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Review
. 2024 Feb 23;12(5):537.
doi: 10.3390/healthcare12050537.

Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis

Sarrah S F S Almarzouq  1 , Helene Chua  2 , Cynthia K Y Yiu  1 , Phoebe P Y Lam  1
Affiliations
Review

Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis

Sarrah S F S Almarzouq et al. Healthcare (Basel). .

Abstract

Background: Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12.

Method: A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses.

Result: A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children.

Conclusions: The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.

Keywords: anxiety management; dental anxiety; nonpharmacological intervention; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
Forest plot comparison between distraction and Tell–Show–Do.
Figure A2
Figure A2
Forest plot comparison between VR and traditional behavioural methods.
Figure A3
Figure A3
Forest plot comparison between TSD and no treatment.
Figure 1
Figure 1
PRISMA flowchart of the current meta-evaluation.
Figure 2
Figure 2
Assessment of risk of bias using ROB2: A revised Cochrane risk of bias for randomized trials.
Figure 3
Figure 3
Meta-analysis subgroup analysis. HR/PR between distraction vs. Tell–Show–Do.
Figure 4
Figure 4
Forest plot comparison. HR/PR between VR vs. traditional behavioural methods.
Figure 5
Figure 5
Forest plot comparison. HR/PR between TSD vs. no treatment.
Figure 6
Figure 6
Forest plot comparison between VP vs. no VP.
See this image and copyright information in PMC

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