Impact of story telling in reducing dental anxiety among 4-8 year old children – A randomized clinical trial.

Introduction:

Child dental anxiety has been a matter of concern for many years. A pediatric dentist’s role in guiding a child with dental anxiety to cooperativeness is two-fold: primarily, treating the child’s chief complaint and secondarily, to instill a positive attitude with effective management of fear and anxiety.

Every pediatric dentist has variety of techniques in managing patient such as tell-show-do, relaxation, distraction, systemic desensitization, modelling. Additionally, a number of communication-aided approaches, like applied behavioural analyses, visual pedagogies, pictorial or iconic images and audio-visual aids, have been proposed to aid behavioural changes among people.

Story telling helps children what they can expect to see, hear, and do at the dental clinic. It can also lead to establishing a sense of bond, trust and comfort, between story teller and audience. It is an important method of conveying what the dentists want to tell the children in ways they can understand. Also imparting knowledge is an important factor that will make the children less anxious, increases children’s confidence, cooperation and familiarity on the treatment, thus decreasing stress and fear of dental visits, and maintains their psychological health.

The Tell-Show-Do technique is based on the principles of learning theory. Playing with a dental imitation toy and using euphemisms instead of demonstrating on a model or observing one, provides a better explanatory concept of the dental procedure.Thus Tell-Show-Do technique was modified into the tell play do, using the concept of learning by doing, in reducing children’s fear and anxiety towards dental treatment and promoting adaptive behavior.

Aim:

To evaluate the impact of story telling in reducing dental anxiety among 4-8 year old children.

Objectives:

1.     1) To evaluate anxiety levels in story telling and tell play do groups before and after intervention and immediately after the dental procedure using physiological (pulse rate) and subjective measures (RMS-PS).

2.      2)To compare anxiety levels in story telling and tell play do groups before and after intervention and immediately after the dental procedure using physiological (pulse rate) and subjective measures (RMS-PS).

Methodology:

This study will be carried out in a sample of 30 children attending the Department of Pediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore. Healthy children between the age group of 4-8 years and meeting the inclusion criteria will be divided into two groups (15 in each) by simple random sampling. Group 1: Story telling and Group 2: Tell play do. In both the groups, physiological measures (pulse rate) by pulse-oximeter and subjective measures by RMS pictorial scale will be recorded prior to the intervention. Child will be asked to select the image from RMS pictorial scale that he/she could closely associate with that moment. Following which the child will receive the particular intervention i.e., Story telling/Tell play do. After the intervention, the physiological measures (pulse rate) by pulse-oximeter and subjective measures by RMS pictorial scale will be recorded. This will be followed with the needed treatment to the child i.e., preventive resin restorations/pit and fissure sealants/composites. Both Physiological as well as subjective measures will be noted again immediately after the completion of the treatment.