Evaluation of The Role of Music and Bach Flower Remedies in The Management of Anxious Pediatric Dental Patients: A Randomised Clinical Trial

Year 2024, Volume: 14 Issue: 4, 882 - 888, 29.12.2024

Canan Bayraktar , Sümeyra Akkoç

https://doi.org/10.33808/clinexphealthsci.1485687

Abstract

Objective: Dental fear and anxiety describe negative feelings towards the dental environment, particularly significant in pediatric dentistry due to their cognitive, behavioral, and physical impacts on children. Managing this anxiety through positive dentist-child relationships and behavioral guidance techniques is crucial. This study aims to evaluate the effectiveness of passive distraction using music and Bach flower remedy in reducing dental fear and anxiety in children aged 6-8 years.
Methods: This randomized controlled clinical study included 12 children (n=4 for each group) aged 6-8 years, randomly assigned to Group 1 (control), Group 2 (Bach flower remedy), or Group 3 (passive distraction with music) for treating superficial dentin caries in primary teeth without local anesthesia. Dental fear and anxiety levels were assessed using objective (heart rate, oxygen saturation, systolic and diastolic blood pressure) and subjective (Facial Image Scale and Venham’s Picture Test) measures before and after treatment.
Results: The study included 12 children (6 female, 6 male) with a mean age of 7.3±0.8 years. In Group 2, heart rate significantly decreased after treatment (97.8 ± 10.1 to 90.5 ± 8.8, p<.05). However, no statistically significant differences were found between Groups 1, 2, and 3 in either objective or subjective measures when comparing before and after treatment results (p>.05).
Conclusion: In this study, although passive distraction with music and Bach flowers did not have a significant effect on physiological and projective measurement tools in children with dental fear and anxiety, a decrease in heart rate was observed in children exposed to Bach flowers.

Keywords

Dental fear, dental anxiety, bach flower remedy, passive distraction with music

Ethical Statement

This randomized controlled study protocol was approved by the Tokat Gaziosmanpaşa University Clinical Research Local Ethics Committee (Approval No. 22-KAEK-068 and dated 31.03.2022).

Supporting Institution

None

Thanks

None

References

• Morgan AG, Porritt JM. Background and prevalence of dental fear and anxiety. Campbell C, editor. Dental Fear and Anxiety in Pediatric Patients - Practical Strategies to Help Children Cope. Basel, Switzerland: Springer International Publishing; 2017.p.3-19.
• Alsaadoon AM, Sulimany AM, Hamdan HM, Murshid EZ. The use of a dental storybook as a dental anxiety reduction medium among pediatric patients: A randomized controlled clinical trial. Children. 2022; 9(3):328. DOI: 10.3390/children9030328
• Kasimoglu Y, Kocaaydin S, Karsli E, Esen M, Bektaş I, İnce G, Tuna EB. Robotic approach to the reduction of dental anxiety in children. Acta Odontol Scand. 2020;78(6):474-480. DOI: 10.1080/00016357.2020.1800084
• Janthasila N, Keeratisiroj O. Music therapy and aromatherapy on dental anxiety and fear: A randomized controlled trial. J Dent Sci. 2023;18(1):203-210. DOI: 10.1016/j.jds.2022.06.008
• Naithani M, Viswanath D. Child’s Dental Anxiety: Management by audio and audio-visual Distraction Technique–a comparative study. Univ Res J Dent. 2014;4(2):1-01. DOI: 10.4103/2249-9725.132974
• Gupta H, Gupta P. Evaluation of the role of music as a nonpharmacological technique in management of child patients. JCDP. 2017;18(3):194-197. DOI: 10.5005/jp-journals-10024-2015
• Arslan I, Aydinoglu S, Karan NB. Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial. Eur J Pediatr. 2020;179:985-992. DOI: 10.1007/s00431-020-03595-7
• Sadeghi M, Sarlak H, Nakhostin A, Almasi-Hashiani A. Which audio distraction technique is more effective for reduction the pain and anxiety of pediatric dental patients; “music” or “kids-story”? A randomized split-mouth crossover clinical trial. J Psychosom Res. 2023;168:111218. DOI: 10.1016/j.jpsychores.2023.111218
• Shekhar S, Suprabha B, Shenoy R, Rao A. Effect of active and passive distraction techniques while administering local anaesthesia on the dental anxiety, behaviour and pain levels of children: A randomised controlled trial. Eur Arch Paediatr Dent. 2022;23(3):417-427. DOI: 10.1007/s40368-022-00698-7
• Thakkar T, Naik S, Dixit U. Assessment of dental anxiety in children between 5 and 10 years of age in the presence of a therapy dog: A randomized controlled clinical study. Eur Arch Paediatr Dent. 2021;22:459-467. DOI: 10.1007/s40368-020-00583-1
• Dixit UB, Jasani RR. Comparison of the effectiveness of Bach flower therapy and music therapy on dental anxiety in pediatric patients: A randomized controlled study. J Indian Soc Pedod Prev Dent. 2020;38(1):71-78. DOI: 10.4103/JISPPD.JISPPD_229_19
• Serra-Negra J, Abreu M, Flores-Mendoza C, Brant M, Auad S. The reassuring role of music associated with the personality traits of children during dental care: A randomized clinical trial. Eur Arch Paediatr Dent. 2019;20:441-449. DOI: 10.1007/s40368-019-00422-y
• Ainscough S, Windsor L, Tahmassebi J. A review of the effect of music on dental anxiety in children. Eur Arch Paediatr Dent. 2019;20:23-26. DOI: 10.1007/s40368-018-0380-6
• Külhmann AR, van Rosmalen, J, Staals LM,, Keyzer-Dekker CM, Dogger J, de Leeuw TG, van Dijk M. Music interventions in pediatric surgery (the music under surgery in children study): A randomized clinical trial. Anesth Analg. 2020;130(4):991-1001. DOI: 10.1213/ANE.0000000000003983
• Wang X, Zhang J, Xi, H, Tan W, Liu Y, Wan J. Effectiveness of two distraction strategies in reducing preoperative anxiety in children in China: A randomized controlled trial. J. Pediatr. Nurs. 2023;68:e8-e15. DOI: 10.1016/j.pedn.2022.10.013
• Rocha MA, Queiroz CG, dos Santos KVG, dos Santos Dantas JK, de Araujo SCM, Dutra SVO, Dantas DV, Dantas RAN. Bach Flower Remedies as Complementary Therapies in Health Care: A Scope Review. Holist Nurs Pract. 2022;36(6):E64-E71. DOI: 10.1097/HNP.0000000000000552
• Beena J. Dental subscale of children′ s fear survey schedule and dental caries prevalence. Eur J Dent. 2013;7(02):181-185.
• Buchanan H, Niven N. Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent. 2002;12(1):47-52. DOI: 10.1046/j.0960-7439.2001.00322.x
• Venham LL, Gaulin-Kremer E, Munster E, Bengston-Audia D, Cohan J. Interval rating scales for children's dental anxiety and uncooperative behavior. Pediatr Dent. 1980; 2(3):195-202.
• Pradopo S, Sinaredi BR, Januarisca BV. Pandan leaves (Pandanus amaryllifolius) aromatherapy and relaxation music to reduce dental anxiety of pediatric patients. J Int Dent Med Res. 2017;10(3):933-937.
• Kaur R, Jindal R, Dua R, Mahajan S, Sethi K, Garg S. Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients. J Indian Soc Pedod Prev Dent. 2015;33(3):192-203. DOI: 10.4103/0970-4388.160357
• Prabhakar A, Marwah N, Raju O. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. J Indian Soc Pedod Prev Dent. 2007;25(4):177-182. DOI: 10.4103/0970-4388.37014
• Jindal R, Kaur R. Can we tune our pediatric patients? Int J Clin Pediatr Dent. 2011;4(3):186. DOI: 10.5005/jp-journals-10005-1107
• James J, Retnakumari N, Vadakkepurayil K, Thekkeveetil AK, Tom A. Effectiveness of aromatherapy and music distraction in managing pediatric dental anxiety: A comparative study. Int J Clin Pediatr Dent. 2021;14(2):249. DOI: 10.5005/jp-journals-10005-1911
• Singh D, Samadi F, Jaiswal J, Tripathi AM. Stress reduction through audio distraction in anxious pediatric dental patients: An adjunctive clinical study. Int J Clin Pediatr Dent. 2014;7(3):149. DOI: 10.5005/jp-journals-10005-1254
• Aitken JC, Wilson S, Coury D, Moursi AM. The effect of music distraction on pain, anxiety and behavior in pediatric dental patients. Pediatr Dent. 2002;24(2):114-118.
• Klein SA, Winkelstein ML. Enhancing pediatric health care with music. J Pediatr Health Care. 1996;10(2):74-81. DOI: 10.1016/S0891-5245(96)90030-9