Comparison of two Alternative Techniques: Audio Distraction and White Noise for the Control and Management of Anxious Paediatric Dental Patients

Background: Assessment of procedural distress is essential while treating children. Anxiety can be measured by subjective and objective methods. It has been shown that galvanic skin response is an extremely accurate objective method and has been used to measure dental anxiety. The subjective nature of anxiety has often made its measurement difficult. Audio and white noise can be used to distract children during dental procedures.
Aim: To compare two non-aversive techniques: audio distraction and white noise and was evaluated by galvanic skin response, heart rate, and oxygen saturation during a dental procedure.
Material and method: 60 children aged between 4 to 8 with no previous local anaesthesia (LA) (infiltration) exposure were selected. They were divided into three groups of 20 children each:. group 1 (n=20) control group- no distraction method used; group 2 (n=20) made to listen audio using headphones; group-3 (n=20) made to listen white noise by headphones. Simultaneously, local anaesthesia was delivered in all groups via infiltration technique. Anxiety was measured by using galvanic skin response, heart rate, and oxygen saturation in all the groups.
Result: A statistically significant difference (p < 0.05) was observed between the control group and both distraction groups. No significant difference was reported between the audio distraction and white noise groups.
Discussion: Local anaesthesia is the most fearful and anxiety-provoking procedure in paediatric dentistry. Some author suggest that 4-6 and 6-8 years revealed equal anxiety levels. Audio distraction is the most used relaxation method to distract children during procedures. Heart rate, according to McCarthy, 1957, acts as a reliable indicator of stress and anxiety. Galvanic skin response can be used as a valid and reliable objective indicator of children’s anxiety (Ebrahim Najafpour et al., 2017). Pulse-oximeter, measuring the pulse rate and oxygen saturation, is the most acceptable method to measure physiological changes.
Conclusion: Distraction techniques of choice could be an effective method in reducing a child’s dental anxiety. Audio and white noise are equally effective in reducing anxiety in children.