Gomes Heloisa Sousa, Viana Karolline Alves, Batista Aline Carvalho, Costa Luciane Rezende, Hosey Marie Therese, Newton Tim
Dentistry Graduate Program, Universidade Federal de Goiás, Goiânia, Brazil.
Departamento de Estomatologia (Patologia Oral), Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia, Brazil.
Int J Paediatr Dent. 2018 Jul 8. doi: 10.1111/ipd.12405.
There is a paucity of evidence about cognitive behaviour therapy in the management of dentally anxious children.
To systematically review evidence of the effectiveness of cognitive behaviour therapy for children with dental anxiety or dental phobia.
Clinical trial registries, grey literature, and electronic databases, including The Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, LILACS/BBO, and PsycINFO, were searched (April 2018). The reference lists of relevant studies were hand-searched. Randomised controlled trials that evaluated the effects of cognitive behaviour therapy on dental anxiety or on acceptance of dental treatment in dental patients up to 18 years were included. Two trained and calibrated reviewers performed the study selection and risk of bias assessment. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Six studies with a total of 269 patients, aged 41 months to 18 years, were included. Cognitive behaviour therapy decreased level of anxiety compared to control groups and improved cooperation/behaviour, although the quality of the evidence was low.
Cognitive behaviour therapy produces better anxiety reduction than diverse behavioural management techniques but the evidence was of low quality and further studies in children are needed.
关于认知行为疗法在治疗牙科焦虑儿童方面的证据不足。
系统评价认知行为疗法对患有牙科焦虑或牙科恐惧症儿童的有效性证据。
检索了临床试验注册库、灰色文献和电子数据库，包括Cochrane图书馆、EMBASE、PubMed、Scopus、科学网、LILACS/BBO和PsycINFO（2018年4月）。手工检索了相关研究的参考文献列表。纳入了评估认知行为疗法对18岁以下牙科患者的牙科焦虑或接受牙科治疗影响的随机对照试验。两名经过培训和校准的评审员进行了研究选择和偏倚风险评估。使用推荐分级评估、制定和评价（GRADE）对证据质量进行了评估。
纳入了6项研究，共269例患者，年龄在41个月至18岁之间。与对照组相比，认知行为疗法降低了焦虑水平，改善了合作/行为，尽管证据质量较低。
与多种行为管理技术相比，认知行为疗法在减轻焦虑方面效果更好，但证据质量较低，需要对儿童进行进一步研究。
