Storybook and Animation Video Adjuncts to Tell-Show-Do in Pediatric Dentistry

NCT ID: NCT07209696

Last Updated: 2025-10-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2025-12-31

Brief Summary

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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

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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.

Children's anxiety and cooperation will be assessed at three time points: baseline (first examination), after preparation (before treatment), and after completion of dental treatment. The primary outcome measure will be the Jeet Wheel behavioral observation scale, which provides standardized ratings of children's anxiety and cooperation during dental procedures. In addition, baseline dental fear will be assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and the potential need for general anesthesia will be evaluated with the SCAN Index. These baseline measures will be included as covariates in the statistical analysis to adjust for initial variability in anxiety and treatment requirements.

Data will be analyzed using mixed-effects models to examine the interaction between time (three assessment points) and group (three interventions), while controlling for CFSS-DS and SCAN Index scores. This design will enable comparisons of the relative effectiveness of each intervention independent of baseline differences.

The study is expected to provide new evidence on whether storybook and animation video adjuncts can enhance the effectiveness of the Tell-Show-Do method, offering more child-friendly approaches to reducing dental anxiety in pediatric dental practice.

Conditions

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Dental Anxiety Dental Fear Child Behavior Cooperation During Dental Treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned to one of three parallel groups. The control group will receive the Tell-Show-Do (TSD) technique only. The second group will receive storybook preparation at home followed by TSD. The third group will receive animation video preparation at home followed by TSD. Each participant will remain in the assigned group for the duration of the study.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors
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.

Study Groups

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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.

Group Type ACTIVE_COMPARATOR

Tell-Show-Do

Intervention Type BEHAVIORAL

The conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them.

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.

Group Type EXPERIMENTAL

Tell-Show-Do

Intervention Type BEHAVIORAL

The conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them.

Storybook Preparation

Intervention Type BEHAVIORAL

Home-based preparation using a child-friendly storybook that introduces the dental visit, instruments, and procedures in simple language and illustrations.

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.

Group Type EXPERIMENTAL

Tell-Show-Do

Intervention Type BEHAVIORAL

The conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them.

Animation Video Preparation

Intervention Type BEHAVIORAL

The conventional behavior guidance method where the dentist explains and demonstrates dental procedures before performing them, to reduce anxiety and improve cooperation.

Interventions

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Tell-Show-Do

The conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them.

Intervention Type BEHAVIORAL

Storybook Preparation

Home-based preparation using a child-friendly storybook that introduces the dental visit, instruments, and procedures in simple language and illustrations.

Intervention Type BEHAVIORAL

Animation Video Preparation

The conventional behavior guidance method where the dentist explains and demonstrates dental procedures before performing them, to reduce anxiety and improve cooperation.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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
Minimum Eligible Age

4 Years

Maximum Eligible Age

8 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Inonu University

OTHER

Sponsor Role lead

Responsible Party

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Merve Bilmez Selen

PROF LECTURER

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Merve Bilmez Selen, prof lecturer

Role: CONTACT

+05457673089

References

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Alsaadoon AM, Sulimany AM, Hamdan HM, Murshid EZ. The Use of a Dental Storybook as a Dental Anxiety Reduction Medium among Pediatric Patients: A Randomized Controlled Clinical Trial. Children (Basel). 2022 Mar 1;9(3):328. doi: 10.3390/children9030328.

Reference Type BACKGROUND
PMID: 35327700 (View on PubMed)

Barrera-Avalos C, Luraschi R, Acuna-Castillo C, Vidal M, Mella-Torres A, Inostroza-Molina A, Vera R, Vargas S, Hernandez I, Perez C, Vallejos-Vidal E, Valdes D, Imarai M, Reyes-Lopez FE, Sandino AM. Description of Symptoms Caused by the Infection of the SARS-CoV-2 B.1.621 (Mu) Variant in Patients With Complete CoronaVac Vaccination Scheme: First Case Report From Santiago of Chile. Front Public Health. 2022 Mar 21;10:797569. doi: 10.3389/fpubh.2022.797569. eCollection 2022.

Reference Type BACKGROUND
PMID: 35387187 (View on PubMed)

Wang Q, Chen S, Li Y, Li P, Wu C, Wu Z, Wu Q, Sun F, Li J, Zheng W, Deng C, Zhang F, Li Y. Positive association of genetic variations in the phospholipase C-like 1 gene with dermatomyositis in Chinese Han. Immunol Res. 2016 Feb;64(1):204-12. doi: 10.1007/s12026-015-8738-x.

Reference Type BACKGROUND
PMID: 26603167 (View on PubMed)

Wiley DJ, Grosser S, Qi K, Visscher BR, Beutner K, Strathdee SA, Calhoun B, Palella F, Detels R; Multicenter AIDS Cohort Study Group. Validity of self-reporting of episodes of external genital warts. Clin Infect Dis. 2002 Jul 1;35(1):39-45. doi: 10.1086/340743. Epub 2002 Jun 6.

Reference Type BACKGROUND
PMID: 12060873 (View on PubMed)

Thyne SM, Marmor AK, Madden N, Herrick G. Comprehensive asthma management for underserved children. Paediatr Perinat Epidemiol. 2007 Nov;21 Suppl 3:29-34. doi: 10.1111/j.1365-3016.2007.00882.x.

Reference Type BACKGROUND
PMID: 17935573 (View on PubMed)

Other Identifiers

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2024-162

Identifier Type: -

Identifier Source: org_study_id

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