# Effectiveness of Non-Pharmacological Interventions in Reducing Dental Anxiety Among Children with Special Needs: A Scoping Review with Conceptual Map

## TL;DR

This study reviews non-drug methods to reduce dental anxiety in children with special needs, finding that techniques like distraction and virtual reality can be effective.

## Contribution

The paper introduces a conceptual map to guide non-pharmacological behavior management for special needs children during dental care.

## Key findings

- Non-pharmacological interventions showed trivial to large reductions in dental anxiety among special needs children.
- Strategies like audio-visual distraction and virtual reality were effective in clinical settings.
- The conceptual map highlights the need for tailored behavior management for special needs patients.

## Abstract

Background: Children with special needs often need tailored approaches to oral healthcare to address their unique needs effectively. It is essential to analyze the effectiveness of non-pharmacological management in reducing dental anxiety among special needs children during dental treatment. Methods: Five electronic databases, PubMed, Scopus, Web of Science, Embase, and Google Scholar, were searched from 2007 to August 2024 for randomized control trials and observational studies comparing the effectiveness of non-pharmacological techniques in reducing dental anxiety during invasive and noninvasive dental treatment. The primary outcomes of the studied intervention were reduced dental anxiety and improved behavior during dental treatment. The conceptual map was created to understand the need for assessment and behavior management for special needs children (SN). Results: Nineteen articles qualified for the final analysis from 250 screened articles. Included studies evaluated the effect of strategies applied clinically, such as audio–visual distraction, sensory-adapted environment, and virtual reality. The included studies measured the trivial to large effect of measured interventions and supported non-pharmacological interventions in clinical settings. Conclusions: Most basic non-pharmacological interventions showed a trivial to large reduction in dental anxiety among SN patients. The conceptual map developed in this study supports the need for non-pharmacological interventions as they are cost-effective and create a positive environment in dental clinics. However, more studies need to focus on non-pharmacological behavior interventions in SN children to support the findings of this scoping review.