The Japanese Journal of Pediatric Dentistry
Online ISSN : 2186-5078
Print ISSN : 0583-1199
ISSN-L : 0583-1199
ORIGINAL ARTICLE
Development of Real-time Stress Monitoring System for Pediatric Dentistry
Assessment of Autonomic Nerve and Brain Activities
Taki SEKIYAHiroko IMURASachiko ITOMichiyo MIYASHINKumiko SUGIMOTO
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JOURNAL FREE ACCESS

2016 Volume 54 Issue 4 Pages 443-449

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Abstract

To provide safe and comfortable pediatric dental treatment, it is important to understand emotional changes of child patients undergoing such treatment. Appropriate behavioral control of child patients based on such an understanding can help them avoid a negative image regarding dental treatment and acquire desirable oral health behavior habits, such as regular visits to a dentist. In order to develop an objective real-time monitoring system of the emotional state of child patients, we investigated changes of physiological factors in response to internal stress induced by dental treatment in the present study. For physiological factors, we analyzed autonomic nervous responses from heart rate variation and the electroencephalogram (EEG) frequency power spectrum throughout treatment procedures conducted for composite resin restoration. Eleven child patients aged 6-9 years old who came to our pediatric clinic voluntarily participated in this study after parental informed consent was obtained. Sympathetic nervous activity in the children was significantly elevated during infiltration anesthesia and placement of a rubber dam, as compared with the resting level before treatment, indicating a stronger sense of stress during those procedures. Furthermore, a significant reduction in parasympathetic nervous activity, another indicator of stress, occurred during oral examinations, surface anesthesia, infiltration anesthesia, placement of a rubber dam, and cavity preparation. Frequency analysis of the EEG recordings demonstrated that a component of the αwave was prominent, though the αwave ratio showed no significant change at any time during treatment. On the other hand, the ratio of θwaves tended to decrease during treatment that included cutting with a contra-angle, while that of βwaves tended to increase during surface and infiltration anesthesia. Results obtained from both autonomic nervous analysis and spectral analysis of EEG demonstrated similar changes of emotion during several of the treatment procedures, indicating that the present method may be useful for real-time assessments of internal stress and emotional change in children during dental treatment. Collectively, our results suggest that real-time monitoring of internal emotion in children undergoing dental procedures provides useful information for behavioral control by pediatric dentists, thus contributing to the oral health of children.

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© 2016 Japanese Society of Pediatric Dentistry
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