Exploring the role of a thematic approach in dental anxiety and physiological stress: an investigation into dental radiology

Abstract

Background: Dental anxiety in pediatric patients can lead to avoidance of care and increased stress. While previous research has explored various anxiety-reduction interventions, the role of environmental modifications, such as thematic design, remains underexplored. This study examines the impact of a thematic approach in dental radiology on anxiety and physiological stress markers. Methods: A comparative observational study was conducted with 42 children (6–14 years) undergoing panoramic radiographic imaging in a private dental clinic in Istanbul, Turkey. Participants were assigned to a standard imaging environment or a thematically designed environment. Anxiety levels and physiological markers, including salivary cortisol, pulse rate, oxygen levels, and body temperature, were measured before and after the procedure. Results: No significant differences were observed in pulse rate, oxygen levels, or body temperature between groups. However, post-procedure salivary cortisol levels were significantly lower in the thematically designed environment group (p = 0.005), indicating reduced physiological stress. Conclusions: Thematic modifications in dental radiology may help lower stress responses, particularly in cortisol regulation. While broader physiological effects were not observed, the findings highlight the potential of environmental interventions in pediatric dental care. © 2025 Elsevier B.V., All rights reserved.