Unnikrishnan Greeshma, Singh Abhinav, Purohit Bharathi M
Department of Dentistry, Regional Training Centre for Oral Health Promotion (RTCOHP), All India Institute of Medical Sciences(AIIMS), Bhopal, India.
Department of Dentistry, Regional Training Centre for Oral Health Promotion (RTCOHP), All India Institute of Medical Sciences (AIIMS), Bhopal, India.
Evid Based Dent. 2025 Mar;26(1):70-71. doi: 10.1038/s41432-024-01081-9. Epub 2024 Nov 6.
The study aims to compare the effectiveness of behavioural therapy and inhalational sedation in reducing dental anxiety among patients visiting dental clinics.
A search was conducted in PubMed, Cochrane databases, Scopus, and Google scholar through August 2024. All the randomized control trials, cohort studies, case control, cross-sectional studies that evaluated the effectiveness of behavioural therapy with inhalational/conscious sedation among children and adults to reduce dental anxiety were included. Outcome assessed was change in the dental anxiety scores as measured by the validated tools. PRISMA guidelines were followed for the meta-analysis. Meta-analysis was conducted using Cochrane Review Manager (Revman) version 5.3. Random effects model was used to compare the two groups in reducing dental anxiety. Quality of the studies included was evaluated using the Risk of Bias Assessment tool and Newcastle-Ottawa tool. Heterogeneity was assessed using I values. Certainty of evidence was assessed using GRADE pro software. The protocol was registered in PROSPERO (CRD-NIHR) database with Reference ID CRD42024581013.
A total of 940 participants were included in the analysis. Behavioural therapy was significantly more effective than inhalational sedation in reducing dental anxiety among patients prior to the dental treatment (SMD: -0.87; 95% CI: -1.29 to -0.45; P < 0.0001; I:78%). Additionally, behavioural therapy demonstrated more effectiveness than inhalational sedation in reducing the dental anxiety among children (SMD: -0.64; 95% CI: -1.16 to -0.11, P = 0.02%; I:88%). Certainty of evidence was high among the randomized controlled trials and moderate among the observational studies.
The findings of this review and meta-analysis suggests that behavioural therapy is more effective than inhalational sedation in reducing dental anxiety specifically among children.
本研究旨在比较行为疗法和吸入镇静在降低前往牙科诊所就诊患者的牙科焦虑方面的效果。
截至2024年8月，在PubMed、Cochrane数据库、Scopus和谷歌学术上进行了检索。纳入了所有评估行为疗法联合吸入/清醒镇静在儿童和成人中降低牙科焦虑效果的随机对照试验、队列研究、病例对照研究和横断面研究。评估的结局是通过经过验证的工具测量的牙科焦虑评分的变化。荟萃分析遵循PRISMA指南。使用Cochrane综述管理器（Revman）5.3版进行荟萃分析。采用随机效应模型比较两组在降低牙科焦虑方面的效果。使用偏倚风险评估工具和纽卡斯尔-渥太华工具评估纳入研究的质量。使用I值评估异质性。使用GRADE pro软件评估证据的确定性。该方案已在PROSPERO（CRD-NIHR）数据库中注册，参考编号为CRD42024581013。
共有940名参与者纳入分析。在牙科治疗前，行为疗法在降低患者牙科焦虑方面比吸入镇静显著更有效（标准化均数差：-0.87；95%置信区间：-1.29至-0.45；P＜0.0001；I²：78%）。此外，行为疗法在降低儿童牙科焦虑方面比吸入镇静更有效（标准化均数差：-0.64；95%置信区间：-1.16至-0.11，P = 0.02%；I²：88%）。随机对照试验中的证据确定性高，观察性研究中的证据确定性中等。
本综述和荟萃分析的结果表明，行为疗法在降低牙科焦虑方面，特别是在儿童中，比吸入镇静更有效。
