• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.1-8
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• 2023

Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-in^TM) and the classic needle method during treatment-required infiltration anesthesia in children. Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05. Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750). Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-in^TM system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance.

• Journal of dental hygiene science
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• v.10 no.5
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• pp.357-363
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• 2010

The aim of this study was to measure the dental anxiety, the factors associated with dental anxiety and the utilization behavior of dental treatment. Modified dental anxiety scale(MDAS) and Dental fear survey(DFS) were used as measurement, where through the mean and the standard deviation were worked out and also the T-test and ANOVA were performed. In relation to MDAS, females and males showed the mean, '$2.86{\pm}0.06$' and '$2.49{\pm}0.06$' (p=0.000). Also, less than 20 and more than 21 showed the mean, '$2.81{\pm}1.01$' and '$2.61{\pm}0.99$' (p=0.023). In relation to dental utilization behavior, the subjects were classified into three groups, a group who uses dental clinics periodically, a group who uses them only when problems arise, and a group who has not ever used them. MDAS indicated a higher value in the group who use dental clinics only when problems arise, which was significant statistically (p=0.000). In the case of MDAS, many respondents answered that they felt anxious in the process of actual treatment; in the case of DFS, they felt anxious due to the factors that cause irritation.

• Journal of Korean society of Dental Hygiene
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• v.6 no.4
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• pp.339-348
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• 2006

The present paper described the relationship between dental anxiety and main colors of elementary student's drawing of dentists. This paper is based on the survey with 555 samples were chosen from a first, second and third grade students of the elementary school located in Chilgok-gun Gyeongsangbuk-do. During the survey, students were asked to picture a dentist by using 12 colors crayon randomly. And the survey result was summarized in three categories. Those are the main color(most frequently used color) distribution in the children's drawings, ratio differences of the main color in terms of gender and the anxiety score for the each color. 1. The order of main colors was blue, white, green, gray, yellow, purple, ocher yellow, orange, pink, red, black and brown from the top to bottom. 2. The main colors distribution in terms of gender, male mostly used green and black compare to female, and female mostly used pink, yellow and white compare to male(p<0.01). 3. The order of the anxiety score for main colors is black, brown, red, yellow, pink, orange, green, white, gray, blue, purple and ocher yellow form the top to bottom(p<0.01).

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.277-288
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• 2019

Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.143-149
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• 2019

Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

• Journal of dental hygiene science
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• v.18 no.4
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• pp.227-233
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• 2018

The purpose of this study was to investigate the factors affecting dentists' attitudes and dental hygienists' services on dental anxiety in adults. The subjects were 300 adults older than 20 years of age living in Seoul, Gyeonggi, Daejeon, and Daegu. Data were collected using structured questionnaires. Among the distributed questionnaires, 225 respondents were selected as subjects, excluding 74 people who did not answer and 1 person who was not faithful. Data were analyzed using statistical software with a t-test, one-way ANOVA, and multiple regression. As a result, the gender was slightly higher in women (54.7%) than in men, and the last dental visit was less than one year in 59.6% of respondents. Most of the respondents' educational level was higher than college level (79.1%), and the monthly income was less than 2 million won in 53.8 of respondents. This study showed that distrust of dentists affected dental anxiety and anxiety stimulation. Higher reliability of the dentist was correlated with less dental anxiety in patients. Dental anxiety showed statistically significant results in dentist subcategories of patient slight and dentists' trust (p<0.01). Additionally, the factors affecting dental anxiety and anxiety stimulus were knowledge of dental hygienist and distrust of dentist (p<0.01). According to this study, dentists' and dental hygienists' trust of dental staff show the importance of oral health professionals' role in reducing dental anxiety in patients. It is also suggested that efforts should be made to improve public awareness of oral health experts. It is believed that dentists, and dental hygienists need to promoted to become professionals. In addition, a variety of programs have been developed to reduce dental anxiety, so patients need to be comfortable to receive dental treatment.

• Journal of Korean society of Dental Hygiene
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• v.17 no.3
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• pp.395-404
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• 2017

Objectives: The purpose of this study was to identify the effects of music intervention on the patient's fear and anxiety during scaling. Methods: 360 patients who had visited W University dental hygiene laboratory were selected as study subjects and divided into experiment group and control group. Results: Study results showed that the control group (71.9%) and the experimental group (75.1%) had experiences avoiding dental treatment due to fear. In the control group (37.6%) and experimental group (40.6%), the highest influencing factor was the sound of machine and followed by pain. The experimental group preferred classical music, followed by pop songs, trot music and instrumental music. In the experimental group (83.3%), fear and anxiety were alleviated by music, and 77.9% of the patients mentioned they would recommend music for scaling to other patients. There was an interaction effect (p=0.014) between the groups before and after the measurement of the lowest blood pressure. There was a significant difference in pulse before and after pulse measurement (p=0.000). There was a significant difference in respiration between groups (p=0.042) and before and after respiration (p=0.030). Conclusions: Study results showed that music intervention that utilizes music during scaling showed significant effects on the alleviation of fear and anxiety, affecting Pulse number among vital signs. Therefore, more systematic program is to be required to alleviate dental fear and anxiety with music therapy not only for scaling, but also for dental clinic in the future.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.2
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• pp.147-158
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• 1998

The purpose of this study was to identify the effect of music therapy on state anxiety, perception of pain of dental patients. The subjects consisted of forty patients undergoing dental treatment at one dental clinic. Twenty eight of them were assigned to the experimental group, while twelve subjects to the control group. The data were collected from June 29 to August 1, 1998 by means of a state anxiety scale (by Spielberger) questionnaire and visual analog scale for pain measurement. The data were analysed with $X^2$-test, t-test, and paired t-test. The results are as follows 1) There were no significant differences between the experimental and the control group on the post treatment the state anxiety score. However, in the experimental group, the state anxiety score decreased significantly after music therapy(t=3.19, p=0.003). In the control group, the state anxiety score did not decrease significantly(t=1.65, p=0.126). Especially, high score group on the state anxiety was found to be of significant differences in the experimental group (t=3.09, p=0.007). 2) There were no significant differences between the experimental and the control group on the post treatment perception of pain. However, after music therapy, the experimental group had a lower post treatment perception of pain than the control group. 3) After music therapy, subjective response of the experimental group was one of relative contentment. From these results, it is concluded that music therapy as a nursing intervention can be effective in decreasing anxiety in dental patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.171-184
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• 1998

The purpose of the study was to observe the association between the main colors of school children's drawings of dental treatment situation and their dental anxiety. The subjects of study were 688 school children from 2nd to 4th grade. Caries experience was investigated by oral examination. Questionnaire survey was done regarding children's attitude toward the dentist and dental treatment and their experience of pain and fear during the dental treatment. Colors with high frequency of use were green, blue, yellow, orange, pink, purple, gray, brown, yellow ochre, red, white, and black in order. Boys used green and blue, and girls used yellow and orange, more than each other. As the grade increased, white, yellow, and blue increased and brown decreased. Colors with high dental anxiety level were black, brown, red, white, blue, orange, yellow and green, yellow ochre, gray, pink, and purple in order, and the upper four represented 10.5% of the subjects. Children with high decayed teeth rate had a tendency to use colors of high dental anxiety level. Black color had the most obvious association with the pain and fear of dental treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.2
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• pp.119-128
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• 2021

Background: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. Methods: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. Results: The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001⁎) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. Conclusion: A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.