Objective assessment of internal stress in children during dental treatment by analysis of autonomic nervous activity.
OBJECTIVE
The aim of this study was to assess the internal stress of children during dental treatment based on autonomic nerve activity and facial muscle activity.


METHODS
We recorded the electrocardiogram of children during the treatment of composite resin restoration and analysed autonomic nerve activity by means of power spectral analysis of heart rate variability. Simultaneously, electromyography (EMG) activity of the corrugator muscle was recorded in children during dental treatment, and the relationship between sympathetic nerve activity and corrugator EMG activity was analysed.


RESULTS
In all subjects, the mean sympathetic nerve activity was significantly higher during oral examination and after treatment compared with pre-treatment. Depending on the sympathetic nerve responses to the other treatment procedures, the subjects could be classified into two groups: the stress group and the nonstress group. Sympathetic nerve activity was significantly higher during infiltration anaesthesia and cavity preparation compared with pre-treatment activity in the stress group, whereas it was consistently lower than the pre-treatment levels during most treatment procedures in the nonstress group. The mean amplitudes of the averaged corrugator muscle EMG during dental treatment did not differ between the stress and nonstress groups.


CONCLUSIONS
The present results suggest that the measurement of autonomic nervous activity, especially sympathetic nervous activity, is quite useful in assessing the internal stress of children, even when no expressed sign of unease are present during dental treatment.
Division of Oral Health Science, Department of Orofacial Development and Function, Developmental Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. nao0725.dohs@tmd.ac.jp
Naoko
N
Uehara
Yuzo
Y
Takagi
Zenzo
Z
Miwa
Kumiko
K
Sugimoto
D001341:Autonomic Nervous System / Q000502:physiology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D016854:Dental Anxiety / Q000175:diagnosis* / Q000503:physiopathology; D019140:Dental Care for Children / Q000379:methods / Q000523:psychology*; D003731:Dental Caries / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods; D004562:Electrocardiography; D004576:Electromyography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D012016:Reference Values; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000175:diagnosis* / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000502:physiology