Pediatrik Hastada Dental Anksiyete ve Bilişsel Davranışçı Terapi Yöntemi

Year 2024, Volume: 3 Issue: 1, 344 - 356, 10.05.2024

Çağla Şimşek Mine Koruyucu

https://doi.org/10.58711/turkishjdentres.vi.1344229

Abstract

Dental anksiyete; belirgin bir kaynağı olmayan, dental uyaran ve prosedürlere karşı aşırı korku ile kendini gösteren özel bir anksiyete türüdür. Anksiyete yaşayan çocuk ve gençler, muayene ve tedavi esnasında çeşitli davranış bozuklukları sergileyebilir; huzursuzluktan öfke nöbetlerine kadar farklı tepkiler gösterebilirler. Bazı durumlarda, tedavi sırasında yaşadıkları ciddi ağrılar uygun bakımla hafifletilebilecek dahi olsa tedaviyi reddetme eğiliminde olabilirler. Bugüne kadar yapılan araştırmalar, farmakolojik ve farmakolojik olmayan çeşitli davranış yönlendirme teknikleri aracılığıyla dental kaygının yönetilmesi amacıyla literatüre katkı sağlamıştır. Klinik çalışmaya uyum sağlayamayan hastalarda diş hekimleri, ileri seviye davranış yöntemleri olan sedasyon ve genel anestezi metotları ile çalışmaktadır. Bilişsel davranışçı terapi (BDT), gençler ve çocuklar arasında sıkça kullanılan bir terapi yaklaşımıdır ve psikopatolojilerin tedavi edilmesi ve önlenmesinde kanıta dayalı bir yöntem olarak kabul edilmektedir. BDT, insan davranışlarını ve psikopatolojilerini temelde bilişsel ve davranışsal kuramlar çerçevesinde açıklamayı amaçlamaktadır. Bu yaklaşım, düşünceler, duygular ve davranışlar arasındaki karmaşık ilişkilere odaklanır. Özellikle çocuklar ve gençler arasında, uygun tekniklerle uygulandığında anksiyete bozuklukları, depresyon, yıkıcı davranış bozuklukları ve dışa dönük davranış sorunlarının etkili bir şekilde tedavi edilmesinde başarı sağlamaktadır. Bu derleme ile diş hekimlerinin anksiyete, dental anksiyete ve bilişsel davranışçı terapi kavramları ile tanıştırılması ve klinik uyum sağlayamayan hastalarda gerekli yönlendirmelerin teşviki hedeflenmektedir.

Keywords

çocuk diş hekimliği, bilişsel davranışçı terapi, dental anksiyete, psikoterapi

Pediatric Patient’s Dental Anxiety and Cognitive Behavioral Therapy Methods

Abstract

Dental anxiety is a distinct form of anxiety characterized by an excessive fear of dental stimuli and procedures without a clear source. Children and adolescents experiencing anxiety can exhibit various behavioral disturbances during examination and treatment; they may display different reactions ranging
from restlessness to anger outbursts. In some cases, even if they could alleviate severe pain through appropriate care, they may tend to refuse the treatment. Research conducted so far has contributed to the literature on managing dental anxiety through pharmacological and non-pharmacological behavior
guidance techniques. Dentists tend to work with advanced behavior methods such as sedation and general anesthesia in patients who cannot comply with clinical treatment. Cognitivebehavioral
therapy (CBT) is a frequently utilized therapeutic approach among youths and children, acknowledged as an evidence-based method for the treatment and prevention of psychopathologies. CBT aims to explain human behaviors and psychopathologies primarily within the framework of cognitive and behavioral theories. This approach focuses on the intricate relationships between thoughts, emotions, and behaviors. Particularly among children and adolescents, when applied with appropriate techniques, CBT has proven successful in treating anxiety disorders, depression, disruptive behavior disorders, and externalizing behavioral issues. This compilation aims to acquaint dentists with the concepts of
anxiety, dental anxiety, and cognitive-behavioral therapy and promote guidance for necessary interventions

Keywords

pediatric dentistry, cognitive behavioral therapy, dental anxiety, psychotherapy

References

• Adasal R. Ruh Hastalıkları. Türkiye: Ankara Üniversitesi Matbaası, 1976, 309–312.
• Akbay Oba A, Dülgergil CT, Sönmez IS. Prevalence of dental anxiety in 7- to 11-year-old children and its relationship to dental caries. Med Princ Pract. 2009;18(6):453-7. Epub 2009 Sep 30. PMID: 19797921.
• Akiskal HS, Hirschfeld RM, Yerevanian BI. The relationship of personality to affective disorders. Arch Gen Psychiatry. 1983 Jul;40(7):801-10. PMID: 6344834.
• Akiskal HS, Mallya G. Criteria for the “soft” bipolar spectrum: treatment implications. Psychopharmacol Bull. 1987;23(1):68-73. PMID: 3602332.
• Alwin N, Murray JJ, Niven N. The effect of children’s dental anxiety on the behaviour of a dentist. Int J Paediatr Dent. 1994 Mar;4(1):19-24. PMID: 7748843.
• Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Aust Dent J. 2013 Dec;58(4):390-407; quiz 531. PMID: 24320894.
• Asselmann E, Wittchen HU, Lieb R, Beesdo-Baum K. Sociodemographic, clinical, and functional long-term outcomes in adolescents and young adults with mental disorders. Acta Psychiatr Scand. 2018 Jan;137(1):6-17. PMID: 28861892.
• Avsar A, Mobaraki S. Pediatric Dentistry and Dental Anxiety. Turkish J of Health Science and Life 2020; 3(3): 19–25.
• Badin E, Alvarez E, Chu BC. Cognitive Behavioral Therapy for Child and Adolescent Anxiety. CBT in a Nutshell 2020; 41–71.
• Baumrind D. Patterns of parental authority and adolescent autonomy. New Dir Child Adolesc Dev. 2005 Summer;(108):61-9. PMID: 16121897.
• Bayrak S, Tunc E. Ebeveyn Dental Kaygısı ve Sosyodemografik Faktörlerin Çocukların Dental Kaygısı Üzerine Etkisi. Atatürk Univ. Dis Hek. Fak. 2010; 20(3): 181–188.
• Beck A, Weishaar M. Cognitive Theraphy. Comprehensive Handbook of Cognitive Theraphy. Plenum Press; 1989.
• Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am. 2009 Sep;32(3):483-524. PMID: 19716988.
• Beesdo-Baum K, Knappe S. Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am. 2012 Jul;21(3):457-78. PMID: 22800989.
• Buchanan H, Niven N. Validation of a Facial Image Scale to assess child dental anxiety. Int J Paediatr Dent. 2002 Jan;12(1):47-52. PMID: 11853248.
• Caspi A, Moffitt TE. All for One and One for All: Mental Disorders in One Dimension. Am J Psychiatry. 2018 Sep 1;175(9):831-844. PMID: 29621902; PMCID: PMC6120790.
• Cermak SA, Stein Duker LI, Williams ME, Lane CJ, Dawson ME, Borreson AE, Polido JC. Feasibility of a sensoryadapted dental environment for children with autism. Am J Occup Ther. 2015 May-Jun;69(3):6903220020p1-10. PMID: 25871593; PMCID: PMC4453036.
• Chapman HR, Kirby-Turner NC. Dental fear in children- -a proposed model. Br Dent J. 1999 Oct 23;187(8):408-12. PMID: 10715999.
• Colizzi M, Sironi E, Antonini F, Ciceri ML, Bovo C, Zoccante L. Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey. Brain Sci. 2020 Jun 3;10(6):341. PMID: 32503172.
• de Jongh A, Muris P, ter Horst G, Duyx MP. Acquisition and maintenance of dental anxiety: the role of conditioning experiences and cognitive factors. Behav Res Ther. 1995 Feb;33(2):205-10. PMID: 7887880.
• Esmali Kooraneh A, Amirsardari L. Predicting Early Maladaptive Schemas Using Baumrind’s Parenting Styles. Iran J Psychiatry Behav Sci. 2015 Jun;9(2):e952. PMID: 26288648.
• Firat D, Tunc EP, Sar V. Dental anxiety among adults in Turkey. J Contemp Dent Pract. 2006 Jul 1;7(3):75-82. PMID: 16820810.
• Friedberg RD. Pediatrician-friendly perspectives on cognitive behavioral therapy for anxious youth: Current status and clinical implications for the next normal. World J Clin Pediatr. 2021 Nov 9;10(6):112-123. PMID: 34868888.
• Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry. 2000 Apr;157(4 Suppl):1-45. PMID: 10767867.
• Hughes J, Kwok OM. Influence of Student-Teacher and Parent-Teacher Relationships on Lower Achieving Readers’ Engagement and Achievement in the Primary Grades. J Educ Psychol. 2007 Feb;99(1):39-51. PMID: 18084625.
• Işık E, Taner Y. Çocuk, Ergen ve Erişkinlerde Anksiyete Bozuklukları. Golden Print; 2006.
• Jeddy N, Nithya S, Radhika T, Jeddy N. Dental anxiety and influencing factors: A cross-sectional questionnaire-based survey. Indian J Dent Res. 2018 Jan-Feb;29(1):10-15. PMID: 29442080.
• Jeffrey D. McDonald and Avery’s Dentistry for the Child and Adolescent. Elsevier: 11th ed; 2021.
• Kaplan AS, Fishbein B. Integrating the dental phobic into the general dental practice. Dent Clin North Am. 1988 Oct;32(4):771-7. PMID: 2972571.
• Kendall PC, Kane M. Cognitive-Behavioral Treatment of Anxious Children: Treatment Manual. Ardmore, PA: Workbook Publishing. Ardmore, PA: Workbook Publishing; 2006.
• Kim H, Park KJ, Shin YW, Lee JS, Chung S, Lee T, Kim MJ, Jung J, Lee J, Yum MS, Lee BH, Koh KN, Ko TS, Lim E, Lee JS, Lee JY, Choi JY, Han HM, Shin WA, Lee NJ, Kim SH, Kim HW. Psychological Impact of Quarantine on Caregivers at a Children’s Hospital for Contact with Case of COVID-19. J Korean Med Sci. 2020 Jul 20;35(28):e255. PMID: 32686372; PMCID: PMC7371455.
• Kirbas ZO, Ozkan H. Determination of the state anxiety levels of 9-12 year-old children applying to oral and dental health center. Journal of Dr. Behcet Uz Children’s Hospital 2014; 4(2): 128–134.
• Klinberg G. Dental anxiety and behaviour management problems in paediatric dentistry--a review of background factors and diagnostics. Eur Arch Paediatr Dent. 2008 Feb;9 Suppl 1:11-5. PMID: 18328243.
• Klingberg G, Löfqvist LV, Hwang CP. Validity of the Children’s Dental Fear Picture test (CDFP). Eur J Oral Sci. 1995 Feb;103(1):55-60. PMID: 7600251.
• Kömerik N, Muğlalı M. Ağız Cerrahisinde Anksiyete Kontrolü: Hastaların Bilgilendirilmesi. Atatürk Üniv. Dis. Hek. Fak. 2005; 15(3): 25–33.
• Kothari S, Gurunathan D. Factors influencing anxiety levels in children undergoing dental treatment in an undergraduate clinic. J Family Med Prim Care. 2019 Jun;8(6):2036-2041. PMID: 31334176.
• Kroniņa L, Rasčevska M, Care R. Psychosocial factors correlated with children’s dental anxiety. Stomatologija. 2017;19(3):84-90. PMID: 29339671.
• Locker D, Liddell A, Dempster L, Shapiro D. Age of onset of dental anxiety. J Dent Res. 1999 Mar;78(3):790-6. PMID: 10096455.
• Murad MH, Ingle NA, Assery MK. Evaluating factors associated with fear and anxiety to dental treatment-A systematic review. J Family Med Prim Care. 2020 Sep 30;9(9):4530-4535. PMID: 33209758.
• Nikayin S, Rabiee A, Hashem MD, Huang M, Bienvenu OJ, Turnbull AE, Needham DM. Anxiety symptoms in survivors of critical illness: a systematic review and metaanalysis. Gen Hosp Psychiatry. 2016 Nov-Dec; 43:23-29. PMID: 27796253.
• Önçağ Ö. Ailenin Sosyoekonomik Durumu ve Eğitim Düzeyinin Çocuklarda Dental Kaygı Üzerine Etkisi 2005; 32(1), 45–54.
• Özcan Ö, Çelik G. Bilişsel Davranışçı Terapi. Türkiye Klinikleri J 2017; 3(2): 115–120.
• Panda PK, Gupta J, Chowdhury SR, Kumar R, Meena AK, Madaan P, Sharawat IK, Gulati S. Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis. J Trop Pediatr. 2021 Jan 29;67(1): 122. PMID: 33367907.
• Raadal M, Strand GV, Amarante EC, Kvale G. Relationship between caries prevalence at 5 years of age and dental anxiety at 10. Eur J Paediatr Dent. 2002 Mar;3(1):22-6. PMID: 12871013.
• Rajeswari SR, Chandrasekhar R, Vinay C, Uloopi KS, RojaRamya KS, Ramesh MV. Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children. Int J Clin Pediatr Dent. 2019 Sep-Oct;12(5):419-422. PMID: 32440048.
• Rantavuori K, Tolvanen M, Hausen H, Lahti S, Seppä L. Factors associated with different measures of dental fear among children at different ages. J Dent Child (Chic). 2009 Jan-Apr;76(1):13-9. PMID: 19341574.
• Rapee RM, Abbott MJ, Lyneham HJ. Bibliotherapy for children with anxiety disorders using written materials for parents: A randomized controlled trial. J Consult Clin Psychol. 2006 Jun;74(3):436-44. PMID: 16822101.
• Reddy RS, Kotha R, Pavani K, Subbarayudu G, Rajesh N, Sruthi, R. Dental anxiety – neglect of dental care. International Journal of Health 2015; 3(1): 20.
• Reinecke MA, Dattilio FM, Freeman A. Cognitive Therapy with Children and Adolescents: A Casebook for Clinical Practice. 2nd Edition. Can Child Adolesc Psychiatr Rev. 2005 Feb;14(1):32.
• Roza SJ, Hofstra MB, van der Ende J, Verhulst FC. Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: a 14- year follow-up during childhood, adolescence, and young adulthood. Am J Psychiatry. 2003 Dec;160(12):2116-21. PMID: 14638580.
• Rozenman M, Piacentini J, O’Neill J, Bergman RL, Chang S, Peris TS. Improvement in anxiety and depression symptoms following cognitive behavior therapy for pediatric obsessive compulsive disorder. Psychiatry Res. 2019 Jun; 276:115-123. PMID: 31075706.
• Sadat Sajadi F, Pishbin L, Hadi Azhari S, Moosazadeh M. Impact of Oral and Dental Health on Children’s and Parents’ Quality of Life Based on Early Childhood Oral Health Impact Scale (ECOHIS) Index. International Journal of Dental Sciences and Research 2015; 3(2): 28–31.
• Šarac Z, Zovko R, Ćurlin M, Filaković P. Dental Medicine and Psychiatry: The Need for Collaboration and Bridging the Professional Gap. Psychiatr Danub. 2020 Summer;32(2):151-158. PMID: 32796779.
• Seligman LD, Hovey JD, Chacon K, Ollendick TH. Dental anxiety: An understudied problem in youth. Clin Psychol Rev. 2017 Jul; 55:25-40. PMID: 28478271.
• Shahnavaz S, Hedman E, Grindefjord M, Reuterskiöld L, Dahllöf G. Cognitive Behavioral Therapy for Children with Dental Anxiety: A Randomized Controlled Trial. JDR Clin Trans Res. 2016 Oct;1(3):234-243. PMID: 29417092.
• Shapiro M, Melmed RN, Sgan-Cohen HD, Eli I, Parush S. Behavioural and physiological effect of dental environment sensory adaptation on children’s dental anxiety. Eur J Oral Sci. 2007 Dec;115(6):479-83. PMID: 18028056.
• Stabholz A, Peretz B. Dental anxiety among patients prior to different dental treatments. Int Dent J. 1999 Apr;49(2):90- 4. PMID: 10858738.
• Strawn JR, Lu L, Peris TS, Levine A, Walkup JT. Research Review: Pediatric anxiety disorders - what have we learnt in the last 10 years? J Child Psychol Psychiatry. 2021 Feb;62(2):114-139. PMID: 32500537.
• Strawn JR, Sakolsky DJ, Rynn MA. Psychopharmacologic treatment of children and adolescents with anxiety disorders. Child Adolesc Psychiatr Clin N Am. 2012 Jul;21(3):527- 39. PMID: 22800992.
• Torriani DD, Ferro RL, Bonow ML, Santos IS, Matijasevich A, Barros AJ, Demarco FF, Peres KG. Dental caries is associated with dental fear in childhood: findings from a birth cohort study. Caries Res. 2014;48(4):263-70. doi: 10.1159/000356306. PMID: 24503491.
• Türkçapar H, Öner P. Çocuk ve Ergenlerde Bilişsel Davranışçı Terapi: Anksiyete Bozuklukları. Kriz Dergisi 2008; 16(1): 11–18.
• Vehkalahti MM, Palotie U, Valaste M. Age-related variation in volume and content of restorative private dental care for adults in Finland in 2012-2017: A nationwide registerbased observation. J Dent. 2021 Jan; 104:103537. PMID: 33232773.
• Walsh. Anxiety prevention: Implementing the 4 S principle in conservative dentistry; 2007.
• Wehry AM, Beesdo-Baum K, Hennelly MM, Connolly SD, Strawn JR. Assessment and treatment of anxiety disorders in children and adolescents. Curr Psychiatry Rep. 2015 Jul;17(7):52. PMID: 25980507.
• Willumsen T, Agdal ML, Vika ME. Understanding Development and Persistence of Dental Anxiety; 2022; 167–177.
• Wright GZ, Alpern GD. Variables influencing children’s cooperative behavior at the first dental visit. ASDC J Dent Child. 1971 Mar-Apr;38(2):124-8. PMID: 4251281.
• Wu L, Gao X. Children’s dental fear and anxiety: exploring family related factors. BMC Oral Health. 2018 Jun 4;18(1):100. PMID: 29866080.
• Yahyaoğlu Ö, Baygın Ö. Çocuk Diş Hekimliğinde Diş Hekimi Kaygı ve Korkusunun Değerlendirilmesi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi; 2017.
• Yahyaoğlu Ö, Baygın Ö, Yahyaoğlu G, Tüzüner T. 6-12 Yaş Grubu Çocuklarda Diş Hekiminin Dış Görünüşünün Dental Durum ile İlişkisinin Değerlendirilmesi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2018; 292– 304.
• Yetıs C, Küçükeşmen Ç. Çocuk Hastalarda “Dental Kaygı ve Davranış Idaresı Problemlerının” Gorulme Sıklıgı ve Etıyolojık Faktorlerı. Balıkesir Sağlık Bil Dergisi 2013; 2(1): 62–68.