Comparative evaluation of sensory-adapted dental environment and conventional dental environment on dental anxiety and behaviour in children: a randomized controlled trial.

PURPOSE: To compare the effectiveness of a sensory-adapted dental environment (SADE) and a conventional dental environment (CDE) in reducing dental anxiety and improving behavioural and physiological responses in anxious children. METHODS: The randomized controlled trial included 50 children aged between 4-8 years who required inferior alveolar nerve block administration. Participants were randomly allocated into two equal groups (n = 25) using computer-generated randomization method. Group I received treatment in a CDE, whereas Group II was treated in a SADE. The primary outcome was the reduction in dental anxiety, assessed using the Modified Dental Anxiety Scale (MDAS), Venham Picture Test (VPT), and Wong-Baker Faces Scale (WBFS). Secondary outcomes included changes in physiological stress markers, namely pulse rate, oxygen saturation (SpO₂), and salivary cortisol levels, recorded before and after the procedure and subjected to statistical analysis. RESULTS: Children treated in the SADE group showed significantly lower dental anxiety than those in the CDE group. When comparing pre- and post-treatment values, MDAS scores decreased significantly in the SADE group (10.36 to 7.48; p < 0.05) compared with the CDE group (8.00 to 9.24). Salivary cortisol levels decreased in the SADE group (20.28 to 9.41 ng/mL) but increased in the CDE group. Venham Picture Test and Wong-Baker Faces Scale scores increased significantly in the CDE group (p < 0.05) indicating increased anxiety. CONCLUSION: A SADE significantly reduced dental anxiety and physiological stress responses compared with a CDE. SADE may serve as an effective non-pharmacological approach for managing anxious paediatric patients.