Dental Anxiety Scales Used in Pediatric Dentistry: A Systematic Review and Meta-analysis

Abstract

Aim: To assess various dental anxiety scales used in children and to know the effectiveness of different projective dental anxiety scales used in pediatric dentistry. Background: Dental anxiety poses a significant problem in child patient management and is considered to be the main barrier for successful completion of the dental treatment. Review results: This systematic review and meta-analysis has been registered at the International prospective register of systematic reviews—PROSPERO—CRD42021247586. The systematic review was conducted in accordance with the Preferred Reporting Items in Systematic Review and Meta-Analysis (PRISMA) guidelines. Electronic databases [PubMed (MEDLINE), COCHRANE Library, EMBASE, EBSCO host, and Google Scholar database] were searched for corresponding references up to 2021. Observational cross-sectional studies comparing two different dental anxiety scales were selected for this systematic review. Search strategy generated 500 articles out of which 13 studies included in qualitative synthesis and only 7 studies were taken for quantitative synthesis. Among these seven studies, five studies compared FIS and VPT scales, two studies compared RMS, FIS, and VPT scales. Results of meta-analysis showed that an overall mean difference of dental anxiety between VPT and FIS scales was 0.11 (95% CI: 0.26–0.48), RMS and FIS scales was 0.05 (95% CI: 0.40–0.50), RMS and VPT was 0.27 (95% CI: 0.80–0.27) in the investigated population. Conclusion: No statistically significant difference was noted in all comparisons suggesting that all these scales are at par in assessing anxiety levels in pediatric population. Clinical significance: The projective scales Raghavendra, madhuriu, sujata pictorial scale (RMS), Facial image scale (FIS), and Venham’s picture test (VPT) can be a pragmatic tool in assessing children’s dental anxiety.