Subjective ratings and autonomic responses to dental video stimulation in children and their mothers

Children's fear of dental procedures could be related to their parents' attitude toward these procedures. To investigate this relationship, we compared subjective ratings and autonomic responses to dental and neutral video stimulation in children to the ratings and responses of their mothers. We selected 24 healthy children (12 girls and 12 boys; average age, 9.8 years) and their mothers (average age, 42.6 years). During video stimulation using scenes of dental drilling, vacuum suction, and an ordinary landscape, cardiac activity was monitored using electrocardiograms. Autonomic nerve activity was analyzed by power spectral analysis of heart rate variability at low (LF: 0.04-0.15 Hz) and high (HF: 0.15-0.4 Hz) frequencies. Levels of salivary alpha amylase (sAA) were measured after each video stimulation. LF/HF, heart rate (HR), and sAA values were used as indices of autonomic nerve activity. All subjects rated their response (valence, arousal, disgust, fear, and pain) to the video stimulation on a visual analog scale. Statistical analysis was performed using repeated-measures analysis of variance. No significant main effect of group (children vs. mothers) was observed in ratings of arousal, disgust, fear, and pain or in LF/HF and sAA changes. The main effect of video stimulation was significant for ratings of valence, disgust, fear, and pain (P < 0.001) and changes in LF/HF (P = 0.010). Subjective ratings and autonomic responses to virtual dental procedures could be similar between children and their mothers. Even in children, stimulation using dental videos is useful in assessing subjective perspectives and emotional stress.