Impact of Laughter Therapy on Anxiety and Pain in Pediatric Dentistry: A Double-Blinded Randomized, Controlled Clinical Trial

Objective: To evaluate the effect of laughter therapy on reducing anxiety and pain during dental procedures in children 5-7 years of age. Material and Methods: 48 children aged 5-7 years were included in this cross-over double-blinded clinical trial after the parents completed the Screen for Child Anxiety Related Disorder questionnaire (SCARED). After allocation into two groups: laughter intervention (A) and neutral intervention (B), the anxiety as well as pain were determined by Modified Child Dental Anxiety Scale Faces questionnaire (MCDASF) and the Wong-Baker Faces Scale, respectively. Also, the child's behavior during the treatment was recorded using the Sound, Eye, Motor scale (SEM). Data were analyzed by SPSS 21 using Paired t-test, Independent t-test, Chi-square, Mann-Whitney and Wilcoxon's test. Results: The mean score of anxiety in the laughter intervention group (17.42 +/- 2.74) was significantly less than (22.06 +/- 2.16) in the neutral intervention group (p=0.000) and lower in boys in both groups (p=0.000, p=0.047). The mean pain severity reported by the children in the neutral intervention group (5.33 +/- 1.81) was higher than in the laughter intervention group (2.38 +/- 1.87; p=0.00) and higher in girls in both groups (p=0.02; p=0.03). Conclusion: The laughter intervention before dental procedures had a significant effect on reducing anxiety and pain during dental treatment.