Association between Anxiety and Pain in Dental Treatment: A Systematic Review and Meta-analysis

2016 ◽  
Vol 96 (2) ◽  
pp. 153-162 ◽  
Author(s):  
C.-S. Lin ◽  
S.-Y. Wu ◽  
C.-A. Yi
Keyword(s):  
Dental Treatment ◽  
Meta Analysis ◽  
Dental Anxiety ◽  
Clinical Group ◽  
Anxiety Management ◽  
Dental Patients ◽  
Dental Procedures ◽  
Treatment Procedures ◽  
The Impact

Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain related to dental procedures. However, conclusions from individual studies may be limited by the treatment procedures that patients received, the tools used to assess DA, or the treatment stages when anxiety or pain was assessed. It is unclear whether DA, at the study level, accounts for the variance in pretreatment SA. The impact of DA and SA on pain at different treatment stages has not been systematically investigated. To address these questions, we present novel meta-analytical evidence from 35 articles (encompassing 47 clinical groups) that investigated DA in a clinical group. Subgroup analyses revealed that the studies of surgical and nonsurgical procedures did not significantly differ in either DA or pretreatment SA. Furthermore, metaregressions revealed DA as a significant predictor that explained the variance in SA assessed before and during treatment but not after treatment. The findings suggest that patient DA has a significant impact on patient SA. Metaregressions revealed DA as a significant predictor that explained the variance in expected pain, pain during treatment and posttreatment pain. In contrast, pretreatment SA was a significant predictor that explained the variance in expected pain. The findings reveal that DA has a consistent impact on pain through the entire period of dental treatment. Altogether, the findings highlight the role of DA as an overall indicator for anxiety and pain, across different types of dental procedures or treatment stages. We conclude that anxiety should be assessed as a critical step not only in anxiety management for high-DA patients, but also in pain control for all dental patients.

scholarly journals A New Concept for the Treatment and Rehabilitation of Patients with Pathologic Comorbidities Using Cutting-Edge Digital Technologies in Dental Orthopaedics

2020 ◽  
Vol 14 (04) ◽  
pp. 533-538
Author(s):  
Alexey V. Yumashev ◽  
Maria V. Mikhailova ◽  
Igor V. Fomin ◽  
Jiaqi Li ◽  
Bowen Yang
Keyword(s):  
Statistical Analysis ◽  
Dental Treatment ◽  
Management Strategies ◽  
Digital Technologies ◽  
Statistical Probability ◽  
Dental Patients ◽  
Dental Examination ◽  
Dental Procedures ◽  
Probability Criterion

Abstract Objectives This article investigates the specific aspects of overactive or exaggerated vomiting reflexes affecting the procedure of dental examination and impression in patients with complete secondary adentia, who need orthopaedic dental treatment. Materials and Methods The prevailing manifestation degree of exaggerated vomiting reflex was diagnosed among patients with complete secondary adentia and exaggerated vomiting reflex. Statistical Analysis Exaggerated vomiting reflexes occur when a patient suffers from dentophobia, the term, which is otherwise known as the fear of dentists. The study was performed using methods of mathematical statistics, including the Pearson χ2 criterion and the statistical probability criterion (p). Results The role of an exaggerated vomiting reflex was revealed in the development of patients’ dentophobic experiences, and the nature of such experiences was established. Variations in dentophobic reactions were distinguished and management strategies were studied for patients with complete secondary adentia and exaggerated vomiting reflex. Conclusions These studies were aimed at preventing the development of vomiting reflex during dental procedures and at identifying an optimal strategy for stopping exaggerated vomiting reflex. The role of the vomiting reflex in the orthopaedic treatment of dental patients was determined.

Attitudes to Conscious Sedation in Patients Attending an Emergency Dental Clinic

2005 ◽  
Vol os12 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Edith M Allen ◽  
Nick M Girdler
Keyword(s):  
Conscious Sedation ◽  
Dental Treatment ◽  
Dental Health ◽  
Dental Anxiety ◽  
Dental Clinic ◽  
Dental Patients ◽  
The Past ◽  
Anxious Group ◽  
Dental Appointment ◽  
The Impact

Introduction Anxiety and fear in relation to dentistry are long-standing problems and the incidence of dental fear does not appear to be decreasing. It can result in poor dental health and wastage of clinical time. Conscious sedation is one method of allaying anxiety in dental patients and enables such patients to accept dental treatment. Aims, Materials and Methods A questionnaire survey was undertaken among patients attending an emergency dental clinic. Its aims were to assess the levels of dental anxiety in these subjects, the impact on their attendance for dental treatment, and their knowledge of and desire to have conscious sedation, should it be available. Results The results indicated that in the 72 patients who responded, levels of anxiety regarding dental treatment were high, with 49 (68%) claiming some nervousness or worse. Thirty-one (43%) cited fear/nervousness as a reason for delaying making a dental appointment. Twenty-seven (38%) were not aware of the existence of conscious sedation for dental treatment, of whom half reported that they were in the highly anxious group. Forty (56%) respondents said they would like to have sedation if it were available. Twenty-five (35%) claimed to have received sedation for dental treatment in the past. Conclusion It was concluded that the availability of dental sedation was currently not matching the needs and demands of several patients who took part in the survey. Increased availability of dental sedation could remove a barrier to dental care for many highly anxious dental patients.

scholarly journals Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (4) ◽  
pp. 1025 ◽  
Author(s):  
Nansi López-Valverde ◽  
Jorge Muriel Fernández ◽  
Antonio López-Valverde ◽  
Luis F. Valero Juan ◽  
Juan Manuel Ramírez ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Dental Treatment ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Adult Population ◽  
Dental Anxiety ◽  
Three Dimensional ◽  
Dental Procedures ◽  
Reduction Of Pain ◽  
To Receive

Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations. Results: 31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies (n = 4), anxiety levels in three (n = 3) and anxiety and pain together in seven (n = 7). Our meta-analysis was based on ten studies (n = 10). The effect of VR was studied mainly in the pediatric population (for pain SMD = −0.82). In the adult population, only two studies (not significant) were considered. Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

scholarly journals Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3086 ◽  
Author(s):  
Nansi López-Valverde ◽  
Jorge Muriel-Fernández ◽  
Antonio López-Valverde ◽  
Luis Francisco Valero-Juan ◽  
Juan Manuel Ramírez ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Web Of Science ◽  
Dental Treatment ◽  
Meta Analysis ◽  
Dental Anxiety ◽  
Three Dimensional ◽  
Inclusion Criteria ◽  
Dental Procedures ◽  
Reduction Of Pain ◽  
To Receive

(1) Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. (2) Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used and in standard care situations. (3) Results: 32 studies were identified, of which 8 met the inclusion criteria. The effect of VR in children was significant, both for anxiety (standardized mean difference (SMD) = −1.75) and pain (SMD = −1.46). (4) Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Comparison between Positive Dental Images and Neutral Images in Managing Anticipatory Anxiety of Children

2017 ◽  
Vol 41 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Dalia O Kamel ◽  
Nadia A Wahba ◽  
Dalia M Talaat
Keyword(s):  
Rating Scale ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Control Group ◽  
Anticipatory Anxiety ◽  
Dental Patients ◽  
Group I ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

Objective: To evaluate the impact of positive images versus neutral images on child behavior during dental treatment and their dental anxiety after dental treatment. Study design: Sixty, 4 to 6 year old healthy pediatric dental patients, indicated for pulpotomy and stainless steel crown restorations, were divided randomly into two equal groups. Group I (experimental group viewed positive dental images and group II (control group) viewed neutral cartoon images prior to treatment. Behavior was assessed using Frankl rating scale in all four treatment phases: seating, local anesthesia administration, pulpotomy and overall rating. Patient's anxiety was determined according to Venham Picture Test (VPT) before and after dental procedure. Results: Behavior rating using the Frankl scale showed a statistically significant difference in the two groups in the overall rating (P= 0.003, 0.001 respectively). No statistically significant difference was found between both groups in any of the treatment phases (P= 0.288, 0.060, 0.719 respectively) and between the mean VPT scores before and after procedures (P=0.95, 0.93 respectively. Conclusion: Viewing neutral or positive dental images did not have an effect on child's anticipatory anxiety level. However, it is an effective method of improving the behavior in children.

Effect of Virtual Reality Distraction on Pain and Anxiety During Dental Treatment in 5 to 8 Year Old Children

2019 ◽  
Vol 43 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Vabitha Shetty ◽  
Lekshmi R Suresh ◽  
Amitha M Hegde
Keyword(s):  
Virtual Reality ◽  
Salivary Cortisol ◽  
State Anxiety ◽  
Pain Perception ◽  
Rating Scale ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Dental Procedures ◽  
Cortisol Levels ◽  
The Impact

Objective: This study was aimed at assessing the impact of Virtual Reality (VR) distraction technique on pain and anxiety in 5–8-year-old children, during short invasive dental procedures. Study design: 120 children, aged 5–8 years, scoring less than 25 on the SCARED questionnaire, scheduled to undergo short invasive dental procedures, were randomly divided into a control (without VR distraction) and study group (with VR distraction) of 60 each. State anxiety levels were assessed in the children from both groups using revised version of Modified Child Dental Anxiety Scale, before and after dental treatment. Pain perceived during treatment was assessed using Wong Baker Faces pain rating scale at the end of treatment. Salivary cortisol levels were also assessed before, during and after the dental procedure, in all children. Results: We observed a significant reduction in pain perception and state anxiety in children, using VR distraction (p<0.001, p=0.002). The decrease in salivary cortisol levels was significantly greater in children using VR distraction (p<0.001). Conclusion: Virtual Reality distraction can be used as a successful behavior modification method in children undergoing short invasive dental treatments.

The role of memory on the dentally anxious patient's response to dental treatment

1991 ◽  
Vol 8 (2) ◽  
pp. 110-115 ◽  
Author(s):  
Ruth Freeman
Keyword(s):  
Clinical Setting ◽  
Subjective Experience ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Vicious Circle ◽  
The Past ◽  
Dental Procedures ◽  
Susceptible Patient ◽  
Special Relevance

AbstractThe aetiology of dental anxiety is multifactorial. Psychologically traumatising events associated with dental treatment have been shown to be of particular importance. The present investigation examines the role of memory in relation to these traumatic episodes and investigates their influence on the patient's response to dental treatment.The study has shown that patients with dental anxiety have had more experience of “traumatic dental events” (p<0.001), relate the cause of their dental anxiety to specific dental procedures and report more fear of dental treatment than controls. The memories of such traumatic dental events are important indicators of anxiety in the clinical setting, with dentally anxious patients having significantly higher scores for dental anxiety (p<0.001) compared with controls. Furthermore, the memories of these events have a special relevance to the patient's subjective experience of dental anxiety in the here and now. The past event sensitises the susceptible patient and maintains and intensifies the anxiety through a feed-back mechanism, resulting in a vicious circle of anticipatory dental fear.

scholarly journals Behaviour and Anxiety Management of Paediatric Dental Patients through Virtual Reality: A Randomised Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3019
Author(s):  
Cristina Gómez-Polo ◽  
Ana-Aida Vilches ◽  
David Ribas ◽  
Antonio Castaño-Séiquer ◽  
Javier Montero
Keyword(s):  
Virtual Reality ◽  
Dental Treatment ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Chi Square ◽  
Anxiety Management ◽  
Dental Patients ◽  
Paediatric Patients ◽  
Chi Square Test ◽  
Scale Test

Clinicians should appreciate the effectiveness of virtual reality (VR) headsets for managing both the anxiety and the behaviour of non-cooperative paediatric patients who require treatment over several dental appointments. The aim of this study was to assess the effectiveness of using a VR headset as a distraction for managing the anxiety and behaviour of paediatric patients during their dental treatment. Eighty patients, aged between five and ten years old and who required dental treatment over three or more appointments, were randomly allocated into two groups. One group used a VR headset during all their appointments, and the other one did not use any distraction technique. The patients were asked to take a Facial Image Scale Test during their first and last appointments to assess their level of anxiety. Additionally, the dentist completed the Frankl Test to quantify the child’s behaviour at the beginning and the end of their treatment. The results obtained, both from the group using the VR headset and from the control group, were compared using the chi-square test. The use of a VR headset during dental treatment significantly reduced anxiety (95% of the children were happy) and improved behaviour (100% positive behaviour) as compared with the control group (40% and 57.5%, respectively). A VR headset can effectively distract a paediatric patient, helping to reduce anxiety and manage behaviour during dental treatment

scholarly journals Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students

2021 ◽  
Vol 18 (9) ◽  
pp. 4448
Author(s):  
Katarzyna Mocny-Pachońska ◽  
Rafał J. Doniec ◽  
Sylwia Wójcik ◽  
Szymon Sieciński ◽  
Natalia J. Piaseczna ◽  
...  
Keyword(s):  
Dental Treatment ◽  
High Stress ◽  
Dental Students ◽  
Endodontic Treatment ◽  
Stressful Environment ◽  
Caries Treatment ◽  
Dental Procedures ◽  
Conservative Dentistry ◽  
High Level ◽  
Treatment Procedures

Background: Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures. Methods: A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I—Diagnosis, II—Caries Treatment, and III—Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0–6, where 0 indicates no stress, while 6 indicates high stress. Results: Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures. Conclusion: Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

Why Do Firms Participate in Voluntary Environmental Programs? A Meta-Analysis of the Role of Institutions, Resources, and Program Stringency

2021 ◽  
pp. 108602662199006
Author(s):  
Peter Tashman ◽  
Svetlana Flankova ◽  
Marc van Essen ◽  
Valentina Marano
Keyword(s):  
Quality Management ◽  
Prior Experience ◽  
Meta Analysis ◽  
Institutional Pressures ◽  
Environmental Programs ◽  
Voluntary Environmental Programs ◽  
Management Standards ◽  
Trade Offs ◽  
The Impact

We meta-analyze research on why firms join voluntary environmental programs (VEPs) to assess the impact of program stringency, or the extent to which they have rigorous, enforceable standards on these decisions. Stringency creates trade-offs for firms by affecting programs’ effectiveness, legitimacy, and adoption costs. Most research considers singular programs and lacks cross program variation needed to analyze program stringency’s impact. Our meta-analysis addresses this by sampling 127 studies and 23 VEPs. We begin by identifying common institutional and resource-based drivers of participation in the literature, and then analyze how program stringency moderates their impacts. Our results suggest that strictly governed VEPs encourage participation among highly visible and profitable firms, and discourage it when informal institutional pressures are higher, and firms have prior experience with other VEPs or quality management standards. We demonstrate that VEP stringency has nuanced effects on firm participation based on the institutional and resource-based factors facing them.

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