title: Behavioural and physiological outcomes of biofeedback therapy on dental anxiety of children undergoing restorations: a randomised controlled trial.
abstract: OBJECTIVE
  To explore the efficacy of biofeedback as possible alternative means of psychological behaviour guidance in children receiving dental restorations.
  
  
  METHODS
  Randomised clinical trial with a cross over design carried out on 40 children (19 boys and 21 girls) to determine the efficacy of biofeedback in reducing the dental anxiety through subjective and objective measures during restorative treatments under cotton roll isolation without administration of local analgesia.
  
  
  METHODS
  Highly anxious children with a minimum of five carious lesions were trained to lower their anxiety using biofeedback in five sessions within a 4-week interval, each session lasting for 45 min. After initial training, children were randomly divided into two groups and restorations were placed in four sequential therapeutic sessions with a 1-week interval and a follow-up visit 3 months later. First group received biofeedback in the second and third sessions; whereas the second group received biofeedback in the first and third sessions.
  
  
  RESULTS
  Biofeedback therapy in children led to lower levels of anxiety in the initial appointments when assessed objectively, however the subjective methods of evaluation could not depict any statistically significant difference.
  
  
  CONCLUSIONS
  Biofeedback can be used in the initial visits for dentally anxious children and the usage of simpler biofeedback machines for these appointments in dental setup is suggested.
authors.affiliation: Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, 524003, India.
authors.forename: P
authors.initials: P
authors.lastname: Dedeepya
authors.forename: S
authors.initials: S
authors.lastname: Nuvvula
authors.forename: R
authors.initials: R
authors.lastname: Kamatham
authors.forename: S V S G
authors.initials: SV
authors.lastname: Nirmala
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001676:Biofeedback, Psychology / Q000379:methods*; D001945:Breathing Exercises / Q000379:methods; D002648:Child; D002652:Child Behavior; D018592:Cross-Over Studies; D016854:Dental Anxiety / Q000517:prevention & control*; D003731:Dental Caries / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods; D008297:Male; D011674:Pulse / Q000379:methods; D016896:Treatment Outcome; D064232:Visual Analog Scale
references.citation: N Z Dent J. 2010 Dec;106(4):132-6
references.pmid: 21197816
references.citation: Am Heart J. 2005 Jun;149(6):1137
references.pmid: 15976804
references.citation: J Dent Res. 1999 Mar;78(3):790-6
references.pmid: 10096455
references.citation: J Prosthet Dent. 1993 Aug;70(2):158-64
references.pmid: 8371179
references.citation: J Am Dent Assoc. 1978 Apr;96(4):656-62
references.pmid: 273638
references.citation: Biofeedback Self Regul. 1976 Sep;1(3):253-71
references.pmid: 791382
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Aug;98(2):137-45
references.pmid: 15316539
references.citation: J Behav Ther Exp Psychiatry. 1989 Jun;20(2):179-83
references.pmid: 2584401
references.citation: Int J Clin Pediatr Dent. 2011 Jan-Apr;4(1):35-9
references.pmid: 27616856
references.citation: J Am Soc Prev Dent. 1976 Dec;6(6):19-23
references.pmid: 1074820
references.citation: Anesth Prog. 1986 Jan-Feb;33(1):9-13
references.pmid: 2871777
references.citation: Scand J Dent Res. 1986 Jun;94(3):248-52
references.pmid: 3461545
references.citation: J Dent. 1987 Feb;15(1):16-22
references.pmid: 3471785
references.citation: Arch Dis Child. 1996 Nov;75(5):367-74
references.pmid: 8957948
references.citation: Int J Paediatr Dent. 2002 Jan;12(1):47-52
references.pmid: 11853248
references.citation: Aust Dent J. 1998 Jun;43(3):153-9
references.pmid: 9707777
references.citation: Appl Psychophysiol Biofeedback. 2011 Jun;36(2):63-70
references.pmid: 21365307
references.citation: Behav Res Ther. 1996 May-Jun;34(5-6):459-76
references.pmid: 8687368
references.citation: J Dent Res. 1977 Apr;56(4):362-7
references.pmid: 265967
references.citation: Biofeedback Self Regul. 1978 Dec;3(4):375-84
references.pmid: 751683
references.citation: World J Gastroenterol. 2006 Nov 28;12(44):7069-74
references.pmid: 17131466
references.citation: Pain. 1980 Oct;9(2):231-241
references.pmid: 7005828
references.citation: Int J Paediatr Dent. 1998 Mar;8(1):3-11
references.pmid: 9558540
references.citation: Psychosomatics. 1980 Feb;21(2):157-62
references.pmid: 6987696
references.citation: Eur Arch Paediatr Dent. 2010 Aug;11(4):166-74
references.pmid: 20840826
references.citation: Indian J Dent Res. 2006 Jan-Mar;17(1):27-34
references.pmid: 16900892
references.citation: Dent Clin North Am. 2008 Jul;52(3):579-603, ix-x
references.pmid: 18501736
references.citation: J Dent Res. 1983 Jun;62(6):728-32
references.pmid: 6343440
references.citation: J Indian Soc Pedod Prev Dent. 1995 Aug;13(1):13-7
references.pmid: 9522733
references.citation: J Anxiety Disord. 2013 May;27(4):365-78
references.pmid: 23746494
references.citation: ASDC J Dent Child. 1982 May-Jun;49(3):209-13
references.pmid: 6953082
references.citation: Eur J Oral Sci. 2007 Dec;115(6):479-83
references.pmid: 18028056
references.citation: Cleve Clin J Med. 2008 Mar;75 Suppl 2:S35-8
references.pmid: 18540144
references.citation: J Prosthet Dent. 1984 Mar;51(3):397-403
references.pmid: 6584611
references.citation: Int J Paediatr Dent. 2009 Nov;19(6):431-7
references.pmid: 19708863
references.citation: J Dent Res. 2000 Sep;79(9):1645-51
references.pmid: 11023258
references.citation: J Oral Rehabil. 1982 Mar;9(2):125-31
references.pmid: 7040615
references.citation: Behav Res Ther. 1984;22(5):487-92
references.pmid: 6391462