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Purpose: To present evidence-based recommendations on nonpharmacological behavior guidance for the pediatric dental patient. Methods: The work group assessed eight systematic reviews for effectiveness of nonpharmacological behavior guidance techniques in children undergoing preventive care or a dental treatment visit. The key outcomes assessed included cooperative behavior, anxiety, and procedural pain. To formulate the recommendations, the work group used the GRADE framework to obtain consensus on domains such as priority of the problem, certainty of the evidence, balance between desirable and undesirable consequences, patients’ values and preferences, acceptability, and feasibility. Results: Overall, the use of basic nonpharmacological behavior guidance techniques resulted in trivial-to-small effect on improvement in behavior or reduction in anxiety. However, for children and adolescents undergoing preventive care, mobile applications and modeling showed large effects in reduction of anxiety. For those undergoing dental treatment, strategies such as modeling, positive reinforcement, biofeedback relaxation, breathing relaxation, animal-assisted therapy, combined tell-show-do, audiovisual distraction, and cognitive behavior therapy showed large reduction in anxiety. For children and adolescents with special health care needs, audiovisual distraction and sensory-adapted dental environment showed large reduction of anxiety. Conclusions: All the formulated recommendations were conditional and were mostly based on very low certainty of evidence. Conditional recommendations imply that different choices or combinations of behavior guidance techniques may be most appropriate for different patients. Clinicians should use techniques consistent with the parent/patient values and preferences. These recommendations are based on the best available evidence to-date and are intended to aid clinical decision making. [ABSTRACT FROM AUTHOR]

Although many randomized controlled trials (RCT) have evaluated the efficacy of powered or electric toothbrushes compared with manual or traditional toothbrushes to remove biofilm and plaque, only one systematic review has been published for pediatric patients. The primary objective of this study was to perform a systematic review and meta analysis for this population. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, N = 321 studies were initially identified. Three independent, blinded abstract reviews were completed resulting in a total of n = 38/322 or 11.8% for the final analysis (n = 27 non-orthodontic, n = 11 orthodontic studies). Meta analysis of these outcome data have revealed a strong reduction in plaque index scores among pediatric patients using electric toothbrushes of approximately 17.2% for non-orthodontic patients and 13.9% for orthodontic patients. These results provide strong clinical evidence for recommending electric toothbrushing to pediatric patients, as well as those patients undergoing orthodontic therapy and treatment. [ABSTRACT FROM AUTHOR]

Although many randomized controlled trials (RCT) have evaluated the efficacy of powered or electric toothbrushes compared with manual or traditional toothbrushes to remove biofilm and plaque, only one systematic review has been published for pediatric patients. The primary objective of this study was to perform a systematic review and meta analysis for this population. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, N = 321 studies were initially identified. Three independent, blinded abstract reviews were completed resulting in a total of n = 38/322 or 11.8% for the final analysis (n = 27 non-orthodontic, n = 11 orthodontic studies). Meta analysis of these outcome data have revealed a strong reduction in plaque index scores among pediatric patients using electric toothbrushes of approximately 17.2% for non-orthodontic patients and 13.9% for orthodontic patients. These results provide strong clinical evidence for recommending electric toothbrushing to pediatric patients, as well as those patients undergoing orthodontic therapy and treatment.

Context: Dental fear is a common and imperative emotion that develop as a response to the stressful situation, which raises children's anxiety level and resulting in avoidance behavior. Aims: The aim of this study is to evaluate and compare the tell-show-do technique with and without the aid of a virtual tool in the management of pediatric dental patients. Settings and Design: Department of Pediatric and Preventive Dentistry, nonrandomized clinical trial. Subjects and Methods: A total of 90 children of the age group of 6–9 years who were in the need of restorative treatment without using local anesthesia were assigned into two groups: Control group, where tell-show-do was applied as behavior management technique and intervention group in which tell-show-do with the aid of a virtual tool was applied. Child anxiety level was assessed using a combination of anxiety rating parameters before and after the procedure. Three physiological parameters (heart rate, oxygen saturation, and respiratory rate) and two behavioral parameters (Wright's modification of Frankl' behavior Rating Scale and Facial Image Scale) were recorded. Statistical Analysis Used: Physiological parameters were analyzed using the independent sample t-test and behavioral parameters using the Mann–Whitney U-test (P < 0.05). Results: A significant difference in all five parameters was observed between the control group and intervention group. Conclusions: Virtual tool offers a new concept of virtual distraction aid in pediatric dentistry, and it was found to be very effective in managing anxious pediatric patients. This promising method diminishes the unpleasantness often associated with dental procedures and offers a relaxed state in children.

Context: Dental fear is a common and imperative emotion that develop as a response to the stressful situation, which raises children's anxiety level and resulting in avoidance behavior.Aims: The aim of this study is to evaluate and compare the tell-show-do technique with and without the aid of a virtual tool in the management of pediatric dental patients.Settings and Design: Department of Pediatric and Preventive Dentistry, nonrandomized clinical trial.Subjects and Methods: A total of 90 children of the age group of 6-9 years who were in the need of restorative treatment without using local anesthesia were assigned into two groups: Control group, where tell-show-do was applied as behavior management technique and intervention group in which tell-show-do with the aid of a virtual tool was applied. Child anxiety level was assessed using a combination of anxiety rating parameters before and after the procedure. Three physiological parameters (heart rate, oxygen saturation, and respiratory rate) and two behavioral parameters (Wright's modification of Frankl' behavior Rating Scale and Facial Image Scale) were recorded.Statistical Analysis Used: Physiological parameters were analyzed using the independent sample t-test and behavioral parameters using the Mann-Whitney U-test (P < 0.05).Results: A significant difference in all five parameters was observed between the control group and intervention group.Conclusions: Virtual tool offers a new concept of virtual distraction aid in pediatric dentistry, and it was found to be very effective in managing anxious pediatric patients. This promising method diminishes the unpleasantness often associated with dental procedures and offers a relaxed state in children. [ABSTRACT FROM AUTHOR]