Psychological Stress in Children who Cooperate with Dental Treatment

Objectives: The psychological stress among children who cooperate with dental treatment has not been elucidated. In this study, we assessed the psychological stress, anxiety, and dental fear in cooperative pediatric dental patients; we also assessed the influence of their mothers' anxiety. Methods: We selected 24 pediatric patients who received noninvasive dental treatment from certified pediatric dentists and adapted to the treatment (age, 7–12 years; 12 boys, 12 girls; average age, 9.0 years). To assess psychological stress, salivary alpha-amylase activity (s-AMY) was measured before and immediately after the treatment. The patients were scored on the State Trait Anxiety Inventory-Children Trait (STAI-CT) before treatment and on the STAI-Children State (STAI-CS) before and after treatment, while their mothers were scored on the STAI-Trait (STAI-T) before treatment and on the STAI-State (STAI-S) before and after treatment. The patients were grouped on the basis of the differences in the s-AMY values: increased postoperative s-AMY value (IA group; N=11) or decreased postoperative s-AMY value (DA group; N=13). The STAI-CT and STAI-CS scores, Dental Sub-scale of Children's Fear Survey Schedule (CFSS-DS) scores, treatment time, and number of visits to dentists were compared using Student's t-test. Results: Age and gender composition of the groups were not significantly different. The STAI-CT scores of IA-group patients were significantly higher than those of DA-group patients (P=0.019). No significant intergroup differences were observed in pretreatment STAI-CS and posttreatment STAI-CS scores, CFSS-DS score, treatment time, or number of visits (P=0.985, 0.483, 0.699, 0.608 and 0.307, respectively). No significant intergroup correlation was observed between pretreatment STAI-CS and STAI-S scores. Conclusion: Even in pediatric patients who cooperate with dental treatment, higher levels of anxiety may influence the psychological stress during the procedure. However, the influence of mothers' anxiety on the children's anxiety was not observed. Support: Grant-in-Aid for Young Scientists (No.20890239).