Music Distraction Effectiveness in Dental Anxiety and Treatment Adherence in 6-Year-Old Children: A Randomized Clinical Trial

Abstract

ROJAS-ALCAYAGA, G. A.; ALFARO, K.; RÍOS-ERAZO, M.; HERRERA, A. C. & BARAHONA, P.Music distraction effectiveness in dental anxiety and treatment adherence in 6-year-old children: A randomized clinical trial. Int. J. Odontostomat., 12(1):35-42, 2018. ABSTRACT:Dental anxiety can be a barrier to following healthy behaviours. Musical distraction is an effective strategy to reduce dental anxiety and improve treatment adherence. The aim was to determine the effect of musical distraction on dental anxiety and treatment adherence in 6-year-old children. Multicenter randomized control trial with 176 children who were allocated into two parallel groups. One group received usual dental care (N 88), and the other was exposed to musical distraction during usual dental care (N 88). The primary outcome was dental anxiety and secondary was oral health status and oral health care behaviours. Both were assessed at baseline, discharged and six-month follow-up. Mid/high dental anxiety was exhibited by 16.1 % of the children. Musical distraction had no effect on dental anxiety levels in the experimental compared with the control group at any of the time points assessed. The size effect was 0.35 and 0.15 (Cliff's Delta) for baseline-discharge and 0.57 and 0.35 for baseline-six month. Only 47.7 % of the sample attended at 6-month follow-up. Dental anxiety is not prevalent in the sample and is not beneficially reduced by musical distraction. The educational actions of the dental care programme are not sufficient to attain permanent long-term changes in oral health behaviour.

Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials

“…Included articles were published between 2005 and 2018 and were conducted in Brazil, Chile, India, Iran, Mexico, Saudi Arabia, Thailand, and the USA . All included studies were published in the English language . Sample size ranged from 28 to 176 participants and participant age ranged from 4 to 16 years.…”

“…Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool (Version 5.1). The main shortcoming identified was blinding of participants and personnel, as well as blinding of outcome assessors . Another shortcoming was other sources of bias.…”

“…42 Young children may lack the cognitive ability to sustain focus 42 and depending on the distraction technique and its content, it may not be interesting for both children and adolescents (eg, 3D eyeglasses, biofeedback, children's stories, dental operating microscope, nursery rhymes, live modelling, telescopic needle, toys, virtual reality eyeglasses). Most studies involved only children, 13,15,17,23,[25][26][27][30][31][32][33][34][35][36]38 and no study included only adolescents.…”

“…37 All included studies were published in the English language. 13,[15][16][17][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Sample size ranged from 28 to 176 participants and participant age ranged from 4 to 16 years. Table 1 summarizes the characteristics of all included studies.…”

“…Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool (Version 5.1). The main shortcoming identified was blinding of participants and personnel, 13,[15][16][17]19,20,[23][24][25][26][27][28][29][30][31][32][33][34][35]38 as well as blinding of outcome assessors. 13,16,17,19,20,[23][24][25][26][27][28][29][30][31][32][33][34][35] Another shortcoming was other sources of bias.…”