Evidence map›Paper›PMID 39001562›Full record

ArticleInternational journal of paediatric dentistry2025

A software-based observational coding approach for evaluating paediatric dental pain, anxiety, and fear.

Clare Bocklage, Raven Selden, Olivia Tumsuden, Eleanor Nanney, Caroline Sawicki, Allen Rapolla, Katelyn Cass, Jessica Lee, Jeannie Ginnis, Timothy Strauman and 4 more

Abstract read
In one paragraph

Article in International journal of paediatric dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
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  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Clare BocklageOrthodontics Group, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Raven SeldenDDS Program, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Olivia TumsudenDDS Program, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Eleanor NanneyOrthodontics Group, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Caroline SawickiDivision of Pediatrics and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Allen RapollaOrthodontics Group, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Katelyn CassOrthodontics Group, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Jessica LeeDivision of Pediatrics and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Jeannie GinnisDivision of Pediatrics and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Timothy StraumanDepartment of Psychology and Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, North Carolina, USA.
Christina GravesDivision of Biomedical Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Kimon DivarisDivision of Pediatrics and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-1290-7251
Eric HodgesSchool of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.
Laura Anne JacoxOrthodontics Group, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-1923-6825

Funding

Re-Entry Supplement: Investigation of Oral Microbial Enzymes for the Detection and Treatment of Periodontal DiseaseUL1TR002489 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, SHAHEEN, NICHOLAS J · 2018 to 2022
$48.6M
North Carolina Translational and Clinical Sciences Institute (NC TraCS)UM1TR004406 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI NICHOLAS J SHAHEEN · 2023 to 2026
$37.5M
Orthognathic speech pathology: Understanding how jaw disharmonies and their surgical correction influence speechK08DE030235 · NIDCR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JACOX, LAURA ANNE · 2021 to 2025
$889k
Evaluating the Effects of Animal Therapy on Anxiety in Pediatric Dental PatientsR03DE032768 · NIDCR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JACOX, LAURA ANNE · 2023 to 2024
$308k
American Association of Orthodontists FoundationNCATS NIH HHS UL1 TR002489NCATS NIH HHS UL1TR002489NCATS NIH HHS UM1 TR004406NIDCR NIH HHS K08 DE030235NIDCR NIH HHS K08DE030235NIDCR NIH HHS R03 DE032768NIDCR NIH HHS R03DE032768NIH HHSSouthern Association of Orthodontists
6 · The paper itself

Abstract

backgroundDental practitioners desire non-pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high-quality evidence, however, is required to evaluate methods' efficacy.

aimThis study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain.

designObjective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software.

resultsA novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements.

conclusionPAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.

Indexed as

AnxietyDental AnxietyDental Care for ChildrenFearPain MeasurementSoftwareToothacheAdolescentChildFemaleHumansMalePilot ProjectsVideo Recordingbehaviorcommunity paediatric dentistrypain controlpreventionsedation

Identifiers

PMID39001562
PMCPMC11724945

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.