Several scientific studies underline the usefulness of the behavioral approach in the management of dental pain and anxiety, which represents two of the strongest limitations to the implementation of even the simplest treatments. These considerations are even more important in the field of paediatric dentistry.
Common experience suggests that the patient should be invited to “breathe deeply” during anxiogenic procedures (the so-called “triggers”, of which injection anesthesia is one of the main examples). However, it may be interesting to address these seemingly trivial aspects in a methodological way, so as to have the scientific means to assess the real impact in the clinic. This is what is proposed to evaluate, for cultural background and probably, also, for necessity, a recent Indian work, published in the International Journal of Paediatric Dentistry.
The study was set up as a case-control clinical trial and involved a total of 66 children aged between 7 and 11 years. The case group underwent a relaxation technique called “bubble breath,” which consists of a deep breathing exercise. This technique of distraction has already been successfully tested in the pediatric subject during procedures such as vaccinations or removal of warts by cryotherapy. The bubble breath is also a form of “play therapy,” or a psychological technique of communication based on the presentation of a situation in the form of play, already valid in the early part of childhood. The subjectively reported pain data, statistically evaluated by means of the Wilcoxon-Mann-Whitney test, and also the one measured by observation (using the FLACC scale), subjected to the chi square test, was significantly lower in the group than in the control case. Evaluating the process, the authors highlight how the bubble breath prevents the normal tendency to hold your breath at the first painful stimulation; this would be the mechanism capable of blocking the subsequent increase of the symptom.
The study referred to is the first to experience bubble breath in the dental field.
The results concerning dental anxiety (measured by the Facial Image Scale and heart rate monitoring) and those referring to behavioral data (Behavior Rating Scale according to Frankl) are not supported by statistical significance. The authors, therefore, evaluate the technique specifically investigated (i.e. the bubble breath) as not strictly effective for the management of anxiety.
In conclusion, it is important to underline the numerous evidences that, for effectiveness, you must support the implementation in an orderly and systematic way of behavioral methods of relaxation and distraction. These are also extensively documented by other articles on these same pages.