Children's Drawing as a Projective Tool to Assess Dental Anxiety

Assessment of Dental Anxiety After Children's Drawing as a Projective Tool During Dental Extraction Under Local Anesthesia - A Diagnostic Accuracy Test Study.

The aim in this study is to compare the results of anxiety measurement of the child using the CD:H scale with the long-used Face,Legs,Activity,Cry and Consolability scale (FLACC scale) , Frankl behaviour rating scale and pulse oximeter reading, to see if the drawing alone can be a reliable tool to predict the child's behaviour before the dental procedure.

Dental anxiety is one of the major problems facing us in pediatric dentistry, the new experience that the child has to go through together with the difficulty for the child to express his exact cause of fear increases the problem.

Research has shown that healthcare providers spend more time communicating with parents than pediatric patients. In a typical medical care visit, less than 20% of the communication engaged pediatric patients, regardless of age. Most decision-making and treatment planning are done by dentists and parents.

Even when the dentist tries to engage the child in the conversation it usually includes the social aspect "his favourite hobby, toys, school topics, etc…" rather than the medical history or treatment decisions so the child is unaccustomed to discussing his dental fears and complaints to the dentist, hence we lose a lot of the child's trust.

Drawing has been used in literature as a psychological method to express one's thoughts and fears and can be analyzed by the healthcare provider to know the deeper thoughts of the child.

Thus, the current study aims to deeply understand the children's point of view towards dental treatment and use the drawings as a projective tool to assess the dental anxiety in those children by simple index and defined scores that every dentist could learn and apply.

Inclusion Criteria:

• Children aged from 6 to 12 years.
• Children with past dental experience.
• One or more primary teeth indicated for simple extraction procedure.

Exclusion Criteria:

• Patients lacking cooperative behavior (very young age and patients with certain medical or psychological disorders) according to Wright's classification.
• Refusal of participation.
• Lack of informed consent by the child's parents.
• If the child shows any signs of disinterest in drawing.