Anxiety management plays a major role in the treatment of dental patients, and paediatric patients in particular. In this delicate area, different approaches have been tested, both pharmacological – but they will not be the subject of this brief discussion – and not. In this sense, coping strategies and behavioural approach as a whole should be considered. Alongside these, there has also been an increased interest in alternative methods, such as those of traditional Chinese medicine. The best known technique in this sense is almost certainly acupuncture, which consists of stimulating precise anatomical points and is used to treat various anxiety disorders, insomnia and other medical conditions, such as asthma. In the dental field, a randomised trial a decade ago reported good results in the adult population and a second (a case series, again on adults) even proposed it as an alternative to anxiolytic prophylaxis with midazolam.
In the case of paediatric patients, it does not seem advisable to propose a method involving needles, albeit in a completely different manner from anaesthetic injection procedures, whose performance may however be one of the anxiolytic approach’s aims.
There is a method, called acupressure, which is based on the same principles of acupuncture, but in which stimulation is performed through the use of different tools, such as the derma-roller. With regard to this procedure, positive clinical experiences are also documented in the literature for various specialist fields, including stress management, raising the pain threshold and treatment of lower back pain.
In order to provide scientific feedback in the paediatric dentistry field, the Avisa working group organised a randomised trial on a sample of 150 patients (divided into 3 numerically equivalent groups, illustrated below), aged between 8 and 12 years old, undergoing hygiene or conservative treatments. In addition to a control group, two different case groups were distinguished: the former group’s patients received stimulation of two points documented for the anxiolytic effect, while those in the second group were stimulated at the same number of points, but not ones documented for this effect; one could therefore speak of a sort of intermediate group between case and control. The 4 points involved are located around the eyebrows or the auricle.
The modified child dental anxiety scales MCDAS (simplified version, primary outcome) and the Frankl scale for behavioural assessment were used, as well as the target data for pulsation frequency (secondary outcomes).
The most remarkable result is in fact the statistically significant decrease in the MCDAS score in the first case group. These results are also confirmed by secondary outcomes, decreased frequency and improvement of the Frankl score. Although this is preliminary data, it can be concluded by identifying the promising indications which merit future investigation and potential clinical interest.