Pisano Massimo, Bramanti Alessia, De Benedetto Giuseppina, Martin Carreras-Presas Carmen, Di Spirito Federica
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081 Baronissi, Italy.
Oral Medicine Unit, Department of Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain.
Children (Basel). 2024 Sep 2;11(9):1077. doi: 10.3390/children11091077.
A Special Health Care Need (SHCN) is characterized by any type of physical, mental, sensorial, cognitive, emotional, or developmental condition that requires medical treatment, specialized services, or healthcare interventions. These conditions can negatively impact oral health as SHCN children can hardly cooperate or communicate and experience higher levels of dental fear/anxiety, which interfere with regular appointments. The present narrative review aims to analyze the use of audiovisual (AV) tools in dental setting for the management of SHCN children during dental treatment and to evaluate their effectiveness in anxiety/behavior control from the child, dentist, and care-giver perspectives. This analysis leads to the proposal of a new multi-session model for the behavioral management of SHCN pediatric subjects.
An electronic search on the MEDLINE/Pubmed, Scopus, and Web of Science databases was carried out and through this analysis, a new model was proposed, the "UNISA-Virtual Stepwise Distraction model", a multi-session workflow combining traditional behavior management and the progressive introduction of AV media to familiarize the SHCN child with dental setting and manage behavior.
AV tools helped in most cases to manage SHCN behavior and decreased stress in both the dentist and child during dental treatments. Care-givers also welcomed AV distractors, reporting positive feedback in using them during future treatments.
The present narrative review found increasing evidence of the use of AV media for SHCN pediatric subjects as distraction tools during dental treatment. In the majority of the studies, AV tools proved to be effective for the management of anxiety, dental fear, and behavior in dental setting.
特殊医疗保健需求（SHCN）的特征是任何类型的身体、心理、感官、认知、情感或发育状况，需要医疗治疗、专门服务或医疗保健干预。这些状况会对口腔健康产生负面影响，因为有特殊医疗保健需求的儿童很难配合或沟通，并且有更高程度的牙科恐惧/焦虑，这会干扰定期就诊。本叙述性综述旨在分析在牙科治疗中使用视听（AV）工具来管理有特殊医疗保健需求的儿童，并从儿童、牙医和护理人员的角度评估其在控制焦虑/行为方面的有效性。该分析促成了一种针对有特殊医疗保健需求的儿科患者行为管理的新多阶段模型的提出。
对MEDLINE/Pubmed、Scopus和科学网数据库进行了电子检索，并通过该分析提出了一个新模型，即“萨勒诺大学虚拟逐步分心模型”，这是一种多阶段工作流程，结合了传统行为管理和逐步引入视听媒体，以使有特殊医疗保健需求的儿童熟悉牙科环境并管理其行为。
在大多数情况下，视听工具有助于管理有特殊医疗保健需求儿童的行为，并在牙科治疗期间减轻了牙医和儿童的压力。护理人员也欢迎使用视听分心工具，并报告在未来治疗中使用它们时得到了积极反馈。
本叙述性综述发现越来越多的证据表明，在牙科治疗期间，视听媒体可作为有特殊医疗保健需求的儿科患者的分心工具。在大多数研究中，视听工具被证明在牙科环境中对管理焦虑、牙科恐惧和行为有效。
