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. 2024 Sep 28;24(1):1151.
doi: 10.1186/s12903-024-04919-x.

Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: a network meta-analysis

Xiangrong Kong  1 , Ning Song  1 , Lulu Chen  1 , Yuemei Li  2
Affiliations

Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: a network meta-analysis

Xiangrong Kong et al. BMC Oral Health. .

Abstract

Background: Child dental anxiety is a prevalent issue in the field of pediatric dentistry. At present, several non-pharmacological interventions are employed to mitigate anxiety during dental treatments for children. The objective of this study is to assess the effectiveness of diverse non-pharmacological interventions in reducing dental anxiety, as well as enhancing heart rate during pediatric dental treatments. To achieve this, we conducted a systematic review and a network meta-analysis (NMA) to compare the efficacy of various outcome indicators.

Methods: A thorough search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, Scopus, APA PsycInfo, CINAHL, and AMED to identify all eligible randomized controlled trials (RCTs) from the beginning of the databases up to August 1, 2024. The quality assessment was carried out using the Cochrane Collaboration's bias risk tool. The two outcome measures under consideration were dental anxiety and heart rate. Network graphs, league tables and SUCRA were constructed using R 4.2.3 software and Stata 16 software. This study is registered in PROSPERO under the registration number CRD42023467610.

Results: The study examined 12 different non-pharmacological approaches, drawing from a pool of 61 research studies involving 6,113 participants aged 4 to 16 years. The results of the network meta-analysis revealed that music (SUCRAs: 93.60%) proved to be the most effective measure in mitigating dental anxiety, followed by aromatherapy (SUCRAs: 78.58%) and game (SUCRAs: 70.99%). Moreover, hypnosis (SUCRAs: 98.80%), music (SUCRAs: 79.58%), and relaxation (SUCRAs: 72.41%) were identified as the top three interventions for decreasing heart rate.

Conclusion: In this NMA, when contemplating dental anxiety outcomes, music is recommended as a priority. For heart rate outcomes, hypnosis may be a preferred measure. However, owing to the limited number of articles, the conclusion of this study still requires additional confirmation or correction through more high-quality primary studies in the future.

Keywords: Child; Dental anxiety; Dentistry; Network meta-analysis; Non-pharmacological interventions.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart for study selection
Fig. 2
Fig. 2
Risk of bias summary
Fig. 3
Fig. 3
Network graph of (A) Dental anxiety and (B) Heart rate
Fig. 4
Fig. 4
SUCRA ranking for dental anxiety
Fig. 5
Fig. 5
SUCRA ranking for heart rate
Fig. 6
Fig. 6
Funnel plots for dental anxiety. NoteA: Aromatherapy B: Audiovisual distraction C: Control D: EPI E: Game F: Magic G: Modelling H: Music I: Relaxation J: Robot K: Virtual reality
Fig. 7
Fig. 7
Funnel plots for heart rate. NoteA: Aromatherapy B: Audiovisual distraction C: Control D: EPI E: Game F: Hypnosis G: Modelling H: Music I: Relaxation J: Robot K: Virtual reality
See this image and copyright information in PMC

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