154 - The Impact of Standardized Preoperative Education on Parental Dental Anxiety for Children Undergoing Elective Dental Surgery under General Anesthesia

Introduction
Parental anxiety is common when children undergo elective dental procedures under general anesthesia (GA), particularly in outpatient settings. Elevated anxiety may negatively affect both parent and child, potentially complicating preoperative management, anesthesia induction, and recovery. Although advances in anesthesia have improved safety, parental emotional preparation remains under-addressed. Preoperative education has been shown to reduce perioperative anxiety, with structured interventions—such as videos, brochures, and multimedia tools—demonstrating measurable benefit. However, most studies focus on hospital-based surgical settings, with limited data in office-based pediatric dental intravenous general anesthesia (IVGA), where workflow and parental involvement differ.
This prospective randomized controlled trial evaluates the impact of a standardized preoperative educational intervention on parental anxiety in an outpatient pediatric dental IVGA setting.

Objective:
To evaluate whether a standardized preoperative educational program (brochure, structured counseling, and Q&A session) reduces parental anxiety and improves the perioperative experience in children undergoing outpatient pediatric dental treatment under IVGA.

Methods
Participants:
English-speaking parents of children aged 3–10 years scheduled for elective IVGA were recruited (UCLA IRB #25-0185). Inclusion required at least a middle school education and internet access. Exclusion criteria included prior household exposure to IVGA or surgery and non-English speakers.
Study

Design:
Participants were contacted one week prior to surgery, screened, consented, and randomized using stratified block randomization (child age and parental education level). Allocation concealment was maintained using sealed opaque envelopes.
Groups:
Control: Routine verbal and written preoperative instructions
Intervention: Routine instructions plus standardized education (IVGA brochure and structured Q&A session with the principal investigator)
Outcome Measure:
Parental anxiety was assessed using the Spielberger State Anxiety Inventory (STAI-S), a validated 20-item scale (range 20–80; scores ≥39–40 indicate elevated anxiety), at four time points:
Pre-appointment
Baseline (day of procedure)
Preoperative waiting period
Postoperative recovery
Results
Participant Characteristics:
Twenty-eight parent–child dyads completed the study (16 intervention, 12 control). Groups were comparable at baseline with no significant differences in child age, gender, parental education, or initial STAI-S scores, indicating successful randomization. Baseline anxiety levels were moderate and normally distributed.
Parental Anxiety:
At baseline, mean STAI-S scores were similar between groups. During the preoperative waiting period, the intervention group demonstrated lower mean anxiety scores, with the greatest reduction observed at this time point. Postoperatively, anxiety decreased in both groups; however, the intervention group maintained lower mean scores.
Within-group analyses suggested greater and more consistent reductions in anxiety over time in the intervention group, whereas the control group showed smaller, less consistent changes.
Analysis:
A linear mixed-effects model adjusting for baseline anxiety, child age, and parental education demonstrated a directional Group × Time interaction, suggesting differing anxiety trajectories between groups. Due to the small sample size, findings are considered exploratory.
Conclusion
Standardized preoperative education may reduce parental anxiety in the outpatient pediatric dental IVGA setting. Final conclusions will be determined upon completion of data collection.