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Tanaka S, Uehara N et al. J Dent Sci 2016; 11: 287–292

There is a complex interplay between the child, parent and the dental carer when a child receives treatment. The key aspect of the methodology used in this study, was that anxiety levels were measured objectively using an electrocardiogram, in contrast to other studies that recorded child anxiety using psychometric scales; children are poor historians and therefore such scales lack veracity. The study recruited 27 children, aged 3-6 years old, and their mothers. When tell-show-do and/or distraction methods did not allow restorative dental care (placement of a resin composite), the treating dentist placed the child in a restraining device (n = 13). This study was approved by the Ethics Committee of Faculty of Dentistry, Tokyo Medical and Dental University. The anxiety of mothers was quantified by a questionnaire. 'Uncooperative children' had higher sympathetic nervous activity and lower parasympathetic activity than 'cooperative children'. In addition, mothers of 'uncooperative children' had a higher state of anxiety.