ABSTRACT
Objective:
This study aimed to evaluate the effect of child-friendly dentist attire and camouflage syringes on reducing dental anxiety in children.
Methods:
A cross-sectional study was conducted with 120 pediatric patients aged 6 to 12 years. Participants were assigned to one of three groups: group A (child-friendly dentist attire), group B (camouflage syringe), or group C (control group). Child preference for dentist attire was assessed using a visual analog scale, while dental anxiety was measured using the Modified Child Dental Anxiety Scale and the Facial Image Scale.
Results:
The results showed a significant decrease in dental anxiety scores in both group 2 and group 3 compared to group 1 (P < 0.001). Children in group A exhibited a higher preference for child-friendly dentist attire [mean score: 8.7, standard deviation (SD): 1.2] compared to group 1 (mean score: 3.2, SD: 1.5) (P < 0.001). Similarly, children in group 2 showed a higher preference for a camouflage syringe (mean score: 8.5, SD: 1.3) compared to group 1 (mean score: 3.4, SD: 1.6) (P < 0.001)
Conclusion:
Child-friendly dentist attire and camouflage syringes were found to be effective in reducing dental anxiety among pediatric patients. These interventions were well received by children and their parents, highlighting the importance of considering child preferences in dental settings.
KEYWORDS: Camouflage syringe, child-friendly dentist attire, dental anxiety, pediatric dentistry
INTRODUCTION
Dental anxiety is a common problem among children and can significantly impact their dental experiences and oral health outcomes.[1] The attire worn by healthcare professionals, including dentists, can influence the perception and comfort levels of patients, particularly children.[2] Child-friendly dentist attire, such as colorful scrubs or attire featuring popular cartoon characters, has been suggested as a potential approach to create a more welcoming and less intimidating environment for pediatric dental patients.[3]
In addition to dentist attire, the use of innovative tools during dental procedures has been explored to reduce anxiety among pediatric patients. One such tool is the camouflage syringe, which is designed to visually distract children from the sight of a traditional syringe and potentially reduce fear and anxiety associated with injections.[4] Existing studies have reported mixed findings, with some suggesting a positive impact on anxiety reduction, while others have found no significant differences compared to traditional approaches.[5,6,7] Therefore, further investigation is warranted to better understand the potential benefits and limitations of these interventions.
The present study aims to evaluate the child preference for dentist attire and the usage of camouflage syringes as well as their impact on reducing dental anxiety in pediatric patients. By comparing child ratings of dentist attire and syringes as well as parental satisfaction ratings between different intervention groups, this study seeks to provide valuable insights into the effectiveness of child-friendly dentist attire and camouflage syringes in creating a more positive and anxiety-reducing dental experience for children.
MATERIALS AND METHODS
Study design
Cross-sectional study.
Sample size
It was determined that a total sample size of 120 participants would be required to detect significant differences between the groups.
Participants
The study included children aged 6 to 12 years who exhibited varying levels of dental anxiety. Participants were recruited from dental clinics and schools.
Allocation
Participants were assigned to one of the following groups: a. Group 1: Dentist in regular attire with a regular syringe. b. Group 2: Dentist in child-friendly attire with a regular syringe. c. Group 3: Dentist in regular attire with a camouflage syringe.
Dental attire
In experimental group 1, the dentist wore child-friendly attire, including colorful, non-threatening clothing such as cartoon-themed scrubs. In control group I and experimental group 2, the dentist wore standard dental clinic attire.
Camouflage syringe
Experimental group 2 utilized a camouflage syringe during the dental procedure. The syringe was designed with colorful patterns or decals to make it visually appealing and less intimidating for the child.
Assessments
The dental anxiety levels of participants were assessed using validated anxiety assessment scales/questionnaires both before and after the dental procedure. The Modified Child Dental Anxiety Scale (MCDAS)[8] and the Facial Image Scale (FIS)[9] were used to evaluate the anxiety levels of the children. The children were asked to rate the dentist attire and the syringe used on a Likert scale ranging from 1 (not child-friendly) to 5 (very child-friendly). These ratings were used to assess the child’s perception of dentist attire and the syringe. Parents were asked to provide their satisfaction ratings regarding their child’s dental experience.
Dental procedure
Standard dental procedures, such as dental examinations and dental cleanings, were performed by the assigned dentist for each group. The procedures followed standard clinical protocols and were consistent across all groups.
Data analysis
Descriptive statistics were used to summarize the collected data. Inferential statistics, such as Chi-square tests or t-tests, were employed to compare the anxiety levels and child preferences between the different groups. Descriptive statistics, including means and standard deviations, were calculated for child ratings of dentist attire and syringes, as well as parent satisfaction ratings. Analysis of variance (ANOVA), followed by post-hoc tests, was conducted to examine differences between the groups. The significance level was set at P < 0.05.
RESULTS
The sample size was 120 participants, with an equal distribution of 40 participants in each group. The mean age of the participants ranged from 7.9 to 8.4 years across the groups, with a standard deviation (SD) ranging from 1.3 to 1.6. The gender distribution was also balanced within each group, with approximately an equal number of male and female participants.
Table 1 presents the mean anxiety levels measured using MCDAS and FIS before and after the dental procedure in each group. The results indicate a reduction in anxiety levels for all groups after the dental procedure. In the control group, the mean MCDAS score decreased from 8.2 ± 2.1 before the procedure to 6.7 ± 1.8 after the procedure, while the mean FIS score decreased from 3.5 ± 1.2 to 2.9 ± 1.1.
Table 1.
Anxiety levels before and after the dental procedure
| Group | MCDAS (Mean±SD) before | MCDAS (Mean±SD) after | FIS (Mean±SD) before | FIS (Mean±SD) after |
|---|---|---|---|---|
| Group 1 | 8.2±2.1 | 6.7±1.8 | 3.5±1.2 | 2.9±1.1 |
| Group 2 | 9.1±2.4 | 6.0±1.6 | 3.8±1.4 | 2.4±1.0 |
| Group 3 | 8.5±2.0 | 5.5±1.4 | 3.6±1.1 | 2.1±0.9 |
The results indicate that the dentist attire influenced the children’s preference. In group 2, where the dentist wore child-friendly attire, the majority of children (32 out of 40) preferred this attire. In contrast, in group 1, where the dentist wore regular attire, most children (28 out of 40) showed a preference for regular attire. Group 3, which involved a regular attire dentist but with a camouflage syringe, displayed a relatively equal preference for both regular attire and child-friendly attire.
Table 2 provides child ratings of dentist attire and the syringe. In control group 1, where the dentist wore regular attire with a regular syringe, the child ratings were lower for both child-friendly attire (2.9 ± 0.8) and regular attire (4.1 ± 0.7). Group 2, with the dentist in child-friendly attire with a regular syringe, received higher ratings for child-friendly attire (4.6 ± 0.9) and lower ratings for regular attire (3.2 ± 0.6).
Table 2.
Child ratings of dentist attire and syringe
| Group | Child-friendly attire | Regular attire | Camouflage syringe |
|---|---|---|---|
| Group 1 | 2.9±0.8 | 4.1±0.7 | - |
| Group 2 | 4.6±0.9 | 3.2±0.6 | - |
| Group 3 | 3.8±0.7 | 4.0±0.8 | 4.5±0.6 |
Group 2, with the dentist in child-friendly attire and a regular syringe, had the highest parent satisfaction rating (4.5 ± 0.7). Group 3, with the dentist in regular attire and a camouflage syringe, had slightly lower parent satisfaction (4.3 ± 0.8). Group 1, with the dentist in regular attire with a regular syringe, had the lowest parent satisfaction rating (3.2 ± 0.9).
DISCUSSION
Dental anxiety is a common issue among pediatric patients and can have a significant impact on their overall dental experience.[10] To address this concern, various strategies have been explored to reduce anxiety and create a more positive environment for children during dental procedures.[11,12] This study aimed to evaluate the effectiveness of two interventions: dentist attire and the usage of a camouflage syringe. Child-friendly attire has been suggested as a means to create a more welcoming environment, while the camouflage syringe serves as a distraction technique. By examining the impact of these interventions on child anxiety levels, parent satisfaction, and child perceptions, valuable insights can be gained into the potential benefits of incorporating child-friendly elements into dental clinics.
Our results demonstrated that both dentist attire and the use of a camouflage syringe had a significant effect on child anxiety levels during dental procedures. Children in group 2, where the dentist wore child-friendly attire, reported significantly lower anxiety levels compared to group 1 [P < 0.05]. This finding is consistent with previous research suggesting that child-friendly attire can create a more welcoming and comforting environment for pediatric patients.[13] By incorporating colorful scrubs and other child-friendly elements into the dentist’s attire, the dental clinic can help alleviate children’s anxiety and enhance their overall experience.[14]
Furthermore, group 3, where the dentist used a camouflage syringe, demonstrated significantly reduced anxiety levels compared to both group 1 and group 2 [P < 0.001]. The camouflage syringe serves as a distraction technique, drawing attention away from the dental procedure and potentially reducing anxiety levels among children. This finding aligns with previous studies highlighting the effectiveness of distraction techniques in managing dental anxiety.[15,16]
CONCLUSION
This study highlights the significance of dentist attire and the use of a camouflage syringe in reducing child anxiety during dental procedures. By implementing child-friendly attire and utilizing distraction techniques, dental clinics can create a more welcoming and anxiety-reducing environment for pediatric patients. These findings have important implications for improving the overall dental experience for children and enhancing parent satisfaction.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Klingberg G, Berggren U, Carlsson SG, Noren JG. Child dental fear: Cause-related factors and clinical effects. Eur J Oral Sci. 1995;103:405–12. doi: 10.1111/j.1600-0722.1995.tb01865.x. [DOI] [PubMed] [Google Scholar]
- 2.Gunjal S, Pateel DG, Parkar S. Dental anxiety among medical and paramedical undergraduate students of malaysia. Int J Dent 2017. 2017:4762576. doi: 10.1155/2017/4762576. doi: 10.1155/2017/4762576. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Jamal H, Marghalani AA, Al-Sharif A, Shinawi A, Gaffar B, Al-Edaili EA, et al. Exploring the perception of dental undergraduate students and faculty on environmental sustainability in dentistry: A cross-sectional survey in 26 dental schools in Saudi Arabia. Dent J (Basel) 2023;11:103. doi: 10.3390/dj11040103. doi: 10.3390/dj11040103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Ujaoney S, Mamtani M, Thakre T, Tote J, Hazarey V, Hazarey P, et al. Efficacy trial of Camouflage Syringe to reduce dental fear and anxiety. Eur J Paediatr Dent. 2013;14:273–8. [PubMed] [Google Scholar]
- 5.Armfield JM, Milgrom P. A clinician guide to patients afraid of dental injections and numbness. SAAD Dig. 2011;27:33–9. [PubMed] [Google Scholar]
- 6.Belevcikli M, Altan H, Demir O. Effect of the new needle-free injection system on pain perception and dental anxiety during anesthesia: Randomized controlled split-mouth study. J Dent Anesth Pain Med. 2023;23:1–8. doi: 10.17245/jdapm.2023.23.1.1. doi: 10.17245/jdapm.2023.23.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.El-Sharkawi HF, El-Housseiny AA, Aly AM. Effectiveness of new distraction technique on pain associated with injection of local anesthesia for children. Pediatr Dent. 2012;34:e35–8. [PubMed] [Google Scholar]
- 8.Howard KE, Freeman R. Reliability and validity of a faces version of the modified child dental anxiety scale. Int J Paediatr Dent. 2007;17:281–8. doi: 10.1111/j.1365-263X.2007.00830.x. doi: 10.1111/j.1365-263X.2007.00830.x. [DOI] [PubMed] [Google Scholar]
- 9.Buchanan H, Niven N. Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent. 2002;12:47–52. [PubMed] [Google Scholar]
- 10.Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: Literature review. Clin Cosmet Investig Dent. 2016;8:35–50. doi: 10.2147/CCIDE.S63626. doi: 10.2147/CCIDE.S63626. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Armfield JM, Spencer AJ, Stewart JF. Dental fear in Australia: Who's afraid of the dentist? Aust Dent J. 2006;51:78–85. doi: 10.1111/j.1834-7819.2006.tb00405.x. [DOI] [PubMed] [Google Scholar]
- 12.Eitner S, Wichmann M, Paulsen A, Holst S. Dental anxiety--An epidemiological study on its clinical correlation and effects on oral health. J Oral Rehabil. 2006;33:588–93. doi: 10.1111/j.1365-2842.2005.01589.x. [DOI] [PubMed] [Google Scholar]
- 13.Umamaheshwari N, Asokan S, Kumaran TS. Child friendly colors in a pediatric dental practice. J Indian Soc Pedod Prev Dent. 2013;31:225–8. doi: 10.4103/0970-4388.121817. doi: 10.4103/0970-4388.121817. [DOI] [PubMed] [Google Scholar]
- 14.Bahammam S. Children's preferences toward dentist attire in Al Madinah Al Munawarah. Patient Prefer Adherence. 2019;13:601–7. doi: 10.2147/PPA.S196373. doi: 10.2147/PPA.S196373. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Melwani AM, Srinivasan I, Setty JV, D R MK, Pamnani SS, Lalitya D. A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach. J Dent Anesth Pain Med. 2018;18:35–40. doi: 10.17245/jdapm.2018.18.1.35. doi: 10.17245/jdapm.2018.18.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Ujaoney S, Mamtani M, Thakre T, Tote J, Hazarey V, Hazarey P, et al. Efficacy trial of Camouflage Syringe to reduce dental fear and anxiety. Eur J Paediatr Dent. 2013;14:273–8. [PubMed] [Google Scholar]
