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Original Research

Open Access

Anxiety during the dental care of children aged 4 to 6 years over three consecutive visits

  • Avia Fux-Noy1,*,
  • Raneen Zeineh1
  • Aviv Shmueli1
  • Elinor Halperson1
  • Diana Ram1
  • Moti Moskovitz1

1Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel

DOI: 10.22514/jocpd.2023.084 Vol.47,Issue 6,November 2023 pp.100-105

Submitted: 01 April 2023 Accepted: 20 June 2023

Published: 03 November 2023

*Corresponding Author(s): Avia Fux-Noy E-mail:


Managing the anxiety of children during dental care is a major aspect of a pediatric dentist’s work. Only a sparse body of literature is available regarding anxiety during dental care over consecutive visits. The purpose of the study was to investigate anxiety over three consecutive visits for pediatric dental treatment using an electrodermal activity (EDA) device. We also investigated how patient age, gender, the type of dental care performed and previous dental experience, exerted effect on anxiety.This was an observational cohort study. Anxiety was assessed during treatment, using an EDA device. We also recorded Frankl’s behavior rating, previous dental experience, behavior guidance technique, heart rate and the type of dental care. Our cohort included 30 healthy children aged 4–6 years who needed dental care over at least three visits. Frankl scale scores, EDA values and heart rate did not differ significantly between visits. Behavior and anxiety during treatment did not differ significantly according to gender and age. At the second visit, the Frankl score was higher in children who received pulp treatments and crowns than those who received restorations (p = 0.012). At the third visit, children who received pulp treatments and crowns had higher heart rates than those who received restorations (p = 0.011). Heart rate was significantly higher in children who had negative dental experiences when compared to those with positive experiences (p = 0.030). The levels of anxiety in children aged 4–6 years did not change significantly over three consecutive dental treatments. Therefore, varied and meticulous behavior management methods should be maintained throughout consecutive visits.


Dental anxiety; Pediatric dental care; Child behavior; Consecutive visits

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Avia Fux-Noy,Raneen Zeineh,Aviv Shmueli,Elinor Halperson,Diana Ram,Moti Moskovitz. Anxiety during the dental care of children aged 4 to 6 years over three consecutive visits. Journal of Clinical Pediatric Dentistry. 2023. 47(6);100-105.


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