Comparison of behavioral response to caries removal methods: a randomised controlled cross over trial

The issue of dental fear and anxiety still poses a significant problem in treating children. Various caries management protocols have been tried to make the dental visit more compatible to the child patients.

The aim of the study was to evaluate and compare the behavioral and physiological responses to chemo-mechanical caries removal (CMCR) and conventional drilling method (CDM).

A total of 20 children with an age range of 7 to 11 years with bilateral frank carious lesions were included in this study. They were randomized into two groups: Group A--treated with CDM first followed by CMCR and Group B--treated with CMCR first followed by CDM. The physiological signs (pulse, blood pressure and oxygen saturation) were noted prior to treatment, during treatment, post treatment and 5 min after treatment. The behavioral responses were assessed by face, legs, activity, cry, and consolability scale and facial image scale. The participants were interviewed about pain, discomfort, taste, smell, preference and overall experience after every procedure. The pediatric dentist filled in details about patient behavior, time utilized and need for local anesthesia. The results were statistically analyzed using t-test and Chi-square test appropriately (SPSS version 11).

There was no significant difference in any of the physiological parameters assessed between the two groups. Discomfort was significantly more (P < 0.025) in the CDM group than CMCR group. The time taken by the dentist was significantly lesser (P < 0.01) in the CDM group.

Techniques which enhance the behavioral response in children should be considered for a better pediatric dental practice.