Study investigates silent stress among adolescents in the dental setting

“Child and adolescent patients aren’t always able or confident enough to convey negative experiences during dental treatment. Parallel to this, we know that a significant number of them find dental exams and invasive treatment stressful, whether this is due to fear or pain,” said lead researcher Dr Larisa Krekmanova, a senior lecturer at Sahlgrenska Academy at the University of Gothenburg, in a press release. “We want to uncover this silent stress, a type of stress that’s difficult to detect and can remain hidden. This research aims to increase practitioners’ sensitivity and raise patient voices,” she added.

Sensor measures hand movements and sweating

The study involved 34 patients aged 14–16 years, 20 of whom underwent regular dental examination and 14 of whom received anaesthetic injections and extraction of healthy molars, often over several appointments as part of their orthodontic care. During the treatments, participants wore a device on one hand that measured their hand movements and sweating of their hands.

Real-time application may increase dental treatment experience

The research team found that the participants who underwent the regular dental examination exhibited sporadic stress spikes, whereas those who received invasive treatments experienced significantly higher stress levels for extended periods. This stress was initially recorded when the dentist’s fingers were in the patient’s mouth and during examination with a mirror. However, stress levels increased significantly when anaesthesia was administered, particularly during local anaesthetic injections, although there was some response to the application of anaesthetic gel. At this point, both the hand movements and sweating of the participants peaked. During tooth extraction, the participants’ hand movements reduced slightly, but heavy sweating persisted.

“Children and adolescents are most afraid of invasive interventions, and we now have a picture of the stress caused by these various interventions. Moving forward, the ability to use the device in real time would help practitioners to monitor stress levels and to perhaps pause for remedial measures before continuing treatment,” commented Dr Claudia Jaldin, the dentist who carried out the treatments at the public dental service clinic in Kvillebäcken in Gothenburg. “In dental care, when it comes to fear and pain, it’s important to work preventively with children and adolescents,” she emphasised.

The study, titled “Sensor-tool for detecting young patients’ stress during invasive versus non-invasive dental treatment. A pilot study”, was presented on 13 June at the 2024 congress of the European Academy of Pediatric Dentistry in Gothenburg.

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