Abstract
BACKGROUND: An estimated 6% through 22% of children have dental anxiety, which can contribute to disruptive behavior and oral health care avoidance. Evidence from medical settings indicate reductions in pain and stress after therapy dog implementation. To identify a low-risk, nonpharmacologic approach for anxiety and pain management in dentistry, a pilot prospective clinical trial was conducted to determine best practices for evaluating the efficacy of animal-assisted therapy (AAT). METHODS: The effects of AAT on pediatric patients were measured through physiological, objective measures (ie, heart rate, salivary cortisol and α-amylase, and video coding) and validated self-reported scales of anxiety, fear, and pain, during an invasive dental procedure. Children aged 7 through 14 years were consecutively enrolled into an AAT (n = 18) or control (n = 21) group. Participants underwent an operative or surgical (eg, extraction) dental procedure. Descriptive and bivariate statistics were used. RESULTS: Participants in the AAT group reported significantly less postoperative pain than those in the control group (P = .001). The heart rates of AAT participants dropped after key events and had less variation than control participants. Objective video coding revealed that AAT participants had significantly longer durations of relaxed lower bodies than control participants (P = .204). No differences were seen in salivary cortisol and α-amylase. These physiological and self-report measures are feasible for use in future studies. CONCLUSIONS: AAT may be an effective therapy for alleviating anxiety and pain in pediatric dental patients and warrants additional study using both objective physiological end points and subjective self-report measures. PRACTICAL IMPLICATIONS: Pending further research, canine therapy may be a valuable addition to dental clinics for anxiety and pain management. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT04708028.