EC Paediatrics

Relevance: Many children have anxiety and fear at the very thought of visiting a dentist. Children do not make contact with a doctor, refuse to perform dental manipulations, express their emotions vividly, or withdraw into themselves. In addition, in a state of anxiety, the work of many organ systems changes, and an increase in heart rate is the most common indicator. As a result, such patients refuse to visit-the dentist, which worsens the state of oral health. Alternatively, dental procedures for unadapted patients are performed under anesthesia or sedation. But doctors do not have a proven algorithm for diagnosing a child's anxiety level and how to correct this condition for safe and effective dental treatment.

Aim: Clinical-and functional justification of the choice of a method for correcting anxiety in children aged 4 - 12 years in an outpatient dental appointment.

Materials and Methods: From 2019 - 2024 years, a study was conducted, in which 986 children aged 4 - 12 years participated. Before the start of the examination, general somatic and psychological anamnesis of patients was collected. The level of anxiety of children from 4 to 6 years of age was determined using the" test of child anxiety "by R.Temml, M.Dorka, V.Amen; from 7 to 12 years of age-the" Scale of explicit anxiety CMAS" in the adaptation of A.M.. Parishioners. Hemodynamic parameters (HR and SpO₂) were measured Choice MMed using a Choice MMed 300C5 pediatric pulse oximeter. All patients underwent a dental examination of the oral cavity and the degree of caries activity was determined by T.F. Vinogradova. Based on the results of the examination methods, a decision was made on the further strategy of working with the patient (treatment with the support-of an anesthesiologist or the use of art-therapy as a method of psycho-emotional correction).

Results: According to the results of psychological testing, all patients were divided into three groups: low-level (19.2%), medium-level (52.4%) and high-level anxiety (28.4%). Almost all children with low levels of anxiety had their heart rate within the age norm (86.9%). This group also showed the highest percentage of patients with compensated caries activity (51.9%). Children with a high level of anxiety showed moderate and severe tachycardia (38.8% and 61.2%, respectively), and 62.2% of the subjects in this group showed a decompensated degree of caries activity. Patients with low levels of anxiety required less psychological correction, than children with medium and high levels. Based on the results of our study, a computerized program "Determining the method of correcting anxiety in children before dental treatment" was developed, which will help dentists determine the tactics of working with children's patients before dental manipulations.

Conclusion: Thus, to improve the quality and safety of dental care for children, on the basis of a comprehensive psychological and functional examination, a digital program "Determining the method of correcting anxiety in children before dental treatment" was developed.

 Keywords: Anxiety; Adaptation; Heart Rate; Art Therapy; Degree of Caries Activity

1. Baier K., et al. “Children's fear and behavior in private pediatric dentistry practices”. Pediatric Dentistry 26.4 (2004): 316-321.
2. Alsadat FA., et al. “Dental fear in primary school children and its relation to dental caries”. Nigerian Journal of Clinical Practice 21.11 (2018): 1454-1460.
3. Zhu M., et al. “Experiential learning for children’s dental anxiety: a cluster randomized trial”. BMC Oral Health 20.1 (2020): 216.
4. Yon MJY., et al. “Dental fear and anxiety of kindergarten children in Hong Kong: a cross- sectional study”. International Journal of Environmental Research and Public Health 17.8 (2020): 2827.
5. Armfield JM and Heaton LJ. “Management of fear and anxiety in the dental clinic: a review”. Australian Dental Journal 58.4 (2013): 390-407 quiz 531.
6. Boborov AE and Usatenko EV. "The concept of anxiety disorders: basic development trends". Social and Clinical Psychiatry 31.4 (2021): 62-70.
7. Andrews MD., et al. “Generalized worry disorder: A Review of DSM-IV Generalized anxiety disorder and options for DSM-V”. Depression and Anxiety 27.2 (2010): 134-147.
8. Farhat-McHayleh N., et al. “Techniques for manag- ing behaviour in pediatric dentistry: comparative study of live modelling and tell-show-do based on children’s heart rates during treatment”. Journal of the Canadian Dental Association 75.4 (2009): 283.
9. Shindova MP., et al. “Pulse oximetry in paediatric dentistry”. Folia Medica (Plovdiv) 64.2 (2022): 202-206.
10. Alghareeb Z., et al. “Assessment of dental anxiety and hemodynamic changes during different dental procedures: a report from eastern Saudi Arabia”. European Journal of Dentistry 16.4 (2022): 833-840.
11. Nikolskaya IA., et al. "Fundamentals of formation and correction of dental anxiety". Endodontics Today 21.4 (2023): 280-284.
12. Vlad R., et al. "The evaluation of dental anxiety in primary school children: a cross-sectional study from Romania”. Children (Basel) 7.10 (2020): 158.
13. Anisimova EN., et al. "Russian Federation Patent No. 2024683372 "Determination of the method of anxiety correction in children before dental treatment" (2024).