Dental Anxiety Clinical Trial
Official title:
The Effect of Filmed Modelling on the Anxious and Cooperative Behaviour of 4-6 Years Old Children During Dental Treatment
The aim of this study is to evaluate the effect of Filmed modelling in comparison with commonly used Tell-Show-Do technique on the anxious and cooperative behaviour of 4-6 years old children during dental practice.
This randomized clinical trial study was approved by ethics committee of Zahedan University
of Medical Sciences and conducted in pediatric clinic of Zahedan dental school in 2010.
Among the patients referred to the clinic, forty six children aged 4-6 years (±2 months)
were selected according to the inclusion criteria. They had caries lesion in one of the
primary mandibular molars needed the pulpotomy and restoration treatment. It was confirmed
that they have no previous experience of hospitalization and dental visit. The children with
systemic diseases and developmental disorders were excluded from the study. The examination
was completed and the necessary radiographies were prescribed.
Each child's parent was asked to complete the informed consent and a questionnaire gathering
demographic characteristics of the child and family. Then, the child was enrolled in one of
the study groups based on simple random sampling model as follow:
Group I (Tell- Show- Do Group): Children came in the operation room. Tell-Show-Do,
prophylaxis with paste and rubber cap and fluoride therapy was performed by the dentist for
each participant to increase their familiarity with dental procedures. The duration of the
appointment was about 20 minutes and constant for all children. At the end of the first
visit, the child was rewarded and the date of the second treatment visit was set for one
week later.
In the second session, the child was entered the operating room alone. A video-camera
located on the top of the dental unit light pole under a covering cloth was focused on the
child's head and hands and started to record child's behavior.
The required injection including a mandibular alveolar nerve block technique was performed
by the dentist. The heart beat rate of each child was recorded manually before and following
the injection by the dentist. Then, the occlusal cavity was prepared for pulpotomy and
restoration of the teeth. The treatment protocol was the same for all the participants.
In all children, parameters such as the attending dentist, his assistant, the working
environment, time and duration (30 minutes for each child) of work, and the type of
dialogues were all the same. Care was taken to make sure that the children were not tired,
hungry, or did not have a common cold.
Group II (Filmed modelling Group): the children were directed to a quiet and comfort room to
watch a film presented by a dental assistant. The film showed that the same procedure
consisted of Tell-Show-Do, prophylaxis with paste and rubber cap and fluoride therapy was
performed on a 5-years-old child model with a time of 20 minutes which was cooperative and
reinforced by a reward at the end of the procedure. The produced film had been approved by 3
pediatric dentists.
The second treatment session was set for one week later. Dental procedures, measurement of
the heart rate and recording of the behaviors were all performed as in Group I.
The recorded video tapes of all children were independently evaluated by 2 pediatric
dentists who were blind to the grouping of the children. Children's anxiety reactions and
cooperative behaviors were scored based on Venham Scale and Frankle Index, respectively .The
viewers were asked to rate the child's responses in two stages: At the injection of local
anesthesia and at the beginning of the tooth preparation.
Statistical analysis Mean of heart rate measurements and behavioral ratings were used for
statistical analyses. Data analysis was performed applying t-test method in package of
statistical software (SPSS- 15). All statistical references were made at 0.05.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor)
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