Assessment of psychological changes in young children during dental treatment: Analysis of the autonomic nervous activity and electroencephalogram

Int J Paediatr Dent. 2022 May;32(3):418-427. doi: 10.1111/ipd.12921. Epub 2021 Oct 15.


Background: Understanding the emotional changes in children during dental treatment is necessary for providing stress-free care.

Aim: To objectively assess the stress associated with dental treatment in children, based on the autonomic nervous activity and the electroencephalogram (EEG).

Design: Twenty-two children aged 4-9 years were recruited from outpatients of a paediatric clinic. Electrocardiogram and EEG were recorded throughout the treatment to analyze the autonomic nervous activities and the powers of brain waves, respectively. Changes in these measurements during each treatment process were evaluated in two age groups: 4-6 years and 6-9 years.

Results: Elevations in sympathetic activities accompanied by decreased parasympathetic activities induced by stress were observed during rubber dam setting (RD) in the age group of 4-6 years and during infiltration anesthesia (IA), RD, and cavity preparation with a dental turbine (CP-T) in the age group of 6-9 years. Stress-related beta wave increments in EEG were observed during IA and CP-T in the age group of 6-9 years but not in the age group of 4-6 years.

Conclusion: Monitoring the autonomic nervous activities during treatments is useful in assessing stresses in a wide age of young children, whereas EEG monitoring is applicable only to children older than 6 years.

Keywords: autonomic nervous system; behavior; electroencephalogram; psychological stress; restorative treatment.

MeSH terms

  • Autonomic Nervous System* / physiology
  • Child
  • Child, Preschool
  • Electrocardiography
  • Electroencephalography*
  • Heart Rate / physiology
  • Humans