• The Korean Journal of Pain
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• 제27권1호
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• pp.30-34
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• 2014

Background: Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. Methods: Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. Results: The mean serum cortisol level of the MPDS group showed a highly significant difference (P < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (P < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. Conclusions: These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.

• 한국치위생학회지
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• 제1권1호
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• pp.63-76
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• 2001

This study was designed to evaluate the effects of music on dental pain and anxiety during ultrasonic scaling. One hundred and twenty five patients visited dental unit of Soonchunhyang University Chunan hospital for scaling were enrolled during August 1999 and February 2000. The patients were allocated randomly into two groups. music (n = 61) and control groups (n = 65). The music group patients listened to self-selected music using an earphone during scaling. Standardized questionnaire were used to assess the subjective denial pain and anxiety before and after scaling in both groups. In music group, more information on music effect was collected. To evaluate changes of physical signs by scaling, blood pressure and pulse were checked by a wrist check oscillometric. The results were as follows: 1. No significant difference in dental pain and anxiety between before and after scaling was observed in music group. However, the music group patients were satisfied with music because of reduction of pain(93.5%) and anxiety(93.4%), 96.7% of music subjects wanted to listen to music in next scaling. 2. While no significant difference in systolic blood pressure before scaling between music and control groups, systolic blood pressure of control group during scaling was significantly higher than that of music group(P<0.05). 3. In multiple logistic regression. the odds ratio(OR) of pain was decreased with age and female patients had higher OR (1.7, p>0.05). Patients with previous scaling experience complained of more dental pain during scaling than patients without experience. Music was not a significant predictor of denial pain during scaling, controlling for possible confounders. 4. While age. music. and scaling experience were not related to dental anxiety during scaling, sex and dental hygiene index were significant predictors of dental anxiety in multiple logistic regression. 5. Both during and after scaling. mean blood pressure of music patients were significantly lower than control patients after controlling for age, sex, and BMI. In conclusion, our data demonstrated that although listening to music did not disappear the dental pain and anxiety. but reduced the intensity of pain and anxiety during scaling. Furthermore, our data imply thai music has a effect of reduction of increasing blood pressure by scaling.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.197-204
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• 2022

Background: Injections are one of the most fear-provoking stimuli in dentistry. Painless administration of an injection is a vital step in alleviating anxiety, which in turn leads to good behavior in children. The aim is to evaluate and compare anxiety levels and pain perception using conventional, insulin, and deception syringes during the administration of local anesthesia in children. Methods: Forty-five children aged 6-12 were selected using a standard sample size formula and equally divided into three groups. Local anesthesia was administered using a conventional syringe to Group A participants and an insulin syringe for Group B participants. Group C participants were administered local anesthesia using a deception syringe by showing the patient disposable obturation tips, and eventually a conventional syringe was used for administration of local anesthesia after hiding them from the patient. Anxiety levels were assessed using Venham's Picture Scale and pulse rate at baseline and after administration of local anesthesia. The Wong-Baker Faces Pain Rating Scale was used to assess pain perception after the administration of local anesthesia. Results: Insulin and deception syringes showed better reduction in anxiety levels and pain perception than conventional syringes, demonstrating a high statistically significant difference. Conclusion: The use of insulin and deception syringes for administration of anesthesia was demonstrated to be effective in alleviating anxiety in children and is therefore recommended as an alternative to conventional syringes.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.195-204
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• 2024

Background: Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. Methods: Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests. Results: In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. Conclusion: Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권1호
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• pp.57-65
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• 2024

Background: The objective of behavioral guidance is to establish effective communication that aligns with a child's requirements to manage disruptive behavior. This study aimed to evaluate the effectiveness of the Tell-Show-Do and Ask-Tell-Ask techniques in managing dental anxiety in children during their initial appointment. Methods: The study included 50 children (28 boys and 22 girls) without any prior experience between the ages of 7 and 11 at their first dental visit. The children were randomly categorized into two groups: Group 1, Tell Shows Do, and Group 2, Ask-Tell-Ask. Subsequently, all children underwent noninvasive treatment procedures such as restorations, sealants, and oral prophylaxis. Furthermore, behavioral management techniques were employed based on the allocated group. Finally, anxiety levels for all children were assessed using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS) and heart rate at three different intervals (before, during, and after). The obtained data were entered into Microsoft Excel, and statistical analysis was performed using SPSS software. A paired t-test and Mann-Whitney U-test were used to compare the mean and median values of the two groups and determine their effectiveness. Results: Children in the TSD group exhibited statistically significant heart rates and RMS-PS scores in intra-group comparisons. However, children in the ask-tell-ask group showed a significant reduction only in the RMS-PS scores (P < 0.001) but not in the measures used to assess heart rate (P < 0.001). Conclusion: Tell-Show-Do was more effective than ask-tell-ask in alleviating dental anxiety in children. The simultaneous application of these two strategies can synergistically alleviate dental anxiety during a child's initial dentist appointment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.347-355
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• 2023

Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.35-40
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• 2018

Background: The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6-11-year-old children during local anesthesia administration. Methods: The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6-8 years while group 2 consisted of 15 children aged 9-11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. Results: The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. Conclusions: The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

• 대한심미치과학회지
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• 제28권1호
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• pp.54-60
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• 2019

연구목적: 치과공포는 주로 과거의 부정적인 치과 치료 경험에 기인하여 치과 방문 시 중재되지 않은 불안과 두려움의 감정을 의미하며, 성인에서는 치과치료의 필요함을 인식함에도 불구하고 진료회피로 이어져 구강건강의 악화를 야기할 수 있다. 따라서 본 연구는 일부 성인을 대상으로 치과공포 및 불안 수준을 측정하고, 그와 관련된 요인 및 이에 영향을 미치는 원인에 대해 파악하고자 수행되었다. 연구방법: Kleinknecht's의 치과 공포 척도(Dental Fear Survey scale)를 이용하였고, SPSS 21 프로그램(IBM SPSS Statistics 21)을 사용하여 분석하였다. 연구결과: 치과공포도가 높을수록 "치과병원 문을 열고 들어설 때 두려움"가 가장 높게 나타났으며, "치과의자에 낮아 치료를 기다릴 때 두려움", "치과의사를 쳐다볼 때 두려움", "치과기구가 돌아가는 소리가 들릴 때 두려움", "치과 진료실에서 병원 냄새가 날 때 두려움" 순으로 나타났다. 고안: 치과의사와 치과위생사는 환자가 느끼는 공포와 두려움을 이해하여 체계적인 의료서비스를 제공할 수 있도록 치과 불안에 대한 여러가지 중재법을 모색할 수 있어야 한다.

• Journal of Oral Medicine and Pain
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• 제17권1호
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• pp.19-29
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• 1992

Fear at the dental treatment is a problem not only for patient but for dentist as well, because the anxious patient often require more item, even for simple procedures. The anxiety level in response to dental procedures was evaluated through a simple questionnaire, Corahs, DAS. 783 female and 790 male outpatients were studied at the Dept. of Oral Diagnosis, PNUH from 1988 to 1989. The obtained results were as follows : 1. The anxiety level in female was significantly higher than that in male, and patients in 10s and 30s showed more anxious than those in other groups. 2. Housewives and pupils revealed higher level of anxiety. 3. The anxiety level in 524 (ICD) was the highest in all diseases, inspite of no difference among various diseases. 4. There was significantly higher level of anxiety in the patient of Orthodontics and Pedodontics than those of other departments. 5. There was no difference in anxiety level between acute and chronic group. 6. Dental phobes were more in female than in male.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.345-355
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• 2021

Background: This study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration. Methods: This was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4-11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy^® device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05. Results: Significant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group. Conclusion: External vibration using a Buzzy^® device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.