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Title Use of electronic screen media prior to dental appointment can help to reduce anxiety in patients with Autism Spectrum Disorder
Clinical Question Can use of electronic screen media prior to dental appointment help reduce anxiety in patients with Autism Spectrum Disorder?
Clinical Bottom Line For children with Autism Spectrum Disorder (ASD), certain types of electronic screen media may be helpful to reduce anxiety during dental appointments. This randomized controlled study based on 80 subjects found that electronic screen media could be used to reduce anxiety in children with ASD.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24391123Isong/ 201480 children (age range 7 to 17 years) with a known diagnosis of ASD and history of dental fear. Randomized Controlled Trial
Key resultsEach subject underwent 2 preventive dental visits 6 months apart (visit 1 and visit 2). After visit 1, the subjects were randomly assigned to 1 of 4 groups: 1) group A - control (usual care); 2) group B - treatment (video peer modeling that involved watching a DVD recording of a typically developing child undergoing a dental visit); 3) group C - treatment (video goggles that involved watching a favorite movie during the dental visit using sunglass-style video eyewear); and 4) group D - treatment (video peer monitoring and video goggles). The results showed that there were no significant differences in the baseline characteristics and the subjects’ cognitive ability (p= 0.79) across all groups. Between visits 1 and 2, mean anxiety and behavior scores decreased significantly by 0.9 points for subjects within group C (p= 0.03) and by 0.8 points (p= 0.03) for subjects within group D. There was no significant change in the mean anxiety and behavior scores for subjects in group A and group B. It was also noted that the mean anxiety and behavior scores were lower among subjects in group D who watched the peer modeling video multiple times.
Evidence Search children, autism, anxiety, dental, electronic screen media
Comments on
The Evidence
Validity: This pilot study was well designed. The authors have defined clear eligibility criteria and were able to randomly assign the subjects using the SAS- generated randomization scheme. The primary outcome, the level of anxiety, was measured using a standardized scale. There were 2 raters per subject and the average scores were recorded. However, the raters were not blinded to the assignment of the subjects and the study had a small sample size. Perspective: Children with ASD seem to learn better with visual aids and do better in a familiar environment. Use of electronic screen media as an educational tool for dental visits can be helpful to increase acceptance of dental treatment in this patient population. Further studies with larger sample sizes are needed to confirm the effectiveness of this intervention.
Applicability Children with ASD have increased dental needs. However, due to increased sensory stimulations in the dental setting, children with ASD are unable to undergo treatment with non-pharmacological techniques. These patients often require sedation or general anesthesia, which increases costs of treatment and exposes them to complications of sedation and general anesthesia. Furthermore, it restricts access to care since there are few trained providers. Use of electronic screen media can improve acceptance of dental treatment in these patients in the traditional dental setting.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry)
Keywords autism spectrum disorders; children; dental fear; electronic screen media
ID# 3390
Date of submission: 10/24/2019spacer
E-mail ashers@livemail.uthscsa.edu
Author Sheetal Asher, BDS, DMD
Co-author(s) Jayakumar Jayaraman, BDS, MDS, FDSRCS, PhD
Co-author(s) e-mail jayaraman@livemail.uthscsa.edu
Faculty mentor/Co-author Jeffery Mabry, DDS, MS
Faculty mentor/Co-author e-mail mabryj2@uthscsa.edu
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