Khogeer Layla N, Sabbagh Heba Jafar, Felemban Osama M, Farsi Najat M
Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, PO Box 80200, Jeddah 21589, Saudi Arabia.
BMC Pediatr. 2025 Jul 2;25(1):503. doi: 10.1186/s12887-025-05849-5.
Dental fear and anxiety can significantly hinder the treatment of children. The aim of this research is to compare the effect of puppet play therapy (PPT) and tell-show-do (TSD) behavior guidance technique on child's behavior and anxiety in emergency dental clinics during local anesthesia (LA) administration.
This randomized clinical trial included 50 children aged 3-6 years in need of emergency dental treatment under LA. The subjects were randomized into 2 equal groups: the PPT group, where behavior management was provided using PPT, and the TSD group where TSD was used as the behavior guidance technique. Dental anxiety levels were evaluated using the Facial Index Scale (FIS) and Venham Anxiety Rating Scale. Pulse rates were measured before, during and after anesthesia administration. Patient behavior was also scored using the Frankl Behavior Rating Scale and Venham Behavior Rating Scale. The Face, Legs, Activity, Cry, Consolability (FLACC) scale was used to assess pain.
The mean heart rates were lower for patients who received PPT (94.12 ± 15.71; 106.88 ± 12.67 and 103.16 ± 13.6) compared to TSD (103.4 ± 20.94, 112.5 ± 23.17 and 111.48 ± 25.07) before, during and after the LA, respectively. Anxiety levels measured by FIS were significantly reduced using PPT (p < 0.001) compared to TSD.
This study presents a behavior modification method demonstrating efficacy in reducing anxiety among young children who had no previous dental exposure and underwent immediate invasive dental procedures, utilizing puppet play therapy.
ClinicalTrials.gov with registration number NCT06326307 on March 21, 2024.
牙科恐惧和焦虑会严重阻碍儿童的治疗。本研究的目的是比较木偶戏疗法（PPT）和示范-讲解-操作（TSD）行为指导技术对儿童在急诊牙科诊所局部麻醉（LA）过程中的行为和焦虑的影响。
这项随机临床试验纳入了50名年龄在3至6岁、需要在局部麻醉下进行急诊牙科治疗的儿童。受试者被随机分为两组，每组人数相等：PPT组，采用PPT进行行为管理；TSD组，采用TSD作为行为指导技术。使用面部指数量表（FIS）和韦纳姆焦虑评定量表评估牙科焦虑水平。在麻醉给药前、给药期间和给药后测量脉搏率。还使用弗兰克尔行为评定量表和韦纳姆行为评定量表对患者行为进行评分。使用面部、腿部、活动、哭闹、安慰性（FLACC）量表评估疼痛。
与TSD组（分别为103.4±20.94、112.5±23.17和111.48±25.07）相比，接受PPT治疗的患者在局部麻醉前、麻醉期间和麻醉后的平均心率较低（分别为94.12±15.71、106.88±12.67和103.16±13.6）。与TSD组相比，使用PPT测量的焦虑水平显著降低（p<0.001）。
本研究提出了一种行为矫正方法，该方法在减少未接受过牙科治疗且立即接受侵入性牙科手术的幼儿焦虑方面显示出有效性，即利用木偶戏疗法。
ClinicalTrials.gov，注册号为NCT06326307，于2024年3月21日注册。
