Dental Anxiety Scales Used in Pediatric Dentistry: A Systematic Review and Meta-analysis.

Aim: To assess various dental anxiety scales used in children and to know the effectiveness of different projective dental anxiety scales used in pediatric dentistry.

Background: Dental anxiety poses a significant problem in child patient management and is considered to be the main barrier for successful completion of the dental treatment.

Review Results: This systematic review and meta-analysis has been registered at the International prospective register of systematic reviews-PROSPERO-CRD42021247586. The systematic review was conducted in accordance with the Preferred Reporting Items in Systematic Review and Meta-Analysis (PRISMA) guidelines. Electronic databases [PubMed (MEDLINE), COCHRANE Library, EMBASE, EBSCO host, and Google Scholar database] were searched for corresponding references up to 2021. Observational cross-sectional studies comparing two different dental anxiety scales were selected for this systematic review. Search strategy generated 500 articles out of which 13 studies included in qualitative synthesis and only 7 studies were taken for quantitative synthesis. Among these seven studies, five studies compared FIS and VPT scales, two studies compared RMS, FIS, and VPT scales. Results of meta-analysis showed that an overall mean difference of dental anxiety between VPT and FIS scales was 0.11 (95% CI: 0.26-0.48), RMS and FIS scales was 0.05 (95% CI: 0.40-0.50), RMS and VPT was 0.27 (95% CI: 0.80-0.27) in the investigated population.

Conclusion: No statistically significant difference was noted in all comparisons suggesting that all these scales are at par in assessing anxiety levels in pediatric population.

Clinical Significance: The projective scales Raghavendra, madhuriu, sujata pictorial scale (RMS), Facial image scale (FIS), and Venham's picture test (VPT) can be a pragmatic tool in assessing children's dental anxiety.