Patient-Centered Communication Training for Dental Assistants: Impact on Anxiety Reduction in Pediatric Dental Visits

Abstract

Background: Dental anxiety is a prevalent impediment to successful pediatric oral treatment, which commonly leads to avoidance of treatment, behavioral difficulties, and poorer oral health results. It has been established that patient-centered communication can reduce anxiety, although not much is known about the exact role of dental assistants in implementing the said strategies during the visit of a dentist with children. Methods: It was a quasi-experimental study to test the effect of structured patient-centered communication training in dental assistants when it comes to reducing anxiety in children attending routine dental visits. There were 480 encounters of pediatrics initially documented and 408 (85.0) of the original encounters retained following exclusions. Respondents were placed either in the intervention group, in which the dental assistants would undergo a two-day guided communication workshop (n = 206, 50.5%), or in the control group, in which dental assistants would receive regular care (n = 202, 49.5%). The Modified Child Dental Anxiety Scale (MCDAS) was used to measure child anxiety prior to and following the visit. One of the subsets of encounters (n = 180, 36.5%) involved heart rate monitoring as a physiological measure of anxiety and 48 (10%)-visits were audio-recorded so as to determine fidelity.Results: The children in the treatment group showed a significant difference in anxiety scores relative to the control group (mean difference: 3.2 ± 1.1 vs. 1.4 ± 0.9, p < 0.001). The analysis of heart rate showed that there was more reduction in the intervention group (-9.8 bpm) than in the controls (-3.4 bpm). Conclusion: The training of dental assistants on patient-centered communication was effective to reduce patient dental anxiety subjectively and physiologically (83% vs. 18% in controls, ICC = 0.78). The results highlight the significance of training auxiliary personnel in organized communicational skills to increase the level of child comfort and maximize the results of pediatric dental treatment.