Effect of a relaxation training exercise on behaviour, anxiety, and pain during buccal infiltration anaesthesia in children: Randomized clinical trial

Abstract

Background Cognitive behavioural techniques can decrease procedural pain and anxiety in children. Bubble breath exercise, a play therapy technique, may be used as a relaxation strategy to manage anxiety and pain. The objective of the study was to evaluate the effect of bubble breath exercise on dental anxiety, dental behaviour, and pain intensity during buccal infiltration of local anaesthetic in children. Study Design This randomized controlled trial involved 66 children aged 7‐11 years, randomly allocated to two groups: Group 1 (control) and Group 2 (intervention group). Group 2 was trained in bubble breath exercise. The reaction during buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl's behaviour rating scale), anxiety (Facial Image Scale and pulse rate), and pain perception (Wong‐Baker FACES pain rating scale and the Faces, Leg, Activity, Cry, and Consolability scale). Results The bubble breath exercise significantly reduced the pain perceived, as measured by both the Wong‐Baker FACES pain rating scale (P < 0.001) and the FLACC scale (P < 0.001). There was no statistically significant difference in dental anxiety and behaviour among the groups. Conclusion Use of bubble breath exercise may be beneficial in decreasing the pain perceived during maxillary buccal infiltration anaesthesia in 7‐ to 11‐year‐old children.

Guidelines for reporting randomized controlled trials in paediatric dentistry based on the CONSORT statement

“…Example: “The study was conducted at the Department of Paedodontics and Preventive Dentistry over a period of 8 months from June 2017 to January 2018” 23 …”

“…The block sequences (ABAB, BABA, AABB, etc.) were generated following which the statistician performed random allocation of the samples to the blocks using a random number table” 23 …”

“…Intergroup comparison of behaviour at the time of injection and the outcomes of the pain scale (FLACC) were done using Pearson’s chi‐square test. Intergroup comparison of the outcomes of the Wong‐Baker FACES pain rating scale was done using the Mann‐Whitney U test” 23 …”

“…Example 1: “Hence, this study was carried out to evaluate the effect of this relaxation training exercise on dental anxiety, dental behaviour, and pain intensity during buccal infiltration of the local anaesthetic in children. The null hypothesis was that the bubble breath exercise has no effect on dental anxiety, dental behaviour, and pain intensity during the administration of buccal infiltration anaesthesia in children” 23 …”

Child Drawing: A Projective Tool for Dental Anxiety Assessment

“…The physiological change in the body such as an increase in perspiration, breathing rate, blood pressure, heart rate, and pulse rate, which is primarily due to the release of stress hormones in the blood such as cortisol, adrenaline, and nor-epinephrine could be recorded by the pulse oximeter. 3,11 According to the study by Rosenberg and Katcher et al (1976) Venham picture test was given by Venham 1979, it is one of the few picture scales that fulfills the required criteria to assess dental anxiety in children, which assesses how negative the child feels. In our study though the number of anxious and non-anxious children were equal the mean value for anxious males (4.3) was comparatively more than females (3.9).…”