Sensors: future tools for detecting young patient's stress during a dental invasive versus a non-invasive dental treatment-a pilot study.

Aim: A reliable tool to visualise children's early stress signs to prevent dental fear development is needed. The aim was to evaluate the commercially available, CE marked, Shimmer3 GSR + unit's ability to indicate for stress as a reaction of fear or pain for a non-invasive dental treatment (NI) and an invasive dental treatment (I).

Methods: Patients 14-16 years old were invited to undergo an oral check-up (NI) or an orthodontic premolar extraction (I), respectively. Digital data, measured via electrodes and optical pulse probe, placed on the wrist and fingers, monitored by the Shimmer3 GSR + unit, was transferred via Bluetooth to the HP-laptop. The observed digital parameters were: heart rate based on photoplethysmography (PPG), galvanic skin response (GSR), and 3-axis gyroscope and accelerometer signals for hand movements. Protocols for patient self-report scales were used: coloured analogue scale for pain intensity, facial analogue scale for the mood, and a dental fear scale. Descriptive statistics was performed.

Results: The NI-group: 20 patients, (14.6 ± 0.5 years), underwent 20 oral check-ups. The I-group: 14 patients, (15.3 ± 0.5 years), underwent 28 premolar extractions. All patients tolerated the Shimmer3 GSR + unit well. The GSR signal increased significantly, at start and during the oral injection, in the I-group. The GSR amplitudes persisted throughout and post the dental injection. No general uniform pattern or high GSR amplitudes were produced regarding NI-group.

Conclusions: Considering the limitations of this study, the following conclusions can be made: the invasive treatment resulted in a specific unison GSR pattern, while the non-invasive procedure showed individually scattered GSR reactions. The commercially available CE-marked Shimmer3 GSR + device indicated the patient's stress response triggered by the invasive anaesthetic procedure.