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

NCT07209696 | Active Not Recruiting

• 1 other identifier: 2024-162
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

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.

Conditions

Dental Fear; Child Behavior; Dental Anxiety; Cooperation During Dental Treatment

Keywords

Pediatric Dentistry; Behavior Guidance; Tell-Show-Do; Animation Video Intervention; Jeet Wheel Scale; CFSS-DS; SCAN Index

Outcome Measures

Primary Outcomes (1)

• Change in dental anxiety and cooperation measured by the Jeet Wheel Scale

  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.

  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)

Secondary Outcomes (3)

• 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.

Other Outcomes (2)

• Baseline dental fear assessed by the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS)

  Day 1 (Baseline, before intervention).

• Baseline need for general anesthesia assessed by the SCAN Index

  Day 1 (Baseline, before intervention).

Study Arms (3)

Tell-Show-Do Only (Control)

ACTIVE COMPARATOR

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.

Behavioral: Tell-Show-Do

Storybook + Tell-Show-Do

EXPERIMENTAL

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.

Behavioral: Tell-Show-Do; Behavioral: Storybook Preparation

Animation Video + Tell-Show-Do

EXPERIMENTAL

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.

Behavioral: Tell-Show-Do; Behavioral: Animation Video Preparation

Interventions

Tell-Show-Do BEHAVIORAL

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

Animation Video + Tell-Show-Do; Storybook + Tell-Show-Do; Tell-Show-Do Only (Control)

Storybook Preparation BEHAVIORAL

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

Storybook + Tell-Show-Do

Animation Video Preparation BEHAVIORAL

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

Animation Video + Tell-Show-Do

Eligibility Criteria

• Age: 4 Years - 8 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• 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 -

You may not qualify if:

• 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

Sponsors & Collaborators

• Inonu University: lead

Study Sites (1)

Inönü university faculty of dentistry

Malatya, Battalgazi, 44050, Turkey (Türkiye)

Location

Related Publications (5)

• 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.

  PMID: 35327700 BACKGROUND

• 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.

  PMID: 35387187 BACKGROUND

• 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.

  PMID: 26603167 BACKGROUND

• 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.

  PMID: 12060873 BACKGROUND

• 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.

  PMID: 17935573 RESULT

MeSH Terms

Conditions

Child Behavior

Condition Hierarchy (Ancestors)

Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: 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.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PROF LECTURER

Model Details: 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.

Study Record Dates

• First Submitted: September 17, 2025
• First Posted: October 7, 2025
• Study Start: October 1, 2025
• Primary Completion: February 28, 2026
• Study Completion: March 31, 2026
• Last Updated: March 27, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)