Randomized Controlled Evaluation of Storybook and Animation Video as Adjuncts to the Tell-Show-Do Technique in Pediatric Dentistry
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- Inonu University
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Change in dental anxiety and cooperation measured by the Jeet Wheel Scale
Study Overview
Brief Summary
This study is designed to evaluate strategies for reducing dental anxiety in pediatric patients. The commonly applied "Tell-Show-Do" method involves explaining and demonstrating dental procedures before they are performed. In this randomized controlled trial, three groups of children will be compared:
Children who receive only the Tell-Show-Do method,
Children who are prepared at home with a storybook prior to receiving the Tell-Show-Do method,
Children who are prepared at home with an animation video prior to receiving the Tell-Show-Do method.
Children's dental anxiety will be assessed using validated behavioral observation scales, including baseline measurement at the first examination, after preparation, and following completion of dental treatment. The study will determine whether the addition of a storybook or an animation video provides greater effectiveness in reducing dental anxiety compared with the Tell-Show-Do method alone.
Detailed Description
Dental anxiety is a frequent challenge in pediatric dentistry and can complicate patient cooperation, lead to incomplete treatment, or necessitate the use of general anesthesia. Among the available behavior guidance techniques, the Tell-Show-Do (TSD) method is the most widely applied and has been shown to facilitate children's acceptance of dental procedures. However, recent approaches suggest that additional child-friendly strategies, such as storybooks and animation videos, may further enhance its effectiveness in reducing anxiety and improving cooperation.
This randomized controlled trial aims to evaluate the impact of incorporating a storybook or an animation video in addition to the TSD method on children's dental anxiety and cooperative behavior. Participants will be randomly assigned to one of three groups:
Control group: Tell-Show-Do only.
Storybook group: Children will be prepared at home with a storybook prior to the dental visit, followed by Tell-Show-Do.
Animation video group: Children will be prepared at home with an animation video prior to the dental visit, followed by Tell-Show-Do.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Single (Outcomes Assessor)
Masking Description
The children, parents, and treating dentist were aware of the assigned intervention (storybook, animation video, or Tell-Show-Do only). However, the outcome assessor who rated children's anxiety using the Jeet Wheel scale was blinded to group allocation.
Eligibility Criteria
- Ages
- 4 Years to 8 Years (Child)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Children aged 4 to 8 years
- •Requiring dental treatment in the pediatric dentistry clinic
- •Classified as cooperative enough for chairside treatment without mandatory general anesthesia
- •Parent or legal guardian able to provide written informed consent
- •Child assent obtained where appropriate -
Exclusion Criteria
- •Children with systemic medical conditions that contraindicate routine dental care
- •Children with developmental, cognitive, or behavioral disorders that preclude completion of study procedures
- •Children requiring urgent dental treatment under general anesthesia or sedation
- •Prior exposure to the same storybook or animation video used in the study
- •Parents/guardians who decline to provide consent
Arms & Interventions
Tell-Show-Do Only (Control)
Children in this arm will receive the standard Tell-Show-Do (TSD) behavioral guidance technique before and during dental treatment. No additional preparation such as storybook or animation video will be provided.
Intervention: Tell-Show-Do (Behavioral)
Storybook + Tell-Show-Do
Children in this arm will be prepared at home with a child-friendly storybook that introduces the dental environment, instruments, and treatment steps in an age-appropriate manner. At the clinic, they will then receive the standard Tell-Show-Do (TSD) behavioral guidance technique before and during dental treatment.
Intervention: Tell-Show-Do (Behavioral)
Storybook + Tell-Show-Do
Children in this arm will be prepared at home with a child-friendly storybook that introduces the dental environment, instruments, and treatment steps in an age-appropriate manner. At the clinic, they will then receive the standard Tell-Show-Do (TSD) behavioral guidance technique before and during dental treatment.
Intervention: Storybook Preparation (Behavioral)
Animation Video + Tell-Show-Do
Children in this arm will be prepared at home with an age-appropriate animation video introducing the dental environment, instruments, and treatment steps. At the clinic, they will then receive the standard Tell-Show-Do (TSD) behavioral guidance technique before and during dental treatment.
Intervention: Tell-Show-Do (Behavioral)
Animation Video + Tell-Show-Do
Children in this arm will be prepared at home with an age-appropriate animation video introducing the dental environment, instruments, and treatment steps. At the clinic, they will then receive the standard Tell-Show-Do (TSD) behavioral guidance technique before and during dental treatment.
Intervention: Animation Video Preparation (Behavioral)
Outcomes
Primary Outcomes
Change in dental anxiety and cooperation measured by the Jeet Wheel Scale
Time Frame: Baseline (Day 1, first examination before intervention) Immediately after preparation, before dental treatment (Day 1, pre-treatment) Immediately after completion of dental treatment (Day 1, post-treatment)
The Jeet Wheel Scale (JWS) (Chakraborty et al., 2024) is a validated child-friendly tool for evaluating dental anxiety and cooperation. The scale ranges from 1 to 8, represented by expressive emoji faces from Excited (1) to Shouting (8). Lower scores indicate no or minimal anxiety with good cooperation, whereas higher scores indicate severe anxiety and poor cooperation. Children will be asked to select the emoji that best represents their feelings, and the score will be recorded at each time point.
Secondary Outcomes
- Between-group differences in Jeet Wheel scores after behavioral preparation(Day 1 (Immediately after preparation, before treatment))
- Proportion of children with high anxiety at post-treatment (Jeet Wheel score ≥ 4)(Day 1 (Immediately after completion of dental treatment, post-treatment).)
- Safety and acceptability of behavioral preparations(Throughout the dental visit(s) on Day 1.)
Investigators
Merve Bilmez Selen
PROF LECTURER
Inonu University