procedure performed by a paediatric dentist in both visits: composite resin restoration using local anaesthesia and rubber dam isolation. In both visits, saliva was collected at the children's arrival at the dental clinic, during local anaesthesia and at the end of treatment. The visits were filmed for later analysis of behaviour according to the Ohio State University Behavioural Rating Scale. Results: About 78.5% of children improved their behaviour from the first to the second visit. The salivary cortisol curve of the first visit was maintained in the second visit for 21.4% of children but varied in the remaining participants. Conclusion: Most children presented better behaviour and less stress when sedation was added to non-pharmacological techniques during dental care.

Dental Fear/Anxiety in Children and Child Emotional and Behavioural Problems

ABSTRACT Objective: To investigate the association between emotional and behavioural problems and dental fear/anxiety (DFA) in children aged four to 12 years treated at a clinic in southern Brazil. Material and Methods: In this cross-sectional study where mother-child dyads were interviewed, emotional and behavioural problems were investigated using the Strengths and Difficulties Questionnaire (SDQ) (considering five subscales). Children's DFA was evaluated through the Venham Picture Test. For each SDQ subscale, Poisson regression model was explored. Prevalence ratios (PR) were estimated, considering a significant level of p ≤ 0.05. Results: Overall, 128 children participated in this study. Most children were female (54.7%) and aged between 7 and 9 years (39.8%). The prevalence of emotional problems was 47.7% and behavioural problems were 46.1%. The prevalence of DFA was 18.8%. Children with emotional problems had a 2.3 higher prevalence of DFA (95%CI 1.06-5.04). In general, behavioural problems were not associated with DFA (95%CI 0.84-3.34) only when conduct problems were considered (2.20; 95%CI 1.02-4.70). Conclusion: Children aged between 4 and 12 years who present emotional and conduct problems tend to show higher DFA.

A ansiedade odontológica materna influencia no relato da qualidade de vida relacionada à saúde bucal de pré-escolares? / Does maternal dental anxiety influence the report of oral health-related quality of life in preschool children?

Objetivo: O objetivo desse trabalho foi avaliar a associação entre a ansiedade odontológica materna e o impacto no relato da QVRSB de seus filhos pré-escolares. Métodos: Um estudo transversal foi conduzido com uma amostra de 150 crianças de 4 e 5 anos de idade residentes na cidade de Diamantina-MG. A ansiedade odontológica materna foi avaliada por meio da Escala de Ansiedade Odontológica (Dental Anxiety Scale - DAS) previamente à uma consulta de exame clínico para detecção de alterações bucais. As crianças também foram clinicamente avaliadas para verificar a presença de cárie dentária e traumatismo dentário. As avaliações clínicas foram conduzidas por examinadores treinados e calibrados para esses critérios. As mães responderam o Early Childhood Oral Health Impact Scale (ECOHIS) e preencheram um formulário com características sociodemográficas e econômicas. A análise de dados envolveu estatística descritiva e regressão de Poisson. Resultados: Ansiedade odontológica moderada à alta foi encontrada em 12% (n = 18) das mães e mostrou-se associada a uma pior qualidade de vida de pré-escolares na análise não ajustada. A análise ajustada mostrou uma associação significativa da idade da criança aos 5 anos (RP = 4,45; IC = 2,38-8,30; p≤ 0,001) e da cárie dentária não tratada (RP = 2,77; IC = 1,64-4,65; p ≤ 0,001) com um impacto negativo na qualidade de vida das crianças. A ansiedade materna moderada à alta foi associada a um impacto negativo no relato de qualidade de vida de pré-escolares na análise não ajustada, mas perdeu a associação após o ajuste para outras variáveis. Conclusão: Não foi encontrada associação entre a ansiedade odontológica materna e o relato de QVRSB de seus filhos.

Aim: This study aimed to evaluate the association between maternal dental anxiety and the impact on oral health-related quality of life (HRQoL) of preschool children. Methods: A cross-sectional study was conducted with a sample of 150 children, aged between 4 and 5 years, living in the city of Diamantina, MG, Brazil. Maternal dental anxiety was assessed using the Dental Anxiety Scale (DAS) prior to a clinical examination appointment to detect oral alterations. The children were also clinically evaluated for the presence of dental caries and dental trauma. Clinical assessments were conducted by examiners trained and calibrated to these criteria. Mothers answered the Early Childhood Oral Health Impact Scale (ECOHIS) and filled out a form to provide sociodemographic and economic characteristics. Data analysis involved descriptive statistics and Poisson regression. Results: Moderate to high dental anxiety was found in 12% (n=18) of the mothers and was associated with a poorer quality of life in preschoolers in the unadjusted analysis. The adjusted analysis showed a significant association between the child at 5 years of age (PR = 4.45; CI = 2.38-8.30; p ≤ 0.001) and untreated dental caries (PR = 2.77; CI = 1.64-4.65; p ≤ 0.001) with a negative impact on children's quality of life. Moderate to high maternal anxiety was associated with a negative impact on preschoolers' quality of life in the unadjusted analysis, but the association was lost after adjustment for other variables. Conclusion: No association was found between maternal dental anxiety and their children's HRQoL.

Pediatric dentist attire and relationship with anxiety in children and parents during Covid-19 pandemic

Aim The study aimed to evaluate children's and parent's preferences of dentist's attire during Covid-19 pandemic and their relationship with dental anxiety. Methods A total of 139 Children(71 boys, 68 girls) aged 6-12 years were shown videos of a pediatric dentist working with different attire such as Personal Protective Equipment (PPE) and pedoscrub, and they were asked to express the way they preferred their dentist to be dressed. Children's anxiety levels with different attire of paediatric dentists were assessed in different age groups and for boys and girls separately and recorded it using the Facial image scale. A questionnaire regarding dental anxiety was created online and completed by 139 parents (76 females, 63 males) of various ages and different educational backgrounds who were asked to choose between two outfits. Results were tabulated and statistically analysed using Chi-square test. Results Children aged 10-12 years preferred PPE by 50.6%, whereas 48.1% of children aged 6-9 years least preferred PPE (<0.05). About 46 (33%) were scored as anxious children and they had a preference for pedoscrub. Also, nonanxious children 43(31%) preferred PPE. All educated parents (100%) selected PPE over pedoscrub and the result were shown to be statistically significant. (<0.05). Conclusion Ultimately, the majority of the anxious children chosen pedoscrub, whereas non - anxious children have chosen PPE. Furthermore, the data reveals that both educated parents and older children preferred PPE as their attire for paediatric dentists.