Evaluating pain, fear, anxiety or stress/distress using children's drawings in paediatric dentistry: a scoping review

Purpose The aim of this study was to systematically review the literature to answer the question: Can children's drawings represent a helping tool so the dentist can better understand the children's pain, fear, anxiety or stress/distress and their perception concerning the dentist and/or dental treatment? Methods A scoping review was done. Cochrane Library, EMBASE, LILACS, LIVIVO, PsycINFO, PubMed, Scopus, Web of Science, and Grey literature was searched. Cross-sectional, quasi-experimental and qualitative studies in which patients were children and adolescents were included. Two authors independently selected studies to extract data and evaluate methodological quality by using Joanna Briggs Institute tools. Data collected included: characteristics of the studies, drawing evaluation/scales, main results and conclusion. Results Out of 1037 papers were identified in search, 25 studies verified the emotional state and the children's perceptions regarding dental environment and the dentist and were included in the narrative synthesis. The spontaneous drawings were useful to identify the children's emotions. Drawings might be considered a helping tool to identify children and adolescents' perception in relation to dental treatment. Few studies used validated instruments. There were methodological disparities among studies. Conclusions The drawings can be considered a useful tool in identifying children's pain, fear, anxiety or stress/distress and perceptions about the dentist and/or dental treatment. Future studies with standardized analysis of the drawings are recommended. Code .https://doi.org/ 10.17605/OSF.IO/U5BJH. "Retrospectively registered".