Universidade Federal de Goiás - UFG, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brasil.
Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte, MG, Brasil.
Braz Oral Res. 2022 May 2;36:e067. doi: 10.1590/1807-3107bor-2022.vol36.0067. eCollection 2022.
There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed to retrieve the scientific evidence comparing the results of dental anxiety measured by salivary biomarkers with patient-reported outcomes in pediatric dental setting. The PECOS was as follows: population: pediatric patients aged ≤ 18 years; exposure: patient-reported outcome measures, such as scales and/or questionnaires; comparator: salivary biomarkers; outcome: anxiety, fear, phobia or stress during dental treatment; study design: observational studies or controlled trials. Electronic searches were conducted in PubMed, Scopus, Web of Science, and Ovid databases. Studies that compared scales/questionnaires and salivary biomarkers for the evaluation of dental anxiety, fear, and stress in children/adolescents during dental treatment were included. Certainty of evidence was assessed with GRADE. Risk of bias of the included studies was assessed with the Cochrane tool or the University of Adelaide tool. From the 314 studies identified, eight were included. Participants' age ranged from three to 13 years. The most used salivary biomarkers and instruments were cortisol and the Dental Subscale of the Children's Fear Survey Schedule, respectively. Most studies showed a weak correlation between objective and subjective measures. The main issues regarding bias were on allocation concealment, blinding of assessors, follow up, and exposure assessment. Certainty of evidence was low/very low. Evidence of salivary biomarkers and patient-reported outcome measures to investigate anxiety, fear and stress in children during in the dental environment is limited. There was no correlation between subjective and objective measures in almost all included studies.
目前缺乏唾液生物标志物与儿童牙齿恐惧和焦虑的主观测量之间相关性的证据。本系统评价旨在检索将唾液生物标志物测量的焦虑与儿科牙科环境中患者报告的结果进行比较的科学证据。PECOS 如下：人群：≤ 18 岁的儿科患者；暴露：患者报告的结果测量，如量表和/或问卷；比较：唾液生物标志物；结果：在牙科治疗期间的焦虑、恐惧、恐惧症或压力；研究设计：观察性研究或对照试验。在 PubMed、Scopus、Web of Science 和 Ovid 数据库中进行了电子检索。纳入了比较量表/问卷和唾液生物标志物评估儿童/青少年在牙科治疗期间的牙齿焦虑、恐惧和压力的研究。使用 GRADE 评估证据的确定性。使用 Cochrane 工具或阿德莱德大学工具评估纳入研究的偏倚风险。从确定的 314 项研究中，纳入了 8 项。参与者的年龄从 3 岁到 13 岁不等。最常用的唾液生物标志物和仪器分别是皮质醇和儿童恐惧调查量表的牙科子量表。大多数研究表明客观和主观测量之间存在弱相关性。偏倚的主要问题在于分配隐藏、评估者盲法、随访和暴露评估。证据的确定性为低/非常低。用于在牙科环境中调查儿童焦虑、恐惧和压力的唾液生物标志物和患者报告的结果测量证据有限。几乎所有纳入的研究中，主观和客观测量之间都没有相关性。
