AL KHAFJI NATIONAL

HOSPITAL

"Enhancing Pediatric Dental Care:

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 BACKGROUND
Pediatric patients in a dental setting require special care and attention due to their
young age and potential anxiety or fear associated with dental procedures. It is
important to accurately identify and address dental fear/anxiety in children before
conducting any studies related to treatment duration (Jamali et al., 2018).
Children's fear and anxiety towards dental visits can significantly impact their
behavior and cooperation during dental treatment. Several studies have
highlighted the prevalence and impact of anxiety in children during dental visits.
For example, a study by El-Housseiny et al. found that 20% of children exhibited
dental anxiety, which was associated with negative behavior during dental
treatment. Additionally, a study by ten Berge et al. reported that children with high
dental anxiety required longer treatment durations and displayed more dental fear-
related behavior.

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 BACKGROUND
Moreover, the development of dental fear in children can be influenced by
various factors, including general fears, maternal dental fear, and age (Klingberg
et al., 1995).
Furthermore, a study by Klingberg et al. emphasized the importance of early
identification and management of dental anxiety in children, as it can have long-
term implications for their oral health and future dental visits. Additionally, a
systematic review by Armfield, Spencer, and Stewart provided insights into
various factors contributing to children's dental anxiety, emphasizing the need for
tailored approaches to address this issue.
These studies underscore the significance of addressing children's anxiety in the
dental setting and implementing strategies to alleviate their fears for improved
treatment outcomes and overall well-being.
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 STATEMENT OF THE PURPOSE
The purpose of this evidence-based practice study for Effectively Handling
Pediatric Patient in Dental Setting is to address the specific needs of pediatric
patients in a dental setting, particularly focusing on the identification and
management of dental fear and anxiety in children.
By conducting this research, we aim to develop tailored approaches and
strategies to alleviate children's fears and anxieties during dental visits, ultimately
improving treatment outcomes and overall well-being. By accurately identifying
and addressing dental fear/anxiety in children, we can create a more positive and
comfortable environment for them, leading to increased cooperation and better
oral health outcomes (Jamali et al., 2018).

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 STATEMENT OF THE PURPOSE
It also seeks to build upon existing evidence and research findings to provide a
comprehensive understanding of the factors contributing to children's dental
anxiety and the impact it has on their behavior and cooperation during dental
treatment. By doing so, we aim to establish evidence-based protocols and
interventions that can effectively address and mitigate dental anxiety in pediatric
patients.
Through this EBP study, we endeavor to equip dental professionals with
evidence-based guidelines and best practices for identifying, assessing, and
managing dental fear and anxiety in children. By implementing these evidence-
based strategies, we aspire to create a more supportive and positive dental
experience for pediatric patients, ultimately promoting long-term oral health and
reducing the negative impact of dental anxiety on future dental visits.

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 PICO QUESTIONS
PICO Population/ INTERVENTION COMPARISON OUTCOME
Patient/Problem
How would I What main Is there an alternative to compare with the What do I hope to
describe the intervention, intervention? accomplish, measure,
Guide
problem or a group prognostic factor or improve or affect?
Question
of patients similar exposure am I
to mine? considering?
1. Pediatric dental Implementation Standard care without specific Decreased levels of
patients with of evidence- anxiety management interventions anxiety, improved
dental anxiety based non- treatment outcomes,
pharmacological and increased
anxiety patient satisfaction
management
techniques

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 SUMMARY OF FINDINGS
The study reviewed various non-pharmacological techniques for managing fear and
anxiety in the dental clinic. These techniques ranged from good communication and
establishing rapport to more specialized approaches such as systematic desensitization
and hypnosis. The importance of identifying and understanding the nature of dental fear
was emphasized, as well as the need for tailored treatment approaches based on
individual patient concerns.
The findings highlighted the effectiveness of techniques such as relaxation breathing,
progressive muscle relaxation, distraction, and cognitive restructuring in reducing anxiety.
The study also discussed the importance of patient engagement, scheduling
appointments at optimal times, and creating a supportive clinic environment to manage
dental fear and anxiety.
Overall, the study emphasized the importance of a comprehensive and tailored approach
to managing dental fear and anxiety, with the ultimate goal of improving patient outcomes
and promoting oral health.

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 RECOMMENDATIONS
Based on the findings of the study, it is recommended that dental practitioners adopt a
comprehensive approach to managing fear and anxiety in the dental clinic. Some key
recommendations include:
1. Utilize non-pharmacological techniques: Implement non-pharmacological
approaches such as relaxation breathing, progressive muscle relaxation, distraction,
and cognitive restructuring to help reduce anxiety in fearful patients.
2. Establish good communication and rapport: Focus on building trust and
understanding with patients through effective communication, empathy, and active
listening. This can help alleviate patient anxiety and enhance the overall treatment
experience.
3. Tailor treatment approaches: Individualize treatment plans based on the specific
fears and concerns of each patient. Phased treatment, flexible scheduling, and
gradual exposure to feared stimuli can help patients with varying levels of dental
anxiety progress through their treatment.
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 RECOMMENDATIONS
4. Create a supportive clinic environment: Consider implementing strategies to
enhance the clinic environment, such as using calming scents, providing
distractions, and maintaining a welcoming and comfortable atmosphere to
reduce anxiety levels in patients.
5. Continuously assess and adjust: Regularly evaluate the effectiveness of
anxiety management techniques and be open to adjusting strategies based
on patient feedback and needs. Flexibility and responsiveness to individual
patient concerns are key in successfully managing dental fear and anxiety.
By incorporating these recommendations into clinical practice, dental
practitioners can better support patients with dental fear and anxiety, improve
treatment outcomes, and promote positive experiences in the dental setting.

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 IMPLICATION OF THE EVIDENCE
The findings of the study have several implications for dental nursing practice:
1. Patient-centered care: Dental nurses can apply non-pharmacological anxiety
management techniques, such as relaxation breathing and distraction, to
provide patient-centered care and support anxious individuals during dental
procedures. By incorporating these techniques, dental nurses can help create
a more comfortable and positive experience for patients.
2. Communication and rapport building: Effective communication and
establishing rapport with patients are essential aspects of dental nursing
practice. Dental nurses can enhance patient trust and comfort by using
empathetic communication skills, active listening, and clear explanations of
procedures to alleviate anxiety and fear.

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 IMPLICATION OF THE EVIDENCE
The findings of the study have several implications for dental nursing practice:
3. Collaborative approach: Dental nurses can work collaboratively with dental
practitioners to implement tailored anxiety management strategies based on
individual patient needs. By actively participating in treatment planning and
providing continuous support, dental nurses can contribute to a more holistic
and patient-focused approach to care.
4. Clinic environment: Dental nurses can assist in creating a supportive and
calming clinic environment by ensuring the waiting area is welcoming,
implementing relaxation techniques, and utilizing sensory distractions to help
reduce patient anxiety. A comfortable and soothing environment can
positively impact the overall patient experience.

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 MEASUREMENT
Key Performance Indicator (KPI):
Percentage of Patients Reporting Reduced Anxiety Levels after Implementing
Non-Pharmacological Anxiety Management Techniques
Measurement Method:
1. Baseline Assessment: Conduct a survey or use dental anxiety scales (e.g.,
MDAS, IDAF-4C+) to assess the pre-intervention anxiety levels of patients
presenting with dental fear.
2. Intervention Implementation: Implement non-pharmacological anxiety
management techniques identified in the study, such as relaxation breathing,
progressive muscle relaxation, distraction, and cognitive restructuring, during
patient appointments.

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 MEASUREMENT
3. Post-Intervention Assessment: Reassess patient anxiety levels using the
same survey or anxiety scales post-treatment to determine any changes in
anxiety levels.
4. Calculate Percentage: Calculate the percentage of patients who report a
reduction in anxiety levels after the implementation of non-pharmacological
techniques compared to baseline levels.
5. Analysis and Interpretation: Analyze the data collected and assess the
effectiveness of the evidence-based anxiety management techniques in
reducing patient anxiety.

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 MEASUREMENT
Target Benchmark:
Target: Achieve a minimum of a 20% reduction in anxiety levels post-intervention
compared to baseline levels.
Benchmark: Aim for at least a 50% reduction in anxiety levels post-intervention to
demonstrate a significant impact on patient anxiety management.
Regular monitoring and tracking of this KPI will provide insights into the
effectiveness of implementing evidence-based non-pharmacological anxiety
management techniques in dental practice and help assess the impact on patient
outcomes.

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 REFERENCES
Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: a review.
Aust Dent J. 2013 Dec;58(4):390-407; quiz 531. doi: 10.1111/adj.12118. PMID:
24320894.
Jamali, Z., Najafpour, E., Adhami, Z E., Deljavan, A S., Aminabadi, N A., & Shirazi, S.
(2018, March 14). Does the length of dental treatment influence children’s behaviour
during and after treatment? A systematic review and critical appraisal.
https://doi.org/10.15171/joddd.2018.011
Klingberg, G., Berggren, U., Carlsson, S., & Norén, J G. (1995, December 1). Child
dental fear: cause‐related factors and clinical effects. https://doi.org/10.1111/j.1600-
0722.1995.tb01865.x

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