Impact of Therapy Dogs on Child Anxiety and Behavior During Local Anesthesia for Dental Procedures

Inclusion Criteria: * Age range: children aged 4- to 12-years * Health status: healthy children without significant medical conditions (ASA I or ASA II) * Dental procedure: children scheduled for at least two dental procedures requiring local anesthesia * Consent: written informed consent from the parent or legal guardian * Verbal assent from potential subjects age 4-9 years; written assent for children age 10-12 years Exclusion Criteria: * Allergies: children with known allergies to dogs or animal dander * Children with a fear or phobia of dogs * Children with a behavioral disorder which may negatively impact response to the presence of a therapy dog * Previous exposure: children who have previously undergone dental procedures with local anesthesia in the presence of a therapy dog * Medical conditions: children with medical conditions that might affect their vital signs independently of the dental procedure (e.g., heart conditions) * Parental discomfort: cases where parents are uncomfortable with the presence of a therapy dog during the procedure * Advanced behavior guidance is indicated: children whose behavior for dental examination is classified as "Definitely Negative" (Frankl 1)