Massouda Jacqueline, Ghaltakhchyan Nare, Judd Jennifer, Bocklage Clare, Selden Raven, TumSuden Olivia, Nanney Eleanor, Lee Jessica, Ginnis Jeannie, Strauman Timothy, Sawicki Caroline, Hodges Eric A, Graves Christina, Divaris Kimon, Jacox Laura
J Am Dent Assoc. 2025 Jun;156(6):447-457.e14. doi: 10.1016/j.adaj.2025.03.006.
An estimated 6% through 22% of children have dental anxiety, which can contribute to disruptive behavior and oral health care avoidance. Evidence from medical settings indicate reductions in pain and stress after therapy dog implementation. To identify a low-risk, nonpharmacologic approach for anxiety and pain management in dentistry, a pilot prospective clinical trial was conducted to determine best practices for evaluating the efficacy of animal-assisted therapy (AAT).
The effects of AAT on pediatric patients were measured through physiological, objective measures (ie, heart rate, salivary cortisol and α-amylase, and video coding) and validated self-reported scales of anxiety, fear, and pain, during an invasive dental procedure. Children aged 7 through 14 years were consecutively enrolled into an AAT (n = 18) or control (n = 21) group. Participants underwent an operative or surgical (eg, extraction) dental procedure. Descriptive and bivariate statistics were used.
Participants in the AAT group reported significantly less postoperative pain than those in the control group (P = .001). The heart rates of AAT participants dropped after key events and had less variation than control participants. Objective video coding revealed that AAT participants had significantly longer durations of relaxed lower bodies than control participants (P = .204). No differences were seen in salivary cortisol and α-amylase. These physiological and self-report measures are feasible for use in future studies.
AAT may be an effective therapy for alleviating anxiety and pain in pediatric dental patients and warrants additional study using both objective physiological end points and subjective self-report measures.
Pending further research, canine therapy may be a valuable addition to dental clinics for anxiety and pain management. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT04708028.
据估计，6%至22%的儿童存在牙科焦虑，这可能导致行为干扰和规避口腔保健。医疗环境中的证据表明，实施治疗犬后疼痛和压力有所减轻。为了确定一种用于牙科焦虑和疼痛管理的低风险、非药物方法，开展了一项前瞻性临床试验，以确定评估动物辅助治疗（AAT）疗效的最佳实践。
在侵入性牙科手术期间，通过生理客观指标（即心率、唾液皮质醇和α-淀粉酶以及视频编码）以及经过验证的焦虑、恐惧和疼痛自我报告量表，来衡量AAT对儿科患者的影响。7至14岁的儿童被连续纳入AAT组（n = 18）或对照组（n = 21）。参与者接受了手术或外科（如拔牙）牙科手术。使用了描述性和双变量统计方法。
AAT组参与者报告的术后疼痛明显少于对照组（P = .001）。AAT参与者在关键事件后心率下降，且波动小于对照组参与者。客观视频编码显示，AAT参与者放松下半身的持续时间明显长于对照组参与者（P = .204）。唾液皮质醇和α-淀粉酶未见差异。这些生理和自我报告指标可用于未来的研究。
AAT可能是缓解儿科牙科患者焦虑和疼痛的有效疗法，值得使用客观生理终点和主观自我报告指标进行进一步研究。
在进一步研究之前，犬类治疗可能是牙科诊所焦虑和疼痛管理的一项有价值的补充。本临床试验已在ClinicalTrials.gov注册。注册号为NCT04708028。
