Sensory-Adapted Operatory Lowered Anxiety and Cortisol in Children Getting Nerve Blocks

Edited by Dentaltown staff

Children treated in a sensory-adapted dental environment showed significantly lower anxiety and lower salivary cortisol than children treated in a conventional operatory, according to a randomized controlled trial published Sept. 17 in the European Archives of Paediatric Dentistry.

The trial enrolled 50 anxious children aged 4 to 8 who required an inferior alveolar nerve block. Participants were randomly allocated by computer-generated randomization into two equal groups of 25, one treated in a conventional environment and one in the sensory-adapted environment.

Modified Dental Anxiety Scale scores fell from 10.36 to 7.48 in the sensory-adapted group. In the conventional group they moved in the opposite direction, from 8.00 to 9.24.

Salivary cortisol followed the same pattern, dropping from 20.28 to 9.41 nanograms per milliliter in the sensory-adapted group while rising in the conventional group.

Two other anxiety measures reinforced the finding. Venham Picture Test and Wong-Baker Faces Scale scores increased significantly in the conventional group, indicating rising anxiety over the course of treatment.

Investigators at I.T.S Dental College in Ghaziabad, India, conducted the trial. Primary outcomes were the three anxiety scales, with pulse rate, oxygen saturation, and salivary cortisol recorded before and after the procedure as secondary outcomes.

The authors concluded that a sensory-adapted environment may serve as an effective nonpharmacological approach for managing anxious pediatric patients. The trial enrolled 50 children at a single center and measured outcomes across one appointment, so it does not establish whether the effect holds across a course of treatment.

Sources:
European Archives of Paediatric Dentistry, “Comparative evaluation of sensory-adapted dental environment and conventional dental environment on dental anxiety and behaviour in children: a randomized controlled trial,” published online Sept. 17, 2026: doi.org/10.1007/s40368-026-01281-0
PubMed record, PMID 42753119: pubmed.ncbi.nlm.nih.gov/42753119