Evaluating the Effects of Animal Therapy on Anxiety in Pediatric Dental Patients

抽象的。 牙科焦虑症(DA)影响50%-80%的成年人和6%-22%的儿童。受DA影响的个人经常 表现出破坏性行为和避免牙科护理，导致重大不良健康后果，包括 腐烂、疼痛、拔牙、感染、紧急护理甚至住院的比率增加。经常出现DA 由于创伤经历而在童年发展，并可导致终生DA。行为管理 在儿童时期必须使用旨在改善牙科体验的技术，以避免出现这种情况 后遗症。对于严重焦虑和衰弱的患者，可以使用药物干预。然而， 镇静剂和全身麻醉经常遭到照顾者的反对，因为它们对 不良事件，包括神经损伤和死亡。经过训练的动物辅助疗法(AAT) 狗作为一种非药理学的行为指导方法已经被广泛地应用于许多医疗环境中。 虽然AAT在牙科领域还处于初级阶段，但在儿科人群中的新应用有望为 行为管理，减少焦虑，减轻痛苦，并建立积极的联系。此外，我们的 来自800名患者和父母的数据证实了牙科领域对犬类AAT的普遍需求。这样做的目的是 这项研究旨在评估AAT是否能缓解儿童牙科护理期间的压力并改善人们的认知。我们 假设AAT显著减轻焦虑和疼痛的生物测定和自我报告的测量 儿童牙科患者(相对测量改善20%)。我们建议评估以下措施的效果 AAT关于使用唾液应激激素预防性治疗期间应激和疼痛的客观测量， 心率、出汗反应和观察性编码数据(目标1)以及患者对牙齿的感知 疼痛、焦虑和通过有效问卷进行的未来访问(目标2)。作为正在进行的随机临床试验的一部分 试验中，数据收集自患者(4-7岁)，随机分为短AAT方案、长AAT方案 主动对照加牙科检查和清洁(N=180，每组60人)。总之，从以下方面生成的数据 这些目标将被用来衡量AAT对儿童牙科患者的影响，以指导实施。 这个二次数据分析项目将为AAT产生可行的、快速实施的协议的结果 在牙科中用于缓解DA和改善体验，减少牙齿回避及其显著的健康 后遗症。我们的跨学科团队是唯一有资格进行拟议工作的团队，因为我们拥有 创新的方法、随机对照试验患者数据和样本、BLS2设施和专业知识，以实现我们的目标。 此应用程序包括跨多个学科的资深和初级教员之间的协作，以 确保我们调查结果的严谨性和可译性。

ABSTRACT. Dental anxiety (DA) affects a striking 50-80% of adults and 6-22% of children. Individuals affected by DA often exhibit disruptive behavior and avoidance of dental care, leading to major adverse health outcomes, including increased rates of decay, pain, extractions, infections, emergent care and even hospitalization. DA frequently develops in childhood due to traumatic experiences and can lead to lifelong DA. Behavioral management techniques aimed at improving dental experiences must be employed during childhood to avoid these sequelae. For patients with severe anxiety and decay, pharmacological interventions may be used. However, sedatives and general anesthesia are frequently met with caregiver objections, as they carry low risks for adverse events, including neurological injury and death. Animal-Assisted Therapy (AAT) with a trained therapy dog has been used widely as a non-pharmacologic behavior guidance approach in numerous medical settings. Though in its nascent stages in dentistry, the novel use of AAT in a pediatric population holds promise for behavior management, reducing anxiety, mitigating pain, and creating positive associations. Furthermore, our data from 800 patients and parents confirm a pervasive desire for canine AAT in dentistry. The objective of this study is to evaluate whether AAT alleviates stress and improves perceptions during pediatric dental care. We hypothesize that AAT significantly alleviates biometric and self-reported measures of anxiety and pain in pediatric dental patients (with relative measure improvements of >20%). We propose to evaluate effects of AAT on objective measures of stress and pain during preventative treatment using salivary stress hormones, heart rate, sweat response, and observational coding data (Aim 1) along with patients' perceptions of dental pain, anxiety, and future visits with validated questionnaires (Aim 2). As part of an ongoing randomized clinical trial, data are collected from patients (age 4-7 years) randomized to a short AAT protocol, a long AAT protocol and an active control with a dental exam and cleaning (N=180, 60 per group). Altogether, data generated from these aims will be used to measure the impact of AAT on pediatric dental patients to guide implementation. This secondary data analysis project will generate results on feasible, rapidly implementable protocols for AAT use in dentistry to mitigate DA and improve experiences, to reduce dental avoidance and its significant health sequelae. Our interdisciplinary team is uniquely qualified to conduct the proposed work as we have the innovative methodologies, RCT patient data and samples, BLS2 facilities, and expertise to achieve our aims. This application includes collaboration between experienced and junior faculty across multiple disciplines to ensure the rigor and translatability of our findings.