Fakhruddin Kausar Sadia, Gorduysus Mehmet Omer, El Batawi Hisham
Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkiye.
Eur J Dent. 2016 Oct-Dec;10(4):551-555. doi: 10.4103/1305-7456.195159.
Assessing the effectiveness of behavioral modification techniques in combination with visual distraction with/without video eyewear using computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in hearing-impaired pediatric patients undergoing pulp therapy of primary molars.
This randomized, crossover clinical study includes 15 children (7 boys and 8 girls), mean age was 6.1 years. Children were randomly distributed into two groups (Group A, = 7; Group B, = 8). The study involved three sessions, 1-week apart. During Session I, employing Tell-Show-Do technique, prophylactic dental cleaning was done while participants were watching a movie with sign-language interpretation with/without visual eyewear. At the end of Session I, score on Smiley Faces Program was used for anxiety assessment. During Session II and III, respectively, both groups underwent pulp treatment of equivalent teeth in the opposite sides of the mouth with/without video eyewear vice versa. After the procedure, children were instructed to rate their pain during treatment on the Wong-Bakers' (WBs') Faces Pain Scale. Changes in pulse oximeter and heart rate were recorded every 5 min. Paired sample -test and independent sample -test were used to assess the significance of changes during each visit.
There was a significant ( > 0.04) change in the heart rate observed for Group A underwent pulp treatment while watching video using video eyewear. Self-reported mean pain score also increases during treatment sessions' with video eyewear, for both groups.
Routine psychological (Tell-Show-Do) intervention along with visual distraction with full visibility of the surrounding and use of CDS-IS system for anesthetic delivery is recommended as an effective behavior management technique for children with hearing impairment undergoing invasive dental treatment.
评估行为矫正技术结合使用/不使用视频眼镜进行视觉分心,并通过计算机化给药系统-龈沟内给药(CDS-IS),在对患有听力障碍的小儿患者进行乳磨牙牙髓治疗时局部麻醉应用中的有效性。
这项随机交叉临床研究纳入了15名儿童(7名男孩和8名女孩),平均年龄为6.1岁。儿童被随机分为两组(A组,n = 7;B组,n = 8)。该研究包括三个阶段,相隔1周。在第一阶段,采用告知-展示-做技术,在参与者观看有/无视觉眼镜的有手语翻译的电影时进行预防性牙齿清洁。在第一阶段结束时,使用笑脸程序评分进行焦虑评估。在第二阶段和第三阶段,两组分别在口腔对侧进行同等牙齿的牙髓治疗,有/无视频眼镜反之亦然。手术后,指导儿童在Wong-Bakers(WBs)面部疼痛量表上对治疗期间的疼痛进行评分。每5分钟记录一次脉搏血氧饱和度和心率的变化。配对样本t检验和独立样本t检验用于评估每次就诊期间变化的显著性。
A组在使用视频眼镜观看视频时进行牙髓治疗,观察到心率有显著(P>0.04)变化。两组在使用视频眼镜的治疗期间,自我报告的平均疼痛评分也有所增加。
建议将常规心理(告知-展示-做)干预与周围环境完全可见的视觉分心以及使用CDS-IS系统进行麻醉给药相结合,作为对接受侵入性牙科治疗的听力障碍儿童有效的行为管理技术。