Nonpharmacologic Intervention on the Prevention of Pain and Anxiety During Pediatric Dental Care: A Systematic Review

Goettems, Marília Leão; Zborowski, Eduardo Jung; Costa, Francine dos Santos; Costa, Vanessa Polina Pereira; Torriani, Dione Dias

doi:10.1016/j.acap.2016.08.012

Cited by 62 publications

(76 citation statements)

References 31 publications

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“…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 .…”

Section: Resultsmentioning

confidence: 99%

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

Prado

Carcavalli

Abreu

et al. 2019

Int J Paed Dentistry

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Objective To determine whether distraction techniques (DT) reduce children's/adolescent's anxiety and fear during dental treatment. Methods Randomized controlled trials (RCTs) in which any type of DT were used to manage dental anxiety and dental fear in children/adolescents were included. A systematic search of PubMed, Web of Science, Scopus, Cochrane Library, Lilacs, and Google Scholar was conducted. Two independent reviewers selected studies, extracted data, assessed methodological quality of studies using the Cochrane Collaboration's Risk of Bias tool (CCRBT), and approached certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Data were analysed descriptively. Results Twenty studies covering several types of DT (audio, audiovisual, instruments camouflage, biofeedback, dental operating microscope, toys) were included. Qualitative analysis showed with very low certainty of evidence that DT effectively reduced dental anxiety and fear depending on the distraction type, instrument used to measure dental anxiety and dental fear, and dental procedure. CCRBT evaluation identified many methodological issues in included studies. Conclusion There is a very low certainty of evidence that DT can be effective in managing children's/adolescents’ dental fear and anxiety during dental treatment. The heterogeneity of methodologies and findings in the studies, however, suggests more robust, and well‐executed RCTs are needed.

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Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Prado

Carcavalli

Abreu

et al. 2019

Int J Paed Dentistry

View full text Add to dashboard Cite

show abstract

“…Dental anxiety can usually be managed by pharmacological interventions, non‐pharmacological interventions, or both . Pharmacological interventions contain benzodiazepines, nitrous oxide(nitrous oxide usually are matched with oral drugs), general anesthesia, and other agents (chloral hydrate and hydroxyzine) . Non‐pharmacological interventions include virtual reality, audiovisual distraction, musical distraction, reinforcement, stop‐signaling, “tell‐show‐do”, hands over mouth, modeling, and so on .…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, non‐pharmacological interventions can overcome these weaknesses and produce a positive effect on reducing dental anxiety in children undergoing dental treatment, posing as effective as pharmacological treatments, and may gain more acceptance from parents, patients, and practitioners. Hence, non‐pharmacological interventions can be used to decrease dental anxiety in children …”

Section: Introductionmentioning

confidence: 99%

“…12,13 Pharmacological interventions contain benzodiazepines, nitrous oxide(nitrous oxide usually are matched with oral drugs), general anesthesia, and other agents (chloral hydrate and hydroxyzine). 14 Non-pharmacological interventions include virtual reality, audiovisual distraction, musical distraction, reinforcement, stop-signaling, "tellshow-do", hands over mouth, modeling, and so on. 3,12,14 Although pharmacological management is a commonly used method for patients with dental anxiety, disadvantages include nausea, vomiting, respiratory depression, decreased heart rate and blood pressure, and sometimes refusal to take their medications.…”

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confidence: 99%

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Effect of audiovisual distraction on the management of dental anxiety in children: A systematic review

Liu

Wang

et al. 2018

Int J Paed Dentistry

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Summary Background Audiovisual distraction, a non‐pharmacological intervention, has been used to manage dental anxiety in prior clinical trials. Aim Synthesize the available evidences to evaluate the efficacy of audiovisual distraction techniques on the management of dental anxiety in children. Design Electronic databases (PubMed, Cochrane Central Register of Controlled Trials, and Embase) were searched. We included randomized controlled trials (RCTs), and methodological quality of included trials was assessed using the Cochrane Collaboration's criteria. Information on reported anxiety, pain, behaviors, vital signs (including blood pressure, oxygen saturation, and pulse rate), and children satisfaction was analyzed. Results Nine studies were included for a systematic review, and none of them had low risk of bias. Significant differences in anxiety were found. According to the study, a majority of results indicated a significant difference in pain and behavior between the audiovisual and control group. Three studies reported children in the audiovisual group preferred usage of an audiovisual device for future dental visits. No significant differences could be found regarding blood pressure. Conclusions There is some low‐quality evidence suggesting that the usage of audiovisual distraction during dental treatment may relieve children's dental anxiety.

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Factors associated with children’s perception of pain following dental treatment

Mathias

Cademartori

Goettems

2019

Eur Arch Paediatr Dent

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Nonpharmacologic Intervention on the Prevention of Pain and Anxiety During Pediatric Dental Care: A Systematic Review

Abstract: More research is needed to know whether the techniques are effective for improving behavior and reducing children's pain and distress during dental treatment. However, the majority of the techniques improved child's behavior, anxiety, and pain perception.

Cited by 62 publications

References 31 publications

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

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

Effect of audiovisual distraction on the management of dental anxiety in children: A systematic review

Factors associated with children’s perception of pain following dental treatment

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