Effect of Deep Breathing Exercise using Smartwatch on Behaviour, Anxiety and Pain in Children during Buccal Infiltration Anaesthesia-A Randomised Clinical Trial

Abstract

Introduction: Despite the newer innovation and recent technological advances in modern dentistry, fear and anxiety constitute an important theme in dentistry. They are a usual reaction to stressful conditions that help children while staying alert in situations of an impending threat. Aim: To evaluate the effect of deep breathing exercise in reducing dental anxiety, behaviour and pain using smartwatch during maxillary buccal infiltration in children aged 7-11 years. Materials and Methods: A prospective interventional and single-blinded randomised clinical trial conducted in the Department of Paediatric and Preventive Dentistry, NDCH, Nellore, Andhra pradesh, India, from November 2019 to October 2020. A total of 70 children of age between 7-11 years. They were randomly allocated into two groups, 35 in each. Children in group I were trained for deep breathing exercise using smartwatch and group II (control group) was traditional tell show do technique. The reaction of children during maxillary buccal infiltration anaesthesia was recorded in terms of behaviour (Frankl behaviour rating scale), anxiety {Facial Image Scale (FIS) and pulse rate}, and pain perception (Wong-Baker FACES pain rating scale and face, leg, activity, cry and consolability scale). Data was tabulated using Kolmogorov-Smirnov test and Kruskal-Wallis for data distribution. Independent Student’s t-test or Mann-Whitney test (Quantitative variables) and Chisquare test or Mann-Whitney test (Qualitative variables) were used to test statistical significance using Statistical Package for Social Sciences (SPSS) version 25.0. Results: The mean age of children in smartwatch group was 8.9±1.4 years and in control group was 8.9±1.6 years with no statistical significant difference. Statistically significant decrease in pulse rate was observed in smartwatch group (p=0.003), subjective anxiety and pain was lowered in intervention group. Objective pain was decreased significantly in smartwatch group (p=0.007). Conclusion: Children performing deep breathing exercise using smartwatch had efficiency to reduce dental anxiety and pain perceived during maxillary buccal infiltration anaesthesia.