The Effect of a Kaleidoscope and Cartoons for Dental Treatment in Children

NCT07462364 | Recruiting

• 1 other identifier: 21.11.2025/730
• Study Type: interventional
• Target: 126
• Locations: 1 country
• Sites: 1

Brief Summary

Dental fear and anxiety are among the most common challenges encountered in pediatric dental practice and may negatively affect children's cooperation and acceptance of dental treatment. Local anesthesia injections are considered one of the main sources of pain and anxiety during dental procedures in children. Although pharmacological methods can be effective in managing pain and anxiety, they may not always be preferred due to potential side effects, limited applicability, and the possibility of increasing stress in children. Therefore, non-pharmacological behavioral management techniques, particularly distraction methods, are increasingly used in pediatric dentistry to reduce pain perception and anxiety. The aim of this randomized controlled trial is to evaluate the effects of kaleidoscope use and cartoon distraction on pain, fear, and anxiety associated with local anesthesia injections in children undergoing dental treatment. The study will be conducted at the Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University. A total of 126 children aged between 7 and 12 years who require local infiltration anesthesia during dental treatment will be included in the study. Participants will be randomly assigned to one of three groups: the Kaleidoscope Group, the Cartoon Distraction Group, or the Control Group. Children in the kaleidoscope group will use a kaleidoscope during the local anesthesia injection, while children in the cartoon group will watch cartoons during the procedure. In the control group, local anesthesia will be administered according to the routine clinical procedure without any distraction technique. Pain, fear, and anxiety levels will be assessed using the Wong-Baker FACES Pain Rating Scale, the Children's Fear Scale, and the Children's Anxiety Scale-State. Behavioral responses will also be evaluated using the Frankl Behavior Rating Scale. The findings of this study are expected to provide evidence regarding the effectiveness of simple and non-pharmacological distraction techniques in reducing pain and anxiety associated with local anesthesia injections in pediatric dental patients.

Conditions

Dental Anxiety; Dental Fear; Pain

Keywords

Dental anxiety, dental fear, pain, local anesthesia, children

Outcome Measures

Primary Outcomes (1)

• Pain level during local anesthesia injection measured using the Wong-Baker FACES Pain Rating Scale

  Pain perception during the administration of local anesthesia will be assessed using the Wong-Baker FACES Pain Rating Scale. The scale consists of six facial expressions representing increasing levels of pain, scored from 0 (no pain) to 10 (worst pain). Children will be asked to select the face that best represents the pain they experienced during the injection.

  Immediately after the local anesthesia injection

Secondary Outcomes (3)

• Fear level during local anesthesia injection measured using the Children's Fear Scale

  Immediately before and immediately after the local anesthesia injection

• Anxiety level measured using the Children's Anxiety Scale-State (CAS-S)

  Immediately before and immediately after the local anesthesia injection

• Child behavior during dental treatment measured using the Frankl Behavior Rating Scale

  During the local anesthesia administration procedure

Study Arms (3)

Kaleidoscope Group

EXPERIMENTAL

Children in this group will use a kaleidoscope during the administration of local infiltration anesthesia as a visual distraction technique. The child will be instructed on how to use the kaleidoscope before the injection and will continue using it throughout the procedure

Behavioral: Kaleidoscope Distraction

Cartoon Distraction Group

EXPERIMENTAL

Children in this group will watch cartoons as an audiovisual distraction technique during the administration of local infiltration anesthesia. The cartoon will be started before the injection and will continue throughout the procedure.

Behavioral: Cartoon Distraction

Control Group

NO INTERVENTION

Children in this group will receive local infiltration anesthesia according to the routine clinical procedure without the use of any distraction technique.

Interventions

Kaleidoscope Distraction BEHAVIORAL

Children will use a kaleidoscope as a visual distraction technique during the administration of local infiltration anesthesia. Before the procedure, the researcher will explain how to use the kaleidoscope, and the child will continue using it throughout the injection.

Kaleidoscope Group

Cartoon Distraction BEHAVIORAL

Children will watch cartoons as an audiovisual distraction technique during the administration of local infiltration anesthesia. The cartoon will be started immediately before the injection and will continue throughout the procedure.

Cartoon Distraction Group

Eligibility Criteria

• Age: 7 Years - 12 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children aged between 7 and 12 years
• Children requiring local infiltration anesthesia for dental treatment
• Children who apply to the Pediatric Dentistry Clinic of Dicle University Faculty of Dentistry
• Children and their parents who voluntarily agree to participate in the study and provide informed consent
• Children with positive or definitely positive behavior according to the Frankl Behavior Rating Scale

You may not qualify if:

• Children with chronic diseases
• Children with a history of hospitalization or surgery
• Children with neurological or behavioral disorders such as autism, attention deficit hyperactivity disorder (ADHD), or learning disabilities
• Children with mental retardation, hearing impairment, or speech problems
• Children with dental abscesses or fistulas

Sponsors & Collaborators

• Dicle University: lead

Study Sites (1)

Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University

Diyarbakır, Diyarbakır, 21000, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Elif Bilsin Kocamaz, Associate Professor

  Dicle University

  STUDY DIRECTOR

• Elif Bilsin kocamaz, PhD

  Dicle University

  STUDY DIRECTOR

Central Study Contacts

Elif Bilsin Kocamaz, PhD

CONTACT

+904122411000; elifbilsin-86@hotmail.com

Sumeyye Tokmak, BsN

CONTACT

+904122411000; tokmak.2113@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Participants will be randomly assigned to one of three parallel groups: the Kaleidoscope Group, the Cartoon Distraction Group, or the Control Group. Children in the kaleidoscope group will use a kaleidoscope during the administration of local anesthesia, while children in the cartoon group will watch cartoons during the injection procedure. In the control group, local anesthesia will be administered according to the routine clinical procedure without any distraction technique. Pain, fear, and anxiety levels will be assessed before and after the procedure.

Study Record Dates

• First Submitted: March 5, 2026
• First Posted: March 10, 2026
• Study Start: March 10, 2026
• Primary Completion: May 1, 2026
• Study Completion: May 10, 2026
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)