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Evaluating pain, fear, anxiety or stress/distress using children’s drawings in paediatric dentistry: a scoping review

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Abstract

Purpose

The aim of this study was to systematically review the literature to answer the question: Can children’s drawings represent a helping tool so the dentist can better understand the children’s pain, fear, anxiety or stress/distress and their perception concerning the dentist and/or dental treatment?

Methods

A scoping review was done. Cochrane Library, EMBASE, LILACS, LIVIVO, PsycINFO, PubMed, Scopus, Web of Science, and Grey literature was searched. Cross-sectional, quasi-experimental and qualitative studies in which patients were children and adolescents were included. Two authors independently selected studies to extract data and evaluate methodological quality by using Joanna Briggs Institute tools. Data collected included: characteristics of the studies, drawing evaluation/scales, main results and conclusion.

Results

Out of 1037 papers were identified in search, 25 studies verified the emotional state and the children’s perceptions regarding dental environment and the dentist and were included in the narrative synthesis. The spontaneous drawings were useful to identify the children’s emotions. Drawings might be considered a helping tool to identify children and adolescents’ perception in relation to dental treatment. Few studies used validated instruments. There were methodological disparities among studies.

Conclusions

The drawings can be considered a useful tool in identifying children’s pain, fear, anxiety or stress/distress and perceptions about the dentist and/or dental treatment. Future studies with standardized analysis of the drawings are recommended. Code https://doi.org/10.17605/OSF.IO/U5BJH. “Retrospectively registered”.

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Data availability

The authors declare that they agree with the availability of data, upon request of the journal, confirming transparence in the presentation of the data.

Code availability

Code https://doi.org/10.17605/OSF.IO/U5BJH. “Retrospectively registered”.

References

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Funding

The authors declare that there are no conflicts of interest amongst our research team.

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Authors and Affiliations

Authors

Contributions

LFS worked on study conceptualization, design, data collection, data analysis, drafted the initial manuscript, and critically reviewed the manuscript. LBO worked on study conceptualization, design, data collection, data analysis, and manuscript preparation and critically reviewed the manuscript. HP worked on critically reviewed the manuscript. CM worked on study conceptualization, design, data collection, data analysis and critically reviewed the manuscript. GDLC worked on critically reviewed the manuscript.

Corresponding author

Correspondence to L. F. Sanglard.

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Conflict of interest

The corresponding author guarantees that the article has not been published and is not being considered for publication elsewhere.

Ethical approval

This study is a scoping review and IRB approval was not required.

Consent to participate

This study is a scoping review, realized with primary studies.

Consent for publication

All authors approved the final manuscript as submitted.

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Sanglard, L.F., Oliveira, L.B., Massignan, C. et al. Evaluating pain, fear, anxiety or stress/distress using children’s drawings in paediatric dentistry: a scoping review. Eur Arch Paediatr Dent 23, 199–222 (2022). https://doi.org/10.1007/s40368-021-00674-7

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  • DOI: https://doi.org/10.1007/s40368-021-00674-7

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