MANAGING DENTAL ANXIETY 1

Managing Dental Anxiety in Children during Local Anesthetic Administration

Chelsi Vaden

South College

Local Anesthesia

Ms. Mckinney

3/7/2022
MANAGING DENTAL ANXIETY 2

Managing Dental Anxiety in Children during Local Anesthetic Administration

According to research, the provision of pain-free dentistry in children is a vital part of

minimizing fear and anxiety, encouraging the completion of treatment, and preventing the

avoidance of care services in the future (Tirupathi et al., 2019). One of the strategies to enhance

the delivery of pain-free dental care is a local anesthetic (LA), even though there are challenges

with the method. The administration of LA is not only painful but also triggers anxiety issues in

the child leading to behavioral issues that interrupts communication between the child and the

health care provider, thereby causing treatment avoidance. Several interventions can influence

the child to cope with LA delivery, including aromatherapy, eye movement distraction (EMD),

external cold, and a vibrating device.

Tirupathi et al. (2019) explores the possibility of EMD in minimizing the anxiety levels

in children while administering local anesthetic. The eye movement technique is a therapeutic

strategy applied in psychological disorders including panic disorders, depression, and post-

traumatic stress disorders. Findings indicate that EMD is a strategic way of reducing anxiety

levels while administering local anesthesia. Dental fears and anxiety can be a result of

undesirable and negative remarks from friends, family, and the community. According to Jain et

al. (2021), pain management is vital in invasive and non-invasive dental care to lower the risk of

non-compliance with the treatment procedures. During dental procedures, the coldness masks the

pain while the vibrations act as a distraction to the patient, triggering the brain to focus on the

vibrations, thereby providing room for analgesia procedures. Findings indicate that a

combination of external cold and vibrations are effective strategies for reducing pain and anxiety

in children during dental procedures. Administration of LA in children involves behavioral

issues, thus the need for aromatherapy in preventing dental anxiety. Nirmala & Kamatham's
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(2021) research article indicates that Pain scores are also minimal in lavender essential oil with

the use of nebulizer and orange essential oil with the use of both inhaler and nebulizer.

Therefore, aromatherapy with either sweet orange or lavender with the use of an inhaler or

nebulizer reduces the dental anxiety levels in children.

The three articles have been published in the last three years, thus enhancing reliability

levels in the current review. The abstract in the three articles guide readers to gain an insight into

the content and coherently matches the statement of purpose. The articles use different subtitles

to logically subdivide the sections. The methodologies applied in the articles are experimental

and randomized clinical trials with random selection as a sampling technique. In each of the

studies, the subjects have undergone or are undergoing dental procedures which influence the

validity of the outcomes in clinical practice. The sample size is a critical feature in research, thus

a bigger sample size promotes accuracy levels. However, Jain et al. (2021) use a sample size of

30 which is a smaller size compared to Tirupathi et al. (2019) and Nirmala & Kamatham's (2021)

size of 228 and 150 subjects, respectively. In terms of reference, the three articles use a

combination of 95 references to support the research outcomes with Jain et al. (2021) having the

least number at 14 references. Based on the findings, aromatherapy, eye movement distraction

(EMD), external cold and a vibrating device are effective ways of preventing fear and anxiety

during local anesthesia.

Pain, anxiety, and the overall perception of a clinical procedure affect the patient’s

mental status, making it necessary to influence effective intervention in children's dental care

processes. Different methods are available for practitioners with several studies supporting the

use of aromatherapy, eye movement distraction, and cold and vibrations to lower fear and

anxiety in dental care procedures.

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References

Jain, N., Juneja, P., Masih, U., Bhushan, A. B., Bhaduaria, U. S., & Badjatya, K. (2021).

Efficacy of external cold and a vibrating device in reducing pain and anxiety during local

anaesthesia. Journal of Family Medicine and Primary Care, 10(11), 4017-4022.

ncbi.nlm.nih.gov/pmc/articles/PMC8797120/

Nirmala, K., & Kamatham, R. (2021). Effect of Aromatherapy on Dental Anxiety and Pain in

Children Undergoing Local Anesthetic Administrations: A Randomized Clinical

Trial. Journal of Caring Sciences, 10(3), 111.

ncbi.nlm.nih.gov/pmc/articles/PMC8609116/

Tirupathi, S., Krishna, N., Rajasekhar, S., & Nuvvula, S. (2019). Eye movement distraction: a

new distraction technique for management of dental anxiety during intraoral local

anesthesia administration in children. International Journal of Clinical Pediatric

Dentistry, 12(6), 507. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229387/