We could not recruit enough participants.

The goal of this clinical trial is to assess whether the presence of a certified therapy dog during dental procedures that require an injection reduces anxiety and improves behavior in pediatric dental patients.

The main questions it aims to answer are:

• Does the presence of a certified therapy dog during dental procedure requiring an injection reduce anxiety and improve behavior in pediatric dental patients?
• How do the parents of pediatric dental patients who participate in the study view the use of a certified therapy dog in their child's treatment?
• Does the presence of a certified therapy dog result in different concentrations of microbes in the treatment room?

All participants will receive standard of care. Researchers will compare the group with a therapy dog present to a group who does not have a therapy dog present to see if heart rate, oxygen saturation, percentage of nitrous oxide administered, and Frankl scores differ between the groups.

Inclusion Criteria:

• Age 3-7
• Children who are patients at the Medical University of South Carolina Department of Pediatric Dentistry
• Children classified as category 1 or 2 according to the American Society of Anesthesiologists Physical Status Classification
• Children whose parents/guardians are willing to consent to the child participating in the study
• Availability of parent to be present during treatment
• Children who require further care that includes the injection of a local anesthetic and whose procedure will take less than one hour

Exclusion Criteria:

• Patients whose cases are considered emergencies
• Patients who are classified as category 3 or higher according to the American Society of Anesthesiologists Physical Status Classification (6)
• If patient's medical status has worsened since initial evaluation
• Known allergy to dogs or other animals
• Past history of dental trauma
• Past history of animal bites or traumatic experience with a dog
• Emotional or developmental delays
• If, on the day of the treatment, patient presents with fever or other illness