Clinical Application Of Music Therapy Against Children Dental Fear

Background Children dental fear(CDF) is a certain mood of worry, tension and fear,easily occurring in the course of children's oral treatment. Not only increased sensitivity of dental treatment to children, reduced tolerance and compliance, but also reduced work efficiency and tense doctor-patient relationship were resulted from CDF. The incidence of CDF was more than 80%, and children with which would bungle illness due to delay or refuse treatment. In addition, after formation, CDF is difficult to eliminate. Therefore, in the process of children's dental treatment, to discover an effective and accepted easily treatment, which reduce or eliminate CDF, has great practical significance.Nitrous oxide/oxygen inhalation sedation(IHS) is a widely used behavior management in clinical treatment of CDF. But IHS has some defects and shortcomings,such as needing cooperation with professional anesthesiologist, not easy to accept, more contraindication and potential harm to children. Therefore, the clinical application of IHS has great limitations. So an effective and easily accepted behavior management assistant method is desiderated to make up for the deficiency of IHS, and to promote the remission or cure of CDF.Music therapy is based on the psychological treatment, using the unique physiological and psychological effects of the corresponding musical behavior, to achieve the elimination of psychological barriers and improve physical and mental health. Music makes physical resonance in heart rate and blood pressure, resulting in a variety of positive physiological reactions to improve the body's homeostasis. At present, painless and non-intervention of music therapy have been attracting scholar's great attention on the relief of fear, but so far there is no related reports for the effectiveness of music therapy in the treatment of CDF, and collaborative application with HIS in the oral treatment of children is controversial.Objective To explore the application and curative effect of music therapy in relieving CDF and synergistic effect of music therapy and IHS for CDF in children with CFSS-DS grade of 4 or above.MethodsPart one: First-visit-dental children (aged 4-10 years), who were classified as CDF by children's fear survey schedule-dental sub-scale(CFSS-DS),were included in the study.The children were randomly selected to accept music therapy and behavior management,behavior management only. At each vist, heart rate, blood pressure, oxygen saturation were recorded and anxiety level was evaluated by Venham anxiety and cooperative behavior scale.Part two: Children in need of oral treatment (aged 4-10 years), who were classified as severe CDF by children's fear survey schedule-dental sub-scale (CFSS-DS), were included in the study. The children were randomly selected to accept music therapy and nitrous oxide inhalation, or nitrous oxide inhalation only. Heart rate, blood pressure,oxygen saturation were recorded at pretherapy, before nitrous oxide inhalation used and in treatment. Nitrous oxide concentration, sedation onset time, treatment duration, recovery time were also recorded.ResultsPart one: 128 children met the inclusion criteria, which 64 children in each group. 60 planned treatments were completed satisfactorily in experimental group, but only 56 children completed treatment in control group. In the process of treatment, heart rate variation in experimental group was significantly less than the control group. In the experimental group, the heart rate in operation was not significantly increased, but the postoperative rate was significantly lower than that before treatment; while intraoperative and postoperative heart rate was significantly faster than preoperative rate in the control group. Except for children with Venham grade of 4, other children's heart rate decreased significantly after initial visits and before subsequent visits. Systolic pressure also showed similar trends.Part two: 60 children met the inclusion criteria, which 30 children in each group. 26 planned treatments were completed satisfactorily in experimental group, but only 21 children completed treatment in control group. The onset time of nitrous oxide, duration of operation and the recovery time in experimental group were significantly less than the control group. In the course of therapy, children in experimental group possessed emotional homeostasis and good compliance. Their heart rate in operation was not significantly increased, and even significantly reduced.ConclusionPart one: Music therapy could be a safe and acceptable approach for behavior management of children with CDF.Part two: Nitrous oxide inhalation and synergistic effect of music therapy has significant effects on children with CFSS-DS grade of 4 or above. It can improve patient compliance and is a safe and acceptable approach for behavior management of children with CDF.