Behavioural and physiological outcomes of biofeedback therapy on dental anxiety of children undergoing restorations: a randomised controlled trial
To explore the efficacy of biofeedback as possible alternative means of psychological behaviour guidance in children receiving dental restorations.
Randomised clinical trial with a cross over design carried out on 40 children (19 boys and 21 girls) to determine the efficacy of biofeedback in reducing the dental anxiety through subjective and objective measures during restorative treatments under cotton roll isolation without administration of local analgesia.
Highly anxious children with a minimum of five carious lesions were trained to lower their anxiety using biofeedback in five sessions within a 4-week interval, each session lasting for 45 min. After initial training, children were randomly divided into two groups and restorations were placed in four sequential therapeutic sessions with a 1-week interval and a follow-up visit 3 months later. First group received biofeedback in the second and third sessions; whereas the second group received biofeedback in the first and third sessions.
Biofeedback therapy in children led to lower levels of anxiety in the initial appointments when assessed objectively, however the subjective methods of evaluation could not depict any statistically significant difference.
Biofeedback can be used in the initial visits for dentally anxious children and the usage of simpler biofeedback machines for these appointments in dental setup is suggested.
KeywordsBiofeedback Behaviour guidance Children’s dental anxiety
We would like to acknowledge the help of the Department of Psychiatry, Narayana Medical College, Nellore for their technical assistance.
- Bowers D. Doing it right first time—designing a study. In: Medical statistics from scratch. 2nd ed. England: Wiley; 2008. p. 71–90.Google Scholar
- Gordon D, Heimberg RG, Tellez-Merchan M, Ismail AI. A critical review of approaches to the treatment of dental anxiety in adults. J Anxiet Disord. 2013. doi: 10.1016/j.janxdis.2013.04.002.
- Nolan RP, Kamath MV, Floras JS et al. Heart rate variability biofeedback as a behavioral neurocardiac intervention to enhance vagal heart rate control. Am Heart J. 2005;149:1137.e 1–7.Google Scholar
- Peper E, Harvey R, Takabayashi N. Biofeedback an evidence based approach in clinical practice. Jpn J Biofeedback Res. 2009;36:3–10.Google Scholar
- Sowjanya V, Tandon S, Tharian E. Physiological response to dental anxiety in children. J Indian Soc Pedo Prev Dent. 1995;13:13–7.Google Scholar
- Strickland BR, editor. Biofeedback: the gale encyclopedia of psychology. 2nd ed. Detroit: Gale; 2001. p. 77–8.Google Scholar