Effectiveness of Four Different Distraction Techniques in Management of Anxiety during Preventive Dental Treatment in Hearing Impaired Pediatric Dental Patients of age 4 -14 years of age - A Randomized Clinical Study

·       This randomized clinical study aims to evaluate and compare the effectiveness of four different distraction techniques in managing dental anxiety among hearing-impaired pediatric patients aged 4–14 years undergoing preventive dental treatment. Sixty eligible children will be randomly allocated into four groups: breathing-stimulated teddy bear (on mode), breathing-stimulated teddy bear (off mode), fidget spinner, and Picture Exchange Communication System (PECS). All participants will receive routine behavior guidance and topical fluoride application. Anxiety levels will be assessed using physiological parameters (pulse rate and oxygen saturation) and a psychological parameter (Venham’s Picture Scale) recorded before and after the procedure. The study seeks to identify a safe, non-pharmacological, and effective distraction technique to improve cooperation and reduce anxiety in hearing-impaired children during dental care.