2016 Volume 54 Issue 4 Pages 450-461
The purpose of this study was to evaluate psychological anxiety in child patients during dental treatment using non-invasive physiological indicators and a behavior scale. The subjects were 18 healthychildrenaged6to10yearsold.Theirbehavior during dental treatment was rated using the Frankl behavior scale. In addition, we recorded electrocardiogram findings obtained during tooth extraction procedures, which were divided into the following sessions ;relaxation, advance notice of dental treatment, external anesthesia, infiltration anesthesia, tooth extraction, and astriction. We also evaluated the autonomic nervous system (ANS) in the subjects by analyzing power spectral results at high frequency (HF, ＞0.15 Hz) low frequency (LF, 0.05−0.15 Hz), and the ratio of HF and LF (LF/HF), as well as the coefficient of variation of R-R intervals (CVRR) and heart rate (HR). Simultaneously, skin potential level (SPL), a component of electrodermal activity (EDA), was recorded to assess emotional changes in the subjects during dental treatment. For the analysis, we examined the relationships among these physiological indicators (SPL, HF, LF, LF/HF, CVRR, HR) during dental treatment. According to the SPL response during advance notice of dental treatment, the subjects were classified into those with [EC(＋) group] and without [EC(－) group] emotional changes. In the EC(＋) group, ANS activity was significantly higher during the advance notice of dental treatment, infiltration anesthesia, and tooth extraction sessions as compared with relaxation. A significant positive relationship was noted between SPL response and CVRR, and SPL response and LF/HF during advance notice of dental treatment and infiltration anesthesia. Our findings suggest that evaluation of ANS function by use of HR, especially with assessments of CVRR and LF/HF, is quite useful for assessing internal emotional changes of child patients undergoing dental treatment, even when no signs of fear or anxiety are evident.
