Selection of anxiety management strategies in children aged 4–12 years prior to dental treatment

Relevance. Many children experience anxiety and fear at the very thought of visiting the dentist. They may resist engaging with the clinician, display intense emotional reactions, or withdraw socially. Anxiety also affects multiple physiological systems, with elevated heart rate being the most common indicator. As a result, these patients often avoid dental visits, leading to a deterioration in oral health. In such cases, treatment may need to be carried out under general anesthesia or sedation if the child is not adequately adapted. Although pediatric psychology offers a variety of methods for diagnosing and managing childhood anxiety, their application in dentistry remains limited. This complicates the selection of an appropriate intervention strategy tailored to each clinical case. Objective. To establish a clinical and functional rationale for selecting appropriate anxiety management strategies for children aged 4–12 undergoing outpatient dental care. Materials and methods. From 2019 to 2024, a clinical study was conducted involving 986 children aged 4 to 12. Prior to examination, general medical and psychological histories were obtained. Anxiety levels in children aged 4–6 were assessed using a pictorial anxiety test developed by R. Tamml, while children aged 7–12 were evaluated using the Revised Children’s Manifest Anxiety Scale (RCMAS), as adapted by A. M. Prikhozhan. Частоту сердечных сокращений измеряли детским пульсоксиметром ChoiceMMed 300C5. The assessment of caries activity was carried out using the classification proposed by T. F. Vinogradova. Based on the assessment results, individualized treatment strategies were selected: either dental care under the supervision of an anesthesiologist or the use of art therapy as a method of psychoemotional regulation. Results. Psychological testing categorized the children into three groups according to anxiety levels: low (19.2%), moderate (52.4%), and high (28.4%). The highest heart rates were recorded in the high-anxiety group, with 61.2% of these patients exhibiting marked tachycardia. Additionally, 62.2% of children in this group exhibited high caries activity. Children with low anxiety required fewer psychological intervention sessions compared to those with moderate or high levels of anxiety. Based on the findings, a computerized tool entitled “Selection of Anxiety Management Strategy for Children Prior to Dental Treatment” was developed to assist dental professionals in formulating individualized management plans for pediatric patients. Conclusion. o enhance the quality and safety of pediatric dental care, a digital tool—“Selection of Anxiety Management Strategy for Children Prior to Dental Treatment”—was developed based on comprehensive psychological and functional assessment.