 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue2
Subject Area: Dental Medicine
-
DOI: 10.5272/jimab.2026322.6943
Published online: 26 June 2026
Original article
J of IMAB. 2026 Apr-Jun;32(2):6943-6948
DENTAL ANXIETY DURING THE TREATMENT OF CARIOUS LESIONS IN CHILDREN USING BRIX 3000 AND CONVENTIONAL CAVITY PREPARATION
Zornitsa Lazarova
,
Department of Paediatrics Dentistry, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria.
ABSTRACT:
The dentist's ability to assess anxiety and emotional perception in children is essential for effective planning and delivery of dental treatment in paediatric patients.
Aim. Comparative assessment of dental anxiety using the Facial Image Scale during chemo-mechanical caries excavation with Brix 3000 and conventional rotary bur preparation.
Materials and Methods. A total of 72 children aged 4–6 years were included in the study and divided into two groups. Group 1 – 42 children treated with chemo-mechanical caries excavation using Brix 3000, while Group 2 (controlled group) included 30 children treated with conventional rotary bur preparation. Cavity preparation in both groups followed a standardized protocol, and the quality of excavation was assessed using fluorescence control. Dental anxiety was evaluated using the Facial Image Scale before and after treatment.
Results. Chemo-mechanical excavation with Brix 3000 resulted in a marked reduction in dental anxiety. After treatment with Brix 3000, no children were classified at the highest anxiety level (Level 5), while the proportion of children with no anxiety (Level 1) increased significantly. In contrast, the distribution of anxiety levels in the conventional preparation group showed minimal change after treatment. Overall, children treated with Brix 3000 demonstrated lower anxiety levels compared with those treated using the conventional method.
Conclusion. Chemo-mechanical caries excavation using Brix 3000 leads to a significant reduction in dental anxiety compared with conventional cavity preparation. This technique represents a successful and alternative approach for the management of carious lesions in paediatric dentistry.
Keywords: anxiety, Facial Image Scale, Brix 3000, carious lesions,
- Download FULL TEXT /PDF 1573 KB/
Please cite this article as: Lazarova Z. Dental Anxiety During the Treatment of Carious Lesions in Children Using Brix 3000 and Conventional Cavity Preparation. J of IMAB. 2026 Apr-Jun;32(2):6943-6948. [Crossref - 10.5272/jimab.2026322.6943]
Correspondence to: Zornitsa Lazarova, Department of Peadiatric Dentistry, Faculty of Dental Medicine, Medical University – Sofia; 1, St. Georgi Sofiisky Str., Sofia, Bulgaria. E-mail: z.lazarova@fdm.mu-sofia.bg
REFERENCES:
1. Barry M, Alnami M, Alshobaili YT, Felemban OM, Sabbagh HJ. Assessment of Dental Fear and Anxiety Tools for Children: A Review. Healthcare (Basel). 2025 Oct 15;13(20):2597. [PubMed]
2. Bay EJ, Algase DL. Fear and anxiety: a simultaneous concept analysis. Nurs Diagn. 1999 Jul-Sep;10(3):103-11. [PubMed]
3. Woodward A, D'Angelo O, Fontoura C, Karl E, Mantesso A. Dental Anxiety - Definition, Etiology, Diagnosis and Treatment Options. Open Access J Dent Oral Surg. 2022;3:1031. [Internet]
4. Armencia AO, Bamboi I, Toader B, Rapis A, Nicolau A, Balcos C, Edlibi Al Hage W, Panaite T. A Cross-Sectional Study on the Impact of Dental Fear and Anxiety on the Quality of Life of Romanian Dental Students. Medicina. 2025 Apr 9;61(4):688. [Crossref]
5. Almarzouq SSFS, Chua H, Yiu CKY, Lam PPY. Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2024 Feb 23;12(5):537. [PubMed]
6. Hegazi F, Alghamdi N, Alhajri D, Alabdulqader L, Alhammad D, Alshamrani L, Bedi S, Sharma S. Association between Dental Fear and Children's Oral Health-Related Quality of Life. Int J Environ Res Public Health. 2024; 21(9):1195. [Crossref]
7. Ying J, Tao H, He Q, Zhang Z, Hu W, Chen S, Guan Y. Children's Dental Fear: Occurrence Mechanism and Prevention Guidance. J Multidiscip Healthc. 2023 Jul 18;16:2013-2021. [Crossref]
8. Eitner S, Wichmann M, Paulsen A, Holst S. Dental anxiety--an epidemiological study on its clinical correlation and effects on oral health. J Oral Rehabil. 2006 Aug;33(8):588-93. [PubMed]
9. Chiu HHC, Lam PPY, Yiu CKY. The Impact of Minimal Intervention Dentistry on Patient-Reported and Observation-Based Outcomes in the Pediatric Population: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2023 Aug 9;11(16):2241. [PubMed]
10. Akindele BO, Orenuga OO, Olatosi OO, Oladele RO. Comparative evaluation of the clinical effectiveness of chemo-mechanical (Papacarie) and conventional mechanical caries removal methods in treatment of carious primary molars: a randomized controlled clinical study. BMC Oral Health. 2025 Feb 22;25(1):290. [Crossref]
11. Goel D, Awasthi N, Singh Y, Singh S, Yirang N. Pain Perception During Minimally Invasive Caries Removal in Children: A Randomized Clinical Trial Comparing Chemo-Mechanical Caries Removal. J Int Soc Prev Community Dent. 2025 Jul-Aug;15(4):348-356. [Crossref]
12. Bsereni L, Torresi FV, Research on the efficacy of Brix3000® papain gel. [Internet]
13. Maashi M, Elkhodary H, Bamashmous N, Felemban O, Alamoudi N. Clinical performance of two chemo-mechanical caries removal agents in primary molars: a randomized controlled trial. Eur Arch Paediatr Dent. 2025 Aug;26(4):731-739. [PubMed]
14. Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial. J Dent. 2020 Feb;93:103280 [Crossref]
15. Buchanan H, Niven N. Validation of a Facial Image Scale to assess child dental anxiety. Int J Paediatr Dent. 2002 Jan;12(1):47-52. [Crossref]
16. de Menezes Abreu DM, Leal SC, Mulder J, Frencken JE. Patterns of dental anxiety in children after sequential dental visits. Eur Arch Paediatr Dent. 2011 Dec;12(6):298-302. [PubMed]
17. Hasan AT, Abbas MJ, Barakat IF. Assessing Anxiety and Pain During Treatment of Primary Molar Carious Lesions Using Minimal Invasive Techniques: Randomized Controlled Trial. Mustansiria Dent J. 2024; 20(2):152-161. [Crossref]
18. Motta LJ, Bussadori SK, Campanelli AP, da Silva AL, Alfaya TA, de Godoy CH, et al. Pain during Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial. Int J Dent. 2013;2013:896381. [Crossref]
19. Hegde S, Kakti A, Bolar DR, Bhaskar SA. Clinical Efficiency of Three Caries Removal Systems: Rotary Excavation, Carisolv, and Papacarie. J Dent Child (Chic). 2016; 83(1):22-8. [PubMed]
20. Kotb RM, Abdella AA, El Kateb MA, Ahmed AM. Clinical evaluation of Papacarie in primary teeth. J Clin Pediatr Dent. 2009 Winter;34(2):117-23. [PubMed]
Received: 19 November 2025
Published online: 26 June 2026