Does toxic stress impact paediatric dental procedures? An integrative review


Contemp Pediatr Dent 2021:2(3):135-141

Does toxic stress impact paediatric dental procedures? An integrative review

OrcidVictor Cavallaro Bottesini1 ✉, OrcidGabriel Florio Cairo2 , OrcidGabriel Marcelino3, OrcidDanilo Antonio Duarte4


1. Undergraduate student. Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil ( Correspondence:

2. Undergraduate student. Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil

3. Undergraduate student. Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil

4. Professor, Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil


Invasive paediatric dental procedures can produce a stressful situation in young children.

The topic of toxic stress is relevant and should be included in paediatric dentistry research and clinical trials.

Paediatric dentistry needs to recognize and diagnose toxic stress as an aggravating factor in child health.


Toxic stress is defined as strong, repetitive stress with prolonged activation, without the child having the support of an adult caregiver. It is plausible that invasive and complex paediatric interventions produce or contribute to the development of toxic stress. This article aims to evaluate, discuss and synthesize the association between toxic stress and paediatric dental clinical practice through an integrative review of studies published in several databases. The results of this study allow us to state that this subject is little explored in the dental literature and, therefore, that it is essential to encourage clinical studies and specific research. The expansion of these studies will provide health professionals with scientific evidence regarding the implementation of proper clinical practice, thus reducing or even eliminating the development of toxic stress.

Keywords: Adverse Childhood Experiences; Anxiety; Child; Pediatric Dentistry

Copyright © 2021 Contemporary Pediatric Dentistry


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27 August 2021


07 October 2021

Online First:

12 November 2021