An interesting article titled “an Anxiety Reduction Program as an Alternative to General Anesthesia for the Anxious Pediatric Dental Patient” was presented on July 23, 2021, at the virtual session of the 2021 International Association for Dental Research (IADR)/AADR/CADR General Session written by Suher Baker and et al. The research set to investigate the efficacy of a systematic Anxiety Reduction Program (ARP) using progressive desensitization to reduce anxiety in children to a level that would allow dental treatment to be performed in-office without the use of general anesthesia. Dental anxiety has been covered on this site before see for example the post Dental Anxiety and Fear: Impact on Oral Health. Children are more likely to experience an unfavorable and unforeseen incident caused by an error or omission during dental treatment that has negative health consequencies. This is because children do not alwasy cooperate and they often can not sit still. As such to treat children with dental issues, restraints, quiet rooms, and/or general anesthesia is often used.
In the article, the researchers performed a retrospective study and examined records of 227 healthy children who underwent an Anxiety Reduction Program during 2017-2019 and were were initially unable to undergo in-office treatment due to high anxiety. The researchers looked at data containing age, gender, specialty for the treatment, anxiety level at the initial dental visit, age at the first Anxiety Reduction Program, number of Anxiety Reduction Programs received, and whether treatment was provided in-office or with general anesthesia.
The authors found that approximately 90% of children (205 of 227) were able to proceed with in-office treatment who had undergone an Anxiety Reduction Program than had to have their dental treatment performed under general anesthesia. Children were also found to able to successfully complete in-office treatment regardless of their initial level of anxiety. The authors found that 92% of children successfully completed in-office treatment after their Anxiety Reduction Program visit. Further 88% of children required only one Anxiety Reduction Program treatment while 9% and 3% received 2 or 3 Anxiety Reduction Program treatments, respectively. Children were found to be equally successful across ages (range 2.1-15.3 years) at undergoing in-office treatment after their Anxiety Reduction Program visits. The authors found that both boys and girls were equally successful at undergoing in-office dental treatment after their Anxiety Reduction Program.
The authors feel that their results show that a preoperative programmed systematic desensitization treatment allows the majority of children to have successful in-office dental treatments and outcomes without having to use any restraints, quiet rooms, or general anesthesia. This allows for parents to be more satisifed with the dental care their child receives as it is less traumatic and costly. Further more it reduces any potential long term memories of traumatic experiences the child may face at the dentist. It seems that pediatric dentists would be smart to implement Anxiety Reduction Programs for the patients and particularly those who are difficult to treat or in need of treatment. This will surely be a step towards reducing adverse events like dental deaths that can occur during pediatric dental treatments.