Atraumatic Restorative Treatment (ART) is considered to be well accepted, both by children and by adult patients. The objective of this review is to present and discuss the evidence regarding the acceptability of ART, from the patient's perspective. Aspects related to dental anxiety/fear and pain/discomfort have been highlighted, to facilitate better understanding and use of the information available in the literature. Conclusions: The ART approach has been shown to cause less discomfort than other conventional approaches and is, therefore, considered a very promising “atraumatic” management approach for cavitated carious lesions in children, anxious adults and possibly, for dental-phobic patients.
The hypothesis was tested that the level of pain experienced by children during conventional restorative treatment is higher than during atraumatic restorative treatment (ART) or an ultraconservative treatment. The sample consisted of 244 children, 6- to 7 yr of age, who had at least two teeth with dentine carious lesions. Before the first treatment session (Tx-1), in which one of the carious teeth was treated using one of the treatments, the level of dental anxiety was assessed using the Facial Image Scale (FIS). The child reported the intensity of pain experienced during the procedure using the Wong-Baker FACES Pain Rating Scale. When conventional restorative treatment was used, more children needed local anaesthesia. Analyses excluding the data of children who had received local anaesthesia showed no treatment group effect on the Wong-Baker score, a FIS Tx-1 effect on the Wong-Baker score, and a statistically significant correlation between FIS Tx-1 and Wong-Baker scores. There was no significant difference in the pain levels of children treated using conventional restorative treatment, atraumatic restorative treatment or ultraconservative treatment. Local anaesthesia had to be administered more frequently to children in the conventional restorative group than to those in the other two treatment groups.
At the beginning of the second session there was no difference in dental anxiety levels of the children treated in the first session according to the three treatment protocols. A high dental anxiety score before the first session was a predictor of a high dental anxiety score at the second treatment session.
Objective: To compare the level of pain among children treated according to the Atraumatic Restorative Treatment (ART) and the Conventional Restorative Treatment (CRT). Study design: Forty children of both genders, 4-to 7-years old, presenting Class I cavitated dentin lesions in primary molars were randomly allocated to 2 groups. One group (CRT) received conventional restorative treatment using rotary instruments,while in the other one (ART) hand instruments were used to perform the restorations. All children were treated by the same operator. A high-viscosity glass-ionomer cement (Fuji IX) was used to restore the teeth in both groups. Children's pain was measured at the end of the first restorative treatment session using the Wong-Baker FACES Pain Rating Scale (dependent variable). Age, gender, treatment time and treatment group were independent variables. ANOVA and ANCOVA tests were used to analyze the data. Results: The CRT procedure took longer than the ART procedure (p<0.001). Children from the ART group reported less pain than those from the CRT group (p=0.0037). Four year olds reported more pain than 5-to 7-year olds(p<0.0001) in both groups. Conclusions: Restorations placed using ART were less time consuming, children felt less pain when the ART approach was used, and younger children (4-years) reported more pain than the older ones for both restorative treatments.
A gradual exposure of children to the dental environment in sequential dental visits of different natures in a school premise decreased their levels of dental anxiety over a 14.5-month period.
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