Are therapy animals the key to happier dental visits for children?

Abstract

A Commentary on

Massouda J, Ghaltakhchyan N, Judd J, Bocklage C, Selden R, TumSuden O, Nanney E, Lee J, Ginnis J, Strauman T, Sawicki C, Hodges EA, Graves C, Divaris K, Jacox L.

Evaluating effects of animal-assisted therapy on paediatric dental care patients: A pilot clinical trial. J Am Dent Assoc. 2025;156:447–457. https://doi.org/10.1016/j.adaj.2025.03.006

Data sources

This commentary is based on the published pilot clinical trial by Massouda et al. (2025) evaluating animal-assisted therapy (AAT) in paediatric dental care.

Study selection

The study included children aged 7–14 undergoing invasive dental procedures, allocated to either an AAT or control group.

Data extraction and synthesis

Outcome measures included validated self-reported anxiety and pain scales, physiological stress markers, and behavioural observations. Data was synthesised narratively given pilot design and small sample size.

Design

A prospective, non-randomised pilot trial carried out in a university paediatric dental setting assessed the practicality and initial effects of integrating animal-assisted therapy (AAT) into dental treatment.

Case selection

Thirty-nine children aged 7–14 years scheduled for invasive dental procedures were enroled. Participants were allocated to an AAT group (n = 18) or a control group (n = 21). Inclusion criteria included the ability to assent and a willingness to interact with a certified therapy animal. Exclusion criteria included previous traumatic experiences with AAT, or significant developmental or behavioural disorders affecting cooperation.

Data analysis

Physiological and psychological measures were recorded at baseline, during treatment, and post-operatively. Primary outcomes included self-reported pain and anxiety scores using validated scales. Secondary outcomes included heart rate monitoring, salivary cortisol, α-amylase, and video-coded behavioural relaxation. Given the small sample size, statistical analyses employed nonparametric 35 tests with significance set at P < 0.05.

Results

Children exposed to the therapy dog reported significantly lower postoperative pain scores (P = 0.001) and demonstrated smaller heart rate fluctuations during stressful procedural moments, suggesting lower physiological stress responses. Behavioural observations indicated longer periods of relaxed posture in the AAT group, though this did not reach statistical significance (P = 0.204). No significant differences were detected in salivary cortisol or α-amylase. AAT was reported as safe, well-tolerated, and feasible to implement.

Conclusions

AAT shows potential for reducing distress in paediatric dental settings, but larger, randomised studies are required. Within the limits of a pilot design, animal-assisted therapy may reduce pain and physiological stress in paediatric dental patients. While encouraging, larger randomised trials are needed to confirm these effects, explore mechanisms, and assess practicality and cost in routine dental practice.