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Aim: To compare the efficacy of virtual reality (VR) glasses and on-screen distraction techniques in managing anxiety and behavior in children receiving dental treatments. Materials and Methods: Forty patients aged 4–8 years requiring restoration were divided into two groups: group I with 20 members using audio-visual distraction aid in the form of VR glasses and group II with 20 participants utilizing on-screen distraction techniques. Each child underwent two appointments one week apart; their anxiety and behavior levels were assessed at each visit using the Facial Image Scale and Frankel’s Behavior rating scale. Result: The Wilcoxon signed-rank and Chi-squared test were utilized to assess the correlation between two categorical variables, with VR demonstrating a notable divergence from on-screen distraction. Conclusions: Both on-screen distraction and VR applications decreased anxiety levels and improved behavior. However, VR was substantially more effective in managing these areas.

Aim: To compare the efficacy of virtual reality (VR) glasses and on‑screen distraction techniques in managing anxiety and behavior in children receiving dental treatments. Materials and Methods: Forty patients aged 4–8 years requiring restoration were divided into two groups: group I with 20 members using audio‑visual distraction aid in the form of VR glasses and group II with 20 participants utilizing on‑screen distraction techniques. Each child underwent two appointments one week apart; their anxiety and behavior levels were assessed at each visit using the Facial Image Scale and Frankel’s Behavior rating scale. Result: The Wilcoxon signed‑rank and Chi‑squared test were utilized to assess the correlation between two categorical variables, with VR demonstrating a notable divergence from on‑screen distraction. Conclusions: Both on‑screen distraction and VR applications decreased anxiety levels and improved behavior. However, VR was substantially more effective in managing these areas. [ABSTRACT FROM AUTHOR]

Introduction: Fear of the unknown causes anxiety in paediatric patients. The use of tell-show-do, along with audiovisual distraction, promotes positive behaviour and reduces anxiety. The use of a Dental Operating Microscope (DOM) as a visual distraction aid provides better cooperation in paediatric patients. Aim: To evaluate the effects of a DOM on anxiety, behaviour, and treatment time during a restorative procedure in paediatric dental patients. Materials and Methods: The present study was a parallel-arm, randomised clinical trial conducted at IGIDS, Puducherry, India, in 2022, over a period of four months. Healthy five to sevenyear-old children on their first dental visit were selected (n=90) and divided into two groups using simple randomisation. Group A: Restoration of teeth without a DOM, and group B: Restoration of teeth using a DOM. Anxiety and behaviour were measured as soon as the child entered the operatory (T1), after tell-show-do for the procedure (T2), after cavity preparation (T3), and after completion of the restoration (T4). Caries removal efficacy and treatment duration were also assessed. The data obtained were statistically analysed using the Chi-square test and independent sample t-test (p

Rasa cemas pada kedokteran gigi ( dental anxiety ) dilaporkan sebagai salah satu alasan utama untuk menghindar dari perawatan gigi. Tingkat kecemasan merupakan salah satu penyebab tingginya prevalensi penyakit dan keparahan akibat menunda perawatan gigi, termasuk pada pasien anak. Penangan pasien anak dengan dental anxiety dapat dilakukan dengan metode participant modeling. Penelitian ini bertujuan untuk mengetahui efektifitas metode participant modeling dalam menurunkan tingkat kecemasan terhadap pemeriksaan gigi melalui penilaian skala sikap ( Likert scale ). Desain penelitian adalah quasi eksperimental non-equivalent control group. Populasi merupakan murid berusia 7-10 tahun di SDN 26 Jati Utara Padang yang memiliki kecemasan terhadap pemeriksaan gigi sebanyak 36 orang dibagi menjadi 18 orang kelompok participant modeling ( eksperimen ) dan 18 orang kelompok tanpa modeling ( kontrol ). Skala sikap yang digunakan adalah skala wajah atau Facial Image Scale ( FIS ). Analisis data menggunakan paired t-test dan independent sample t-test. Tingkat kecemasan sebelum dan sesudah perlakuan pada kedua kelompok mengalami penurunan dengan rata-rata penurunan kelompok eksperimen adalah 3.17 ± 0.618 dan kelompok kontrol adalah 1.89 ± 0.832 . Analisis penurunan tingkat kecemasan mengunakan paired t-test diperoleh p =0.000. Analysis perbedaan penurunan tingkat kecemasan kelompok eksperimen dan kelompok kontrol menggunakan independent sample t-test menunjukan perbedaan bermakna (p=0.000) . Penerapan metode participant modeling lebih efektif menurunkan tingkat kecemasan pasien anak dengan dental anxiety terhadap pemeriksaan gigi dari pada yang tidak menggunakan metode participant modeling.

Background: Dental anxiety is a major obstacle to children receiving dental care, which can increase their fear. It is of the utmost importance to manage patients with dental anxiety or dental fear in a manner that complements their conflicts. A pediatric dentist’s role is to perform effective treatment using various non-pharmacological behavior management techniques. Aims: Aim of this study is to evaluate the effectiveness of a self-designed dental storybook in reducing dental anxiety among children between 5-9 years. Materials and Methods: The study was conducted on 54 children aged 5-9 years. Children were randomly allocated into two groups, namely, Control group (did not receive story book) and Intervention group (received story book). Research was carried out in two dental visits (screening and examination visit and preventive and restorative treatment) wherein, before and after intervention, Venham Clinical Anxiety Scale (VCAS), Facial Image Scale (FIS), and Frankel’s Behavior Rating Scale (FBRS) were recorded. The data were statistically analyzed using Wilcoxon signed rank test, applied and tabulated using the SPSS software version 25.0. Results: The intervention group showed significantly lower anxiety and more cooperative behavior during treatment than the control group. Conclusion: Self-designed dental storybook as an adjuvant was found to be promising behavior modification technique for 5-9 year old children. [ABSTRACT FROM AUTHOR]

Introduction: Fear of the unknown causes anxiety in paediatric patients. The use of tell-show-do, along with audiovisual distraction, promotes positive behaviour and reduces anxiety. The use of a Dental Operating Microscope (DOM) as a visual distraction aid provides better cooperation in paediatric patients. Aim: To evaluate the effects of a DOM on anxiety, behaviour, and treatment time during a restorative procedure in paediatric dental patients. Materials and Methods: The present study was a parallel-arm, randomised clinical trial conducted at IGIDS, Puducherry, India, in 2022, over a period of four months. Healthy five to seven-year-old children on their first dental visit were selected (n=90) and divided into two groups using simple randomisation. Group A: Restoration of teeth without a DOM, and group B: Restoration of teeth using a DOM. Anxiety and behaviour were measured as soon as the child entered the operatory (T1), after tell-show-do for the procedure (T2), after cavity preparation (T3), and after completion of the restoration (T4). Caries removal efficacy and treatment duration were also assessed. The data obtained were statistically analysed using the Chi-square test and independent sample t-test (p<0.05). Results: Out of the 90 children who participated in the study, 47 (52%) were girls, and 43 (47%) were boys. There was a decrease in anxiety and improved patient behaviour during cavity preparation (T3) and after completion of restoration (T4) in group B (p<0.001). The operator also reported higher visual (71.10%) and tactile (95.60%) scores in caries removal, with a shorter treatment duration in groups where DOM was used (p<0.001). Conclusion: The use of DOM reduced anxiety levels and improved the compliance of children during dental procedures. Operator ergonomics and the quality of treatment could be enhanced by recommending DOM in regular paediatric dental practice. [ABSTRACT FROM AUTHOR]

Background: Various linguistic, innovative, and pharmaceutical therapies have been established to control children's anxious and cooperative behaviors. The use of euphemism in verbal communication is an important part of behavior modification. A dentist's or a staff's choice of words is crucial in order to influence the patient's emotional state. The aim of the study was to evaluate and compare the anxiety level and pulse rate of children with and without using Dental Pictionary in the form of flashcards as a behavior modification technique. Materials and methods: A total of 148 children were included in the study, aged between 4 and 6 years, and divided into two groups. Group A—behavior modification using Dental Pictionary in the form of flashcards and group B—behavior modification without using flashcards. The study was carried out in two visits. Before and after intervention pulse rate, facial image scale (FIS), and Venham scale (VS) were recorded. Results: A statistically significant difference was found between group A and group B regarding pulse rate, FIS, and VS (p = 0.001). Conclusion: Dental Pictionary based on euphemism was found to be a promising behavior modification technique for 4–6-year-old children.

Background: Anxiety perception among children plays a significant part in providing oral health care since both are interlinked. Perception refers to the ways or means by which anything is perceived or interpreted. Perception is awareness of the elements of the environment through physical sensation. As part of oral health-care initiation, the present study aimed to compare the anxiety perception among children following two different restorative modalities of atraumatic restorative treatment versus chemomechanical caries removal (CMCR). Methodology: A nonrandomized clinical trial was conducted over 2 months between February 20, 2021 and April 22, 2021, to compare the anxiety perception among children. Children below 14 years were selected for the study purpose. Results: Poisson regression analysis was used to evaluate the association between outcome and the variables. The results showed that the majority of children had dental anxiety issues, who were willing to improve their cooperative levels during dental treatment appointments. No statistically significant association was seen between the two different restorative modalities. Lower heart rate was observed when CMCR was used (P = 0.013). Conclusion: Anxiety perception among children plays a significant part in providing oral health care. The effectiveness of implementation was appropriate with regard to choosing the right treatment modalities among clinicians. Both the techniques showed minimal or lesser anxiety levels, but on a comparative note, CMCR was better, both in terms of patient acceptance and ease of performance.

Background: Dental anxiety is one of the key factors that prevent children from obtaining dental treatment and raises anxiety levels in children. The first dental visit is usually fearful for the child and contributes to managing the child patient in a dental operatory. A pediatric dentist's role is to perform effective treatment using various nonpharmacological behavior management techniques. Aims: The aim of the study was to evaluate and compare the effect of self-designed dental storybook on behavior and pulse rate before and after dental procedures in 57-year-old children. Settings and Design: The study was a prospective, randomized, controlled trial. Materials and Methods: The study was conducted on 380 aged 57 years. Children were randomly allocated into two groups, namely, Group A − Behavior modification using a self-designed dental storybook and Group B – Behavior modification without storybook. Research was carried out in two dental visits (screening, examination, and preventive and restorative treatment) wherein, before and after intervention, pulse rate, Facial Image Scale (FIS), and Venham Scale (VS) were recorded. Descriptive statistical analyses followed by the paired t-test and Wilcoxon signed-rank test were applied and tabulated using the SPSS software version 23.0. Results: There was a significant difference observed in the interventional group as compared to the control group for pulse rate, FIS, and VS. Conclusion: Self-designed dental storybook as an adjuvant was found to be promising behavior modification technique for 57-year-old children.

Background: Dental anxiety is one of the key factors that prevent children from obtaining dental treatment and raises anxiety levels in children. The first dental visit is usually fearful for the child and contributes to managing the child patient in a dental operatory. A pediatric dentist's role is to perform effective treatment using various nonpharmacological behavior management techniques.Aims: The aim of the study was to evaluate and compare the effect of self-designed dental storybook on behavior and pulse rate before and after dental procedures in 57-year-old children.Settings and Design: The study was a prospective, randomized, controlled trial.Materials and Methods: The study was conducted on 380 aged 57 years. Children were randomly allocated into two groups, namely, Group A - Behavior modification using a self-designed dental storybook and Group B - Behavior modification without storybook. Research was carried out in two dental visits (screening, examination, and preventive and restorative treatment) wherein, before and after intervention, pulse rate, Facial Image Scale (FIS), and Venham Scale (VS) were recorded. Descriptive statistical analyses followed by the paired t-test and Wilcoxon signed-rank test were applied and tabulated using the SPSS software version 23.0.Results: There was a significant difference observed in the interventional group as compared to the control group for pulse rate, FIS, and VS.Conclusion: Self-designed dental storybook as an adjuvant was found to be promising behavior modification technique for 57-year-old children. [ABSTRACT FROM AUTHOR]

Introduction: Dental fear and anxiety pose a significant problem for the practice of dentistry, especially in children. Therefore, it is necessary to identify and quantify this anxiety, to implement, and to monitor the effectiveness of treatment interventions. Materials and Methods: A cross-sectional study was conducted on children in the age group of 3–14 years. The children who had sound health and visited outpatient department of a Dental College, Lucknow, India with their parents for dental care were considered for study purposes. Children’s dental fear and anxiety were measured by using three scales. Result: Out of the total 220 respondents, 118 (53.6%) were males and 102 (46.4%) females. The outcome of the study showed that the dental fear among children was 13.3%, 22.9%, 7.8%, respectively, in existence measured by the three scales, viz., (a) facial image scale (FIS), (b) dental fear scale (DFS), and (c) children’s fear survey schedule-dental subscale (CFSS-DS). About 70.2% of the children showed Frankl’s behavior rating of 3, i.e. positive. Conclusion: Dental fear and anxiety are the most common problems of children and because of this, they are afraid of undergoing any dental treatment. By using the above scale, we can know about those factors which can enhance their fear so that we can modify our treatment approach. Altering in a treatment modality not only leads the children to get the treatment done easily but also removes the fear for dental treatment in the future.

Ankyloglossia is an abnormal congenital condition of the tongue characterized by abnormal attachment of lingual frenum or shorter lingual frenulum. Although various conventional surgical modalities and lasers for frenectomy has been described in literature, only few articles have been reported in the existing literature regarding the diode laser of 808 nm wavelength for frenectomy procedure in pediatric patient. Hence, the current article describes the clinical case report of successful and effective treatment of ankyloglossia using soft-tissue diode laser of 808 nm wavelength with minimally invasive dentistry approach in a 10-year-old male pediatric patient. In addition, the tongue-tie was clinically evaluated using the Hazelbaker Assessment Tool for Lingual Frenulum Function. Diode lasers can be used as a safe alternative surgical tool for managing tongue-tie with minimally invasive dentistry approach and also for alleviating the dental anxiety in pediatric patients. [ABSTRACT FROM AUTHOR]

Introduction: Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels. Materials and Methods: A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software. Results: Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels (P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment (P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety (P = 0.025). Conclusion: Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level.

Fear of dental treatment is the most common obstacle dental professionals face while treating children, especially those requiring invasive treatments. Therefore, this study was conducted on children aged 3-14 years (N=100) in Chennai to assess the prevalence of dental fear. The DFA levels were measured using three fear measurement scales, i.e., facial image scale (FIS), dental fear scale (DFS), and children's fear survey schedule-dental subscale (CFSS-DS). The prevalence of dental fear in this study population was found to be 64%. The mean DFA scores were found to be 2.31 ±0.99 (FIS), 47.94± 13.53 (DFS) and 40.69± 10.65 (CFSS-DS). It was observed that the maximum number of respondents (56.3%) showed Frankl's Rating 3 i.e. positive. More males were found to be less cooperative than females by FBRS (p<0.05). There was also a statistically significant association between the DFA scores and age groups (p<0.05) where the 12-14 year old children showed least DFA. The factors which caused most fear was "fear of needles being injected" and "injections (shots)" respectively. [ABSTRACT FROM AUTHOR]

Objectives: Inferior alveolar nerve block (IANB) does not always provide adequate pulpal anesthesia, and supplemental techniques have been investigated in adults. This study aimed to pre- and intraoperatively evaluate the success of pulpal anesthesia following supplemental mandibular buccal infiltration (SMBI) after failure of IANB in permanent mandibular molars with deep caries of pediatric patients. Materials and methods: Following IANB, preoperative pulpal anesthesia was assessed using the cold test, and success was defined when there was a negative response. In cases with failed IANB, SMBI was administered, and pulpal anesthesia was re-evaluated. A maximum of three SMBIs was allowed. After achieving successful preoperative pulpal anesthesia, treatment was then initiated. Intraoperatively, success of pulpal anesthesia was determined when the Wong-Baker FACES Pain Rating Scale reported by the patients was ≤ four. Results: Sixty molars of patients aged 9.6 ± 2.3 years were included in the study. The success of preoperative pulpal anesthesia following IANB was 33.3%. The overall cumulative preoperative pulpal anesthesia after three SMBIs was 95%. However, the success of intraoperative pulpal anesthesia was only 66.7%. Conclusions: SMBI greatly improved the success of preoperative pulpal anesthesia after failure of IANB. However, the success of preoperative pulpal anesthesia, confirmed by the cold test, does not always guarantee intraoperative pulpal anesthesia, especially in teeth with irreversible pulpitis. Clinical relevance: IANB produced low pulpal anesthesia in vital permanent mandibular molars with deep caries of pediatric patients. Clinicians should always prepare for supplemental injection both pre- and intra-operatively. [ABSTRACT FROM AUTHOR]

Introduction: Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels. Materials and Methods: A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software. Results: Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels (P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment (P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety (P = 0.025). Conclusion: Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine the validity of a scale that uses faces as an indicator to evaluate the children's dental anxiety. Materials and Methods: A total of 50 children (age: 5-18 years) and their parents/guardians were approached in the waiting area of the Department of Preventive and Pediatric Dentistry, Saveetha Dental Hospital. They were asked if they would agree to take part in a study investigating on how children emotionally feel about the dentist. Two scales, namely facial image scale (FIS) and Venham picture test (VPT), were used. The FIS comprises a row of five faces ranging from very happy to very unhappy. The children were asked to point at which face they felt most like at that moment. The VPT comprises eight cards, with two figures on each card, one anxious figure and one non-anxious figure. The children were asked to point at the figure they felt most like at that moment. All cards were shown in their numbered order. The VPT was administered first, with every second participant to control for order effects. Both scales were shown to the children held at an angle such that the parent could not see the choice their child was making, each parent was also asked not to contribute to their child's choice. Results: A strong correlation was found between the two scales, indicating good validity for the FIS. Findings also showed that a small, but significant, number of children are anxious in the dental context. Conclusion: The findings suggest that the FIS is a valid means of assessing child dental anxiety status in a clinical context. [ABSTRACT FROM AUTHOR]

Background: To compare changes in child dental anxiety after treatment for early childhood caries (ECC) using two treatment approaches.Methods: Children with ECC were randomized to test (atraumatic restorative treatment (ART)-based approach) or control (standard care approach) groups. Children aged 3 years or older completed a dental anxiety scale at baseline and follow up. Changes in child dental anxiety from baseline to follow up were tested using the chi-squared statistic, Wilcoxon rank sum test, McNemar's test and multinomial logistic regression.Results: Two hundred and fifty-four children were randomized (N = 127 test, N = 127 control). At baseline, 193 children completed the dental anxiety scale, 211 at follow up and 170 completed the scale on both occasions. Children who were anxious at baseline (11%) were no longer anxious at follow up, and 11% non-anxious children became anxious. Multinomial logistic regression found each increment in the number of visits increased the odds of worsening dental anxiety (odds ratio (OR), 2.2; P < 0.05), whereas each increment in the number of treatments lowered the odds of worsening anxiety (OR, 0.50; P = 0.05).Conclusions: The ART-based approach to managing ECC resulted in similar levels of dental anxiety to the standard treatment approach and provides a valuable alternative approach to the management of ECC in a primary dental care setting. [ABSTRACT FROM AUTHOR]

Aim: To evaluate two short term anxiety rating scales, Facial Image Scale (FIS) and Venham Picture Test, (VPT) that have been used to assess anxiety in children before dental treatment. Materials & Method: Fifty two children aged 6-12 years, who visited the Pediatric Dentistry Department for the first time and whose parents/guardians agreed to take part were included in the study. Anxiety of children was measured on both FIS and VPT scales while they were waiting for treatment in the waiting room. Results: A weak correlation was found between the Facial Image Scale (FIS) and the Venham Picture Test(VPT). (r = 0.087, n = 52 ,p> 0.05) however, the mean anxiety ratings of the two scales did not differ significantly. (t=0.660,/΋>0.05). Conclusions: The findings suggested that both the scales are valid means of assessing child dental anxiety in a clinical context.

AIM: To determine whether gradually exposing Brazilian children to the dental environment would decrease their levels of dental anxiety over a 14.5-month period. STUDY DESIGN AND METHODS: The study was carried out on 302 children of both genders, aged 6-7 years old. Dental anxiety was assessed using the Facial Image Scale (FIS) at five time points: 1) before an epidemiological examination; 2) before the first treatment session; 3) before the second treatment session; 4) before the first evaluation session 5) before the second evaluation session. STATISTICS: ANOVA, Student-t tests and ANCOVA were used to analyse the data. RESULTS: There was a statistically significant decrease in levels of dental anxiety between time points 1 and 5. Eighty-nine percent of the children with FIS score 1 or 2 at baseline had the same scores at the last time point, whereas 82% of children with FIS score 4 or 5 at baseline had a FIS score of 1 or 2 at the last time point. CONCLUSION: 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. [ABSTRACT FROM AUTHOR]

Objective. To test the hypothesis that dental anxiety levels of children treated in accordance with the conventional restorative treatment (CRT) are higher than in children treated with the atraumatic restorative treatment (ART) or ultra-conservative treatment (UCT) protocols. Materials and methods. In total, 302 children aged 6-7-years old, with at least two dentine carious lesions, constituted the sample. A parallel group study design was used with ART and UCT as test groups and CRT as the control. The treatment was divided into two sessions. In the first session, one carious tooth (class II in a primary molar) was randomly selected and treated according to one of the treatments. All other treatments were performed in the second session. Before the first (FIS Tx-1) and before the second session (FIS Tx-2) the level of dental anxiety was assessed using the Facial Image Scale (FIS). The GLM test and Spearman's Rank Correlation Coefficient were used to analyse the data. Results. No treatment group effect was observed on the FIS Tx-2 score ( p == 0.64). A FIS Tx-1 score ( p < 0.0001) effect on the FIS Tx-2 score was observed. The correlation coefficient between FIS Tx-1 and FIS Tx-2 scores was r == 0.30 ( p < 0.0001). Conclusion. 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. [ABSTRACT FROM AUTHOR]