Letter to the Editor: Semiotics of scrubs, children’s perceptions of dentist attire and implications for pediatric procedural anxiety

Abstract

In this article, we comment on the article by Kadiveti et al published in the World Journal of Clinical Cases. Interventions carried out by pediatric proceduralists, such as anesthetists, dentists, surgeons and even nurses, are usually high-stakes procedures in anxious pediatric patients, where non-verbal communication has the power to influence both patient cooperation and outcomes. The proceduralists attire, specifically operating theatre scrubs and related personal protective equipment function as nonverbal communication in pediatric procedural settings. Nonverbal elements comprise a significant proportion of emotional signalling in children and thus offer modifiable levers. There is gradual mounting evidence that proceduralist attire be treated as a modifiable signal within a broader communicative framework and can either reinforce or undermine softskill behaviours depending on their congruence with verbal tone, facial expression, and overall mannerisms. When implementing such finding into practice, practical implications need to be taken into account by pediatric proceduralists to ensure an evidence-driven approach that prioritizes measurable outcomes using validated anxiety scales, induction cooperation scores, time to induction, sedative requirements, and parental satisfaction, over preference alone. Ethical and infection control trade-offs need to be addressed, to ensure that any aesthetic adaptations comply with institutional safety standards and are culturally sensitive. Whether attire modifications translate into clinically meaningful benefits can only be determined after conducting large multi-centric studies that aid transition from mapping children’s preferences to drawing up outcome-oriented yet feasible practice changes.

Keywords: Attire; Communication; Nonverbal; Professional-patient relations; Clinical competence; Procedural sedation and analgesia; Non-verbal communication

Core Tip: Scrubs must be considered as tools of non-verbal communication, by proceduralists, particularly when aligned with age-appropriate communication, and a patient-centred approach can help allay pediatric anxiety, build trust, and improve cooperation and procedural outcomes.