The effect of audio distraction in reducing signs of stress and anxiety during pediatric dental treatment: a systematic review and meta-analysis.

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Investigations Pub Date : 2025-01-13 DOI:10.1007/s00784-024-06035-0

Iago Ramirez, Caio Luiz Bitencourt Reis, Isabela Ribeiro Madalena, Flares Baratto Filho, Maria Angélica Hueb de Menezes Oliveira, Leonardo Santos Antunes, Lívia Azeredo Alves Antunes, Christian Kirschneck, Erika Calvano Küchler, Daniela Silva Barroso de Oliveira

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引用次数: 0

Abstract

Aim: To perform a systematic review to investigate if the use of audio distraction reduces signs of stress and anxiety in paediatric patients undergoing dental treatment.

Materials and methods: Search was made in electronic databases (MEDLINE, Scopus, Embase, Web of Science, Scielo, BVS, Springer Link, Science Direct, Cochrane Library, and grey literature) until March 11th, 2024. The eligibility criteria were: paediatric patients under dental treatment; use of audio as a distraction method; comparison between groups with and without use of audio distraction; Clinical trials. The outcomes measured were alterations in the anxiety, fear and/or stress levels. Evaluation of the risk of bias and assessment of the certainty of the evidence (GRADE) were performed. Meta-analysis was conducted for four outcomes, considering 95% confidence interval (CI), random effects and heterogeneity from Tau².

Results: From 5,495 results, 25 studies composed the narrative sample and 12 composed the meta-analysis. High risk of bias was generally observed. Three results from the meta-analysis showed high heterogeneity and some outcomes presented a statistical association: systolic blood pressure reduction (p = 0.52; CI= -6.05 [-7.50 to -4.60]), pulse rate (p < 0.00001; CI= -4.95 [-9.95 to -3.52]), Venham's test scores (p < 0.00001; CI= -1.24 [-1.79 to -0.68]), and oxygen saturation (p < 0.00001; CI = 0.14 [-0.04 to 0.33]). The outcomes presented "very low" and "low" certainty of evidence.

Conclusion: Although a low certainty of evidence was observed, our study suggests that audio may be an effective alternative for reducing stress and anxiety and pain perception during non-invasive treatments. Future well-designed studies are necessary.

Clinical relevance: Audio distraction presents a potential role as an efficient method to reduce stress in children undergoing dental treatment. More RCTs are necessary to improve the evidence level, considering the main variables related to audio distraction.

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在儿童牙科治疗过程中，音频干扰对减少压力和焦虑症状的影响：一项系统回顾和荟萃分析。

目的：进行一项系统性综述，研究使用音频分散注意力是否能减轻接受牙科治疗的儿科患者的紧张和焦虑症状：在电子数据库（MEDLINE、Scopus、Embase、Web of Science、Scielo、BVS、Springer Link、Science Direct、Cochrane Library 和灰色文献）中进行搜索，直至 2024 年 3 月 11 日。资格标准为：接受牙科治疗的儿科患者；使用音频作为分散注意力的方法；使用和不使用音频分散注意力组之间的比较；临床试验。测量结果为焦虑、恐惧和/或压力水平的变化。对偏倚风险进行了评估，并对证据的确定性进行了评估（GRADE）。对四项结果进行了 Meta 分析，考虑了 95% 置信区间 (CI)、随机效应和 Tau² 的异质性：在 5495 项研究结果中，25 项研究为叙述样本，12 项研究为元分析样本。研究普遍存在较高的偏倚风险。荟萃分析中的三项结果显示出较高的异质性，部分结果存在统计学关联：收缩压降低（p = 0.52；CI= -6.05 [-7.50 to -4.60]）、脉搏率（p虽然证据的确定性较低，但我们的研究表明，在非侵入性治疗过程中，音频可能是减轻压力、焦虑和疼痛感的有效替代方法。未来有必要开展设计良好的研究：临床相关性：音频分散注意力是一种有效的方法，可用于减轻接受牙科治疗的儿童的压力。考虑到与音频分散注意力相关的主要变量，有必要进行更多的 RCT 研究，以提高证据水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Oral Investigations 医学-牙科与口腔外科

CiteScore

6.30

自引率

5.90%

发文量

484

审稿时长

3 months

期刊介绍： The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.