Pediatric Dental Anxiety
Conditions
Keywords
Animated Educational Video, Dental Anxiety, Tell-Show-Do, Artificial Intelligence, Pediatric Dentistry
Brief summary
The goal of this clinical trial is to evaluate the overall effect of an artificial intelligence-generated, instrument-specific animated video series compared with the conventional Tell-Show-Do (TSD) technique on dental anxiety in children aged 4 to 8 years. The study will also investigate whether the anxiety-reducing effect differs according to the dental instrument introduced. Researchers will compare the animated video series with the conventional Tell-Show-Do technique across four dental instruments: dental mirror, dental probe, micromotor handpiece, and saliva ejector. Participants will be randomly assigned to one of the study groups. Children will either watch an instrument-specific animated educational video or receive the Tell-Show-Do technique related to a specific dental instrument. Dental anxiety levels will be evaluated using the Facial Image Scale (FIS), Venham Picture Test (VPT) and Modified Child Dental Anxiety Scale-Faces version (MCDASf), together with pulse rate and oxygen saturation levels, before and after the application procedure.
Detailed description
This prospective, single-center, randomized controlled clinical trial will evaluate the effectiveness of an artificial intelligence-generated animated educational video series in reducing dental anxiety among children aged 4 to 8 years. The study uses a 2×4 factorial design to compare the animated video series with the conventional Tell-Show-Do (TSD) technique across four commonly used dental instruments: dental mirror, dental probe, micromotor handpiece, and saliva ejector. Participants will be randomly assigned to one of eight study groups according to intervention type and dental instrument. Only healthy children with no previous dental treatment experience and a Frankl Behavior Rating Scale score of 3 or 4 will be included in the study. Children in the animation groups will watch an instrument-specific animated educational video, while children in the control groups will receive the conventional Tell-Show-Do technique for the same instrument. Dental anxiety will be assessed using the Facial Image Scale (FIS), Venham Picture Test (VPT), and Modified Child Dental Anxiety Scale-Faces version (MCDASf). Physiological parameters including pulse rate and oxygen saturation levels will also be recorded before and after the application procedure. The study aims to investigate both the overall effectiveness of the animated educational video series and the instrument-specific differences in anxiety reduction among pediatric dental patients.
Interventions
BEHAVIORALAI-Generated Animated Video Series
An original four-episode animated video series produced using AI-assisted animation tools. Each episode is approximately 60 seconds in duration and is designed around a single dental instrument, featuring a recurring maternal character and anthropomorphic dental germ characters whose mischievous behaviour is resolved through the action of the featured instrument. Each child viewed only the single episode corresponding to the instrument assigned to their group.
BEHAVIORALTell-Show-Do (TSD) Technique
The standard Tell-Show-Do technique applied specifically to the instrument assigned to each group. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). Each TSD session lasted approximately 4 minutes, matching the viewing time of the single animated episode in the intervention condition.
Sponsors
Alanya Alaaddin Keykubat University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Participants will be randomized into factorial groups based on behavioral management technique and dental instrument exposure.
Eligibility
Sex/Gender
ALL
Age
4 Years to 8 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 4-8 years * Frankl Behaviour Rating Scale score of 3 or 4 (positive or definitely positive) at initial assessment * No previous restorative or surgical dental treatment * ASA physical status classification I or II * Ability to communicate in Turkish * Written informed consent from the parent or legal guardian
Exclusion criteria
* Confirmed neurodevelopmental disorder (e.g., autism spectrum disorder, attention-deficit/hyperactivity disorder) * Clinically significant visual or hearing impairment * Prior exposure to formal behaviour management conditioning programmes * Requirement for emergency dental care at the study appointment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Venham's Picture Test (VPT) | Baseline (T0) and immediately post-intervention (T1) | An eight-item pictorial anxiety measure requiring children to select the image (anxious or non-anxious figure) that best represents their feelings (score range 0-8). |
| Facial Image Scale (FIS) | Baseline (T0) and immediately post-intervention (T1) | A five-item pictorial self-report scale depicting faces ranging from very happy (1) to very unhappy (5), validated for use in children aged ≥ 4 years with limited literacy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Modified Child Dental Anxiety Scale - Faces Version (MCDASf) | Baseline (T0) and immediately post-intervention (T1) | A six-item self-report scale using facial images (score range 6-30), validated for the paediatric dental setting. |
| Heart Rate (HR) | Baseline (T0) and immediately post-intervention (T1) | Measured using a paediatric pulse oximeter positioned on the index finger of the non-dominant hand. The mean of two consecutive readings was used for analysis. |
| Peripheral Oxygen Saturation (SpO₂) | Baseline (T0) and immediately post-intervention (T1) | Measured using a paediatric pulse oximeter positioned on the index finger of the non-dominant hand. The mean of two consecutive readings was used for analysis. |
Countries
Turkey (Türkiye)
Outcome results
None listed