Shortly before COVID hit, I wrote about dental therapy dogs and the potential benefits and risks associated with having dogs in dentists’ offices to alleviate patient stress. COVID impacted lots of research, including this, but a pilot study got done, looking at the impact of dogs on patient stress. Like a lot of small studies, we have to be careful not to over-interpret things, but this study shows that this area is worth more study.

The study (Gussgard et al, Clin Exp Dent Res 2023) looked at the impact of a therapy dog on stress measures in kids, with a focus on salivary cortisol.

  • 16 children (median age 8.5 years) were studied.
  • Kids underwent a standard dental exam twice, with or without the presence of a trained therapy dog.
  • Kids were randomly assigned to have the dog first or the dog-free session first, to see whether interacting with the dog on the first visit impacted their stress at the second visit.
  • They took samples, including saliva samples for cortisol testing, at both visits. Saliva samples were collected in the waiting room before the procedure, then again in the waiting room after the procedure. A questionnaire was also administered at those timepoints.

Backing up, what’s a ‘specially trained therapy dog’?

It’s a dog that’s trained to be able to interact closely and in a structured manner in a busy and high stimulus (noise, smell, activity) dental office. It was trained to either lay on the child’s lap or be next to them on an elevated table so they could see and touch the dog throughout the procedure.  

Back to the study….

The child was introduced to the dog in the waiting room, then chose whether they wanted the dog on their lap during the exam or next to them.

Parent-reported CFSS-DS (children’s fear survey schedule; dental subscale) scores and child reported happy/sad face scores were obtained.

  • Parent reported CFSS-DS scores at the 2nd visit were lower for children that had their first exam with the dog vs those that did not (36 vs 28). The small sample size precluded statistical analysis but the numerical difference shows promise.

Child reported sad/happy face scores showed a similar outcome

  • Kids that had their first exam with the dog had happiness scores that were higher when they came in for the second visit

Both these suggest that the kids had both a positive response during the dental exam and, importantly, that effect carried over so that when they came for the next visit, they were less anxious.

Saliva cortisol levels were assessed as an indicator of stress. Similar results were obtained.

  • Contact with the dog on the first visit resulted in a greater drop in cortisol levels during the second visit’s clinical exam compared to kids that didn’t have the dog on the first visit (2.5 nmol/l decrease vs 0.4 nmol/L). T

These were not significantly different so we have to be careful not to over-interpret the results; however, given the small sample size, these results suggests there are benefits that need to be studied further.

Will a therapy dog be coming to a dental clinic near you?

Probably not (at least soon). A lot of work goes into training these dogs and they need supervision during the exam, something that’s not going to be of interest everywhere. There are also infection control concerns, but those are manageable, something we’ve previously addressed for both the patients and the dogs.

Despite the small size, this study shows how there is potential for benefit and that we need to understand it more. While there might not be widespread use of this, it could be of particular use in certain situations, so having a dog that’s trained for a clinic for sporadic use could be feasible.