The Impact of a Humanoid Robot on Children's Dental Anxiety, Behavior and Salivary Amylase Levels: A Randomized Clinical Trial

Aim: With the spread of technological possibilities, the idea that humanoid robots can accompany medical interventions has gained momentum. The objectives of this two-armed randomized controlled study were (i) to assess the effects of a human-like robot on behavior guidance during children's dental treatment, by a comparison of the dental anxiety scale, behavioral scale, pulse rate and amylase levels in the saliva and (ii) to determine whether the children would like to have treatment with a humanoid robot. Materials and Methods: One hundred two children (52 girls, 50 boys; mean age: 6.71±1.43 years) were included. The exclusion criteria were children showing definitely negative behavior (Frankl 1) during dental prophylaxis at the first visit and those children who had had dental treatment previously. Fifty children were assigned to the robot group (RG) and 52 children were assigned to the control group (CG). The Facial Image scale (FIS), Frankl Behaviour Rating scale (FBRS), physiological pulse rate and salivary alpha amylase (sAA) levels were used to assess the stress related changes. The Mann-Whitney U test and the Student's t-test were used to compare the groups. In-group comparisons were tested with the Wilcoxon signed-rank test. The chi-squared test, Continuity (Yates) correction, and the Fisher-Freeman-Halton test were used to compare qualitative data. Statistical tests were considered significant at a p-value set at 0.05. Results: The post-treatment FIS scores of the RG in the 6-10-year-olds were significantly lower than in the CG (p<0.05). Post-treatment FBRS scores were statistically significantly higher in the RG than in the CG in both younger and older children (p<0.05). In children aged between 6 and 10 years, pulse rates during and after treatment in the RG were significantly lower than those in the CG (p<0.05). No correlation was found between the children's anxiety/behavior and their sAA levels. Conclusion: The robot was found to be effective in reducing dental anxiety and pulse rates in children aged 6-10 years, and it was preferred more by the children of this age.