Positive Pre-Visit Imagery Does Not Reduce Dental Anxiety in Children

NCT ID: NCT06966726

Last Updated: 2025-05-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 69 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-10-25
• Study Completion Date: 2024-12-17

Brief Summary

This randomized triple-blind clinical trial aims to evaluate the effectiveness of positive pre-visit imagery in managing dental anxiety (DA) in children aged 5 to 13 years. DA is a common barrier to dental treatment and is often triggered by procedures such as local anaesthesia. Participants were randomly assigned to view either positive dental images or neutral nature images before treatment. Anxiety levels were assessed before and after the procedure using the Venham Picture Test. The study hypothesizes that exposure to positive dental imagery prior to the appointment may reduce anxiety levels, promoting a more positive dental experience for pediatric patients.

Detailed Description

Dental anxiety (DA) is a significant barrier to dental care in children and is commonly associated with negative treatment experiences, particularly during procedures such as local anaesthesia. Children with DA are more likely to exhibit poor oral health outcomes and reduced quality of life. Behaviour management techniques (BMTs), such as distraction, tell-show-do, desensitization, and positive reinforcement, are routinely used in pediatric dentistry to help reduce anxiety and improve cooperation.

Among the newer BMTs, positive pre-visit imagery-where children view positive dental-related images prior to treatment-has shown promise. This technique is based on observational learning and aims to create positive associations with dental care. However, current evidence is limited and inconclusive.

This triple-blind randomized controlled trial investigates the effectiveness of positive pre-visit imagery in reducing DA in children. Sixty-nine children aged 5 to 13 years requiring local anaesthesia were randomly assigned to view either a series of positive dental images (intervention group) or neutral nature scenes (control group) prior to treatment. The intervention consisted of four A4 laminated images designed to elicit positive emotional responses related to dental care, while the control group viewed four neutral nature photographs.

Anxiety was assessed before and after the dental procedure using the Venham Picture Test (VPT), a validated tool for evaluating dental anxiety in children. The primary outcome was the change in anxiety level between pre- and post-treatment, and the data were analyzed using non-parametric statistical methods.

The study follows CONSORT guidelines and was approved by the Human Research Ethics Committee at the Federal University of Rio Grande do Norte. This trial aims to provide robust evidence regarding the effectiveness of positive pre-visit imagery as a non-pharmacological strategy for managing dental anxiety in children.

Conditions

Dental Anxiety; Dental Fear and Anxiety

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Positive Imagery Group

Participants were exposed to positive images related to dental care (e.g., smiling children after treatment, positive interactions with the dentist) for 2 minutes prior to the dental procedure.

Group Type: EXPERIMENTAL

Positive Dental Imagery

Intervention Type: BEHAVIORAL

Children were shown four A4-sized laminated color images depicting positive dental scenes (e.g., children interacting happily with the dentist, smiling after treatment) for 2 minutes prior to the procedure.

Neutral imagery group

Participants were exposed to neutral images (nature scenes) for 2 minutes prior to the dental procedure.

Group Type: PLACEBO_COMPARATOR

Neutral Nature Imagery

Intervention Type: BEHAVIORAL

Children were shown four A4-sized laminated color images depicting neutral nature scenes (e.g., a beach, sunset, flowers) for 2 minutes prior to the procedure.

Interventions

Positive Dental Imagery

Children were shown four A4-sized laminated color images depicting positive dental scenes (e.g., children interacting happily with the dentist, smiling after treatment) for 2 minutes prior to the procedure.

Intervention Type: BEHAVIORAL

Neutral Nature Imagery

Children were shown four A4-sized laminated color images depicting neutral nature scenes (e.g., a beach, sunset, flowers) for 2 minutes prior to the procedure.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• children aged 5-13 years who were admitted to the Paediatric Dentistry Clinic of the Federal University of Rio Grande do Norte, and who required local anaesthesia during dental treatment

Exclusion Criteria

• Children with intellectual disabilities, visual or hearing impairments and children requiring emergency treatment were excluded

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 13 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Universidade Federal do Rio Grande do Norte

OTHER

Sponsor Role: lead

Responsible Party

Lavínia Lourenço Costa

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Universidade Federal do Rio Grande do Norte - Departamento de odontologia

Natal, Rio Grande do Norte, Brazil

Countries

Brazil

References

Kamel DO, Wahba NA, Talaat DM. Comparison between Positive Dental Images and Neutral Images in Managing Anticipatory Anxiety of Children. J Clin Pediatr Dent. 2017;41(2):116-119. doi: 10.17796/1053-4628-41.2.116.

Reference Type: BACKGROUND

PMID: 28288299 (View on PubMed)

Other Identifiers

71431923.0.0000.5537

Identifier Type: -

Identifier Source: org_study_id