Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial

Abstract Background This study examines the effects of laser acupuncture and electroacupuncture on anxiety in children with excessive gag reflexes during dental impressions. Methods A three-armed randomized controlled trial involved 63 pediatric dental patients aged 6–9 with excessive gag reflexes....

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Main Authors: Marwa Baraka, Sarah I. Zeitoun, Sara Salah, Sawsan Hafez
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06630-x
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author Marwa Baraka
Sarah I. Zeitoun
Sara Salah
Sawsan Hafez
author_facet Marwa Baraka
Sarah I. Zeitoun
Sara Salah
Sawsan Hafez
author_sort Marwa Baraka
collection DOAJ
description Abstract Background This study examines the effects of laser acupuncture and electroacupuncture on anxiety in children with excessive gag reflexes during dental impressions. Methods A three-armed randomized controlled trial involved 63 pediatric dental patients aged 6–9 with excessive gag reflexes. Participants were equally divided into three groups: group 1 (laser acupuncture), group 2 (electroacupuncture), and group 3 (negative control with a deactivated device). Salivary alpha-amylase (sAA) levels, Frankl scores, facial image scale (FIS), and heart rate were measured before and after interventions to assess dental anxiety. Group comparisons were conducted using one-way ANOVA or Kruskal-Wallis tests, followed by Bonferroni-corrected pairwise comparisons for significant results, with significance defined as p < 0.05. Results The study found no significant differences in sAA levels before the intervention, but electroacupuncture significantly reduced levels post-intervention (p = 0.009) compared to the laser and control groups. Frankl scores also improved significantly with electroacupuncture (p = 0.002), indicating better cooperation during dental procedures. Both electroacupuncture and laser groups reduced heart rates significantly compared to control (p < 0.001), with correlations indicating that higher sAA levels were associated with increased discomfort in the laser group, and that stress levels were linked to heart rate in the control group. Conclusions Both laser acupuncture and electroacupuncture effectively lowered anxiety level in children with gag reflex. While both methods improved objective and subjective scores, electroacupuncture demonstrated superior efficacy in managing anxiety. Clinical relevance These findings support acupuncture techniques as valuable tools in pediatric dentistry for improving patient cooperation and managing anxiety during dental procedures. Trial registration Registered on clinicaltrial.gov; NCT06422286, 16/4/2024.
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spelling doaj-art-bf662aefb0f84b8cb8c9cb9f2f0c81f52025-08-20T04:03:07ZengBMCBMC Oral Health1472-68312025-07-012511910.1186/s12903-025-06630-xComparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trialMarwa Baraka0Sarah I. Zeitoun1Sara Salah2Sawsan Hafez3Faculty of Dentistry, Pediatric Dentistry and Dental Public Health Department, Alexandria UniversityFaculty of Dentistry, Pediatric Dentistry and Dental Public Health Department, Alexandria UniversityFaculty of Dentistry, Pediatric Dentistry and Dental Public Health Department, Alexandria UniversityFaculty of Dentistry, Pediatric Dentistry and Dental Public Health Department, Alexandria UniversityAbstract Background This study examines the effects of laser acupuncture and electroacupuncture on anxiety in children with excessive gag reflexes during dental impressions. Methods A three-armed randomized controlled trial involved 63 pediatric dental patients aged 6–9 with excessive gag reflexes. Participants were equally divided into three groups: group 1 (laser acupuncture), group 2 (electroacupuncture), and group 3 (negative control with a deactivated device). Salivary alpha-amylase (sAA) levels, Frankl scores, facial image scale (FIS), and heart rate were measured before and after interventions to assess dental anxiety. Group comparisons were conducted using one-way ANOVA or Kruskal-Wallis tests, followed by Bonferroni-corrected pairwise comparisons for significant results, with significance defined as p < 0.05. Results The study found no significant differences in sAA levels before the intervention, but electroacupuncture significantly reduced levels post-intervention (p = 0.009) compared to the laser and control groups. Frankl scores also improved significantly with electroacupuncture (p = 0.002), indicating better cooperation during dental procedures. Both electroacupuncture and laser groups reduced heart rates significantly compared to control (p < 0.001), with correlations indicating that higher sAA levels were associated with increased discomfort in the laser group, and that stress levels were linked to heart rate in the control group. Conclusions Both laser acupuncture and electroacupuncture effectively lowered anxiety level in children with gag reflex. While both methods improved objective and subjective scores, electroacupuncture demonstrated superior efficacy in managing anxiety. Clinical relevance These findings support acupuncture techniques as valuable tools in pediatric dentistry for improving patient cooperation and managing anxiety during dental procedures. Trial registration Registered on clinicaltrial.gov; NCT06422286, 16/4/2024.https://doi.org/10.1186/s12903-025-06630-xAlginate impressionGag reflexDental anxietyPediatric dentistrySalivary amylaseAcupuncture
spellingShingle Marwa Baraka
Sarah I. Zeitoun
Sara Salah
Sawsan Hafez
Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
BMC Oral Health
Alginate impression
Gag reflex
Dental anxiety
Pediatric dentistry
Salivary amylase
Acupuncture
title Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
title_full Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
title_fullStr Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
title_full_unstemmed Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
title_short Comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha-amylase levels in pediatric dental patients with excessive gag reflexes: a randomized clinical trial
title_sort comparative efficacy of laser and electroacupuncture on anxiety management and salivary alpha amylase levels in pediatric dental patients with excessive gag reflexes a randomized clinical trial
topic Alginate impression
Gag reflex
Dental anxiety
Pediatric dentistry
Salivary amylase
Acupuncture
url https://doi.org/10.1186/s12903-025-06630-x
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