The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 11 ( November, 2021 ) > List of Articles

REVIEW ARTICLE

Dental Anxiety Scales Used in Pediatric Dentistry: A Systematic Review and Meta-analysis

Shilpi Tiwari, Parimala Kulkarni, Nikita Agrawal, Shikha Mali, Saurabh Kale, Nandani Jaiswal

Keywords : Children, Dental anxiety, Dental anxiety scales, Reliability

Citation Information : Tiwari S, Kulkarni P, Agrawal N, Mali S, Kale S, Jaiswal N. Dental Anxiety Scales Used in Pediatric Dentistry: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2021; 22 (11):1338-1345.

DOI: 10.5005/jp-journals-10024-3229

License: CC BY-NC 4.0

Published Online: 24-02-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim: To assess various dental anxiety scales used in children and to know the effectiveness of different projective dental anxiety scales used in pediatric dentistry. Background: Dental anxiety poses a significant problem in child patient management and is considered to be the main barrier for successful completion of the dental treatment. Review results: This systematic review and meta-analysis has been registered at the International prospective register of systematic reviews—PROSPERO—CRD42021247586. The systematic review was conducted in accordance with the Preferred Reporting Items in Systematic Review and Meta-Analysis (PRISMA) guidelines. Electronic databases [PubMed (MEDLINE), COCHRANE Library, EMBASE, EBSCO host, and Google Scholar database] were searched for corresponding references up to 2021. Observational cross-sectional studies comparing two different dental anxiety scales were selected for this systematic review. Search strategy generated 500 articles out of which 13 studies included in qualitative synthesis and only 7 studies were taken for quantitative synthesis. Among these seven studies, five studies compared FIS and VPT scales, two studies compared RMS, FIS, and VPT scales. Results of meta-analysis showed that an overall mean difference of dental anxiety between VPT and FIS scales was 0.11 (95% CI: 0.26–0.48), RMS and FIS scales was 0.05 (95% CI: 0.40–0.50), RMS and VPT was 0.27 (95% CI: 0.80–0.27) in the investigated population. Conclusion: No statistically significant difference was noted in all comparisons suggesting that all these scales are at par in assessing anxiety levels in pediatric population. Clinical significance: The projective scales Raghavendra, madhuriu, sujata pictorial scale (RMS), Facial image scale (FIS), and Venham's picture test (VPT) can be a pragmatic tool in assessing children's dental anxiety.


HTML PDF Share
  1. Bhatia MS, Goyal A. Anxiety disorders in children and adolescents: need for early detection. J Postgrad Med 2018;64(2):75–76. DOI: 10.4103/jpgm.JPGM_65_18.
  2. Porritt J, Buchanan H, Hall M, et al. Assessing children's dental anxiety: a systematic review of current measures. Commun Dent Oral Epidemiol 2013;41(2):130–142. DOI: 10.1111/j.1600-0528.2012.00740.x.
  3. Grisolia BM, dos Santos APP, D'Hyppolito IM, et al. Prevalence of dental anxiety in children and adolescents globally: a systematic review with meta-analyses. Int J Paediatr Dent 2020;00:1–16. DOI: 10.1111/ipd.12712.
  4. Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J 2013;58(4):390–407. DOI: 10.23804/ejpd.2017.18.02.07.
  5. Cianetti S, Lombardo G, Lupatelli E, et al. Dental fear/anxiety among children and adolescents. A systematic review. Eur J Paediatr Dent 2017;18(2):121–130. DOI: 10.4103/2231-0762.183108.
  6. Shim Y-S, Kim A-H, Jeon E-Y, et al. Dental fear & anxiety and dental pain in children and adolescents: a systematic review. J Dent Anesth Pain Med 2015;15(2):53–61. DOI: 10.17245/jdapm.2015.15.2.53.
  7. Sadana G, Grover R, Mehra M, et al. A novel Chotta Bheem–Chutki scale for dental anxiety determination in children. J Int Soc Prevent Community Dent 2016;6(3):200–205. DOI: 10.4103/2231-0762.183108.
  8. Fathima F, Jeevanandan G. Validation of a facial image scale to assess child dental anxiety. Drug Invention Today 2018;10(1):2835.
  9. Howard KE, Freeman R. Reliability and validity of a faces version of the modified child dental anxiety scale. Int J Paediatr Dent 2007;17:281–288. DOI: 10.1111/j.1365-263X.2006.00830.x.
  10. Setty JV, Srinivasan I, Radhakrishna S, et al. Use of an animated emoji scale as a novel tool for anxiety assessment in children. J Dent Anesth Pain Med 2019;19(4):227–233. DOI: 10.17245/jdapm.2019.19.4.227.
  11. Buchanan H, Niven N. Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent 2002;12(1):47–52. PMID: 11853248.
  12. Dogan MC, Seydaoglu G, Uguz S, et al. The effect of age, gender and socio-economic factors on perceived dental anxiety determined by a modified scale in children. Oral Health Prev Dent 2006;4(4):235–241. PMID: 17153645.
  13. Krishnappa S, Srinath S, Vishwanath SK, et al. Evaluation of facial image scale and Venham picture test used to assess dental anxiety in children. J Indian Assoc Public Health Dent 2013;11(2):31–35. DOI: 10.17245/jdapm.2019.19.4.227.
  14. Shetty RM, Khandelwal M, Rath S. RMS Pictorial Scale (RMS-PS): an innovative scale for the assessment of child's dental anxiety. J Indian Soc Pedod Prev Dent 2015;33(1):48–52. DOI: 10.4103/0970-4388.149006.
  15. Oliveira MF, Stein CE, Schrör FCL, et al. Evaluation of child anxiety prior to dental care by means of Modified Venham Picture Test, RMS Pictorial Scale and Facial Image Scale Tests. Pesqui Bras Odontopediatria Clín Integr 2020;20:e5068. DOI: 10.1590/pboci.2020.052.
  16. Corah NL. Development of a dental anxiety scale. SAGE publication; 1968. p. 596.
  17. Wong HM, Humphris GM, Lee GTR. Preliminary validation and reliability of the modified child dental anxiety scale. Psychol Rep 1998;83:1179–1186. DOI: 10.2466/pr0.1998.83.3f.1179.
  18. Cuthbert MI, Melamed BG. A screening device: children at risk for dental fears and management problems. J Dent Child 1982;49(6): 432–436. PMID: 6960031.
  19. Venham LL, Gaulin-Kremer E. A self-report measure of situational anxiety for young children. Pediatr Dent 1979;1(1):91–96. PMID: 399677.
  20. Tiwari N, Tiwari S, Thakur R, et al. Evaluation of treatment related fear using a newly developed fear scale for children: “Fear assessment picture scale” and its association with physiological response. Contemp Clin Dent 2015;6(3):327–331. DOI: 10.4103/0976-237X.161871.
  21. Al-Namankany A, de Souza M, Ashley P. Evidence-based dentistry: analysis of dental anxiety scales for children. Br Dent J 2012;212(5): 219–222. DOI: 10.1038/sj.bdj.2012.174.
  22. Harsha L, Jeevanandan G. A scale to assess child's dental anxiety. Int J Multidisciplinary Res Modern Educ 2017;3(1):301–303. DOI: 10.5281/zenodo.573166.
  23. Ilgüy D, Ilgüy M, Dinçer S, et al. Reliability and validity of the modified dental anxiety scale in Turkish patients. J Int Med Res 2005;33(2): 252–259. DOI: 10.1177/147323000503300214.
  24. Tickle M, Jones C, Buchannan K, et al. A prospective study of dental anxiety in a cohort of children followed from 5 to 9 years of age. Int J Paediatr Dent 2009;19:225–232. DOI: 10.1111/j.1365-263X.2009.00976.x.
  25. Gould D. Examining the validity of pressure ulcer risk assessment scales: development and using illustrated patient simulations to collect the data information point: visual analogue scale. J Clin Nurs 2001;10:697–706. DOI: 10.1046/j.1365-2702.2001.00525.x.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.