Effect of Puppet-Aided Tell-Show-Do During Dental Emergency Visit on Dental Anxiety and Behavior of Children in a Subsequent Visit: A Randomized Clinical Trial

Subjective Dental Anxiety as Assessed by Venham Picture Test (VPT) for Children Aged 3-5 Years

时间窗: 2 weeks after the intervention

The scale consists of eight pairs of images, each showing a child in both anxious and calm states. Children are asked to select one image from each pair that best represents how they feel. Each anxious image chosen is scored as one, while calm selections are scored as zero. The total dental anxiety score, which ranges from zero to eight, is calculated by summing the individual scores, with higher totals indicating greater anxiety.

Subjective Dental Anxiety as Assessed by Abeer Children Dental Anxiety Scale (ACDAS) for Children Aged 6-9 Years

时间窗: 2 weeks after the intervention

The scale is divided into three sections. Part A includes 13 self-reported items presented in a logical sequence, in which children indicate their feelings toward different dental situations using three facial expressions: happy/relaxed (score = 1), neutral/ "OK" (score = 2), and scared/anxious (score = 3). The total score ranges from 13 to 39; scores ≥26 indicate significant dental anxiety. Part B consists of three yes/no questions exploring the child's cognitive concerns, such as shyness about their teeth or dentist, and fear of losing control during treatment. Part C gathers additional information from both the parent/guardian and the dentist: parents report on the child's previous dental experiences and anticipated behavior, while the dentist records the child's behavior after treatment. By combining self-reported, parental, and clinical perspectives, ACDAS provides a comprehensive assessment of dental anxiety in children

Objective Dental Anxiety as Assessed by the Venham Anxiety Rating Scale (VARS)

时间窗: 2 weeks after the intervention

The VARS is constructed of six behaviorally defined categories that range from zero to five, with higher scores indicating higher levels of dental anxiety. The score gradually increases from relaxed (Score 0), to the child is totally out of control (Score 5). The target population for this scale is children aged 3-12 years.

Behavior as Assessed by the Behavior Profile Rating Scale (BPRS)

时间窗: 2 weeks after the intervention

An independent observer, other than the operating dentist, is required to systematically record the occurrence of 27 distinct behavioral aspects over a series of 3-minute intervals. Four of these behaviors assess the child's reaction to his separation from a parent. The remaining 23 aspects assess the child's behavior in the dental office. Each behavior is assigned a weighted score that reflects its level of disruptiveness. The total score is calculated by multiplying the frequency of each behavior during the 3-minute periods by its weight, then summing the results across all categories and dividing by the number of intervals. In this study, the BPRS was adapted to be applied once per quadrant during oral prophylaxis, rather than at fixed 3-minute intervals, because the procedure was short and, in some cases, did not extend to three minutes.