Dental AnxietyNCT07209696
Storybook and Animation Video Adjuncts to Tell-Show-Do in Pediatric Dentistry
A study testing Tell-Show-Do, Storybook Preparation and Animation Video Preparation in people with Dental Anxiety and Dental Fear, run by Inonu University at 1 site in Turkey (Türkiye).
Trial 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. Read more about this study
- Who is it for?
- Ages 4 to 8 yearsHealthy volunteers can take part
- Conditions the study is for
- Dental Anxiety, Dental Fear, Child Behavior
- What is being tested?
- Tell-Show-Do, Storybook Preparation and Animation Video Preparation
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Oct 2025to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 4 to 8 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- 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 -
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Inönü university faculty of dentistry
Malatya, Battalgazi, 44050
About this study
Official title: Randomized Controlled Evaluation of Storybook and Animation Video as Adjuncts to the Tell-Show-Do Technique in Pediatric Dentistry
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,
Read more
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.
Read the detailed description
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.
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.
- Being tested
- Tell-Show-Do, Storybook Preparation, Animation Video Preparation
- Keywords
- Pediatric Dentistry, Behavior Guidance, Tell-Show-Do, Animation Video Intervention, Jeet Wheel Scale, CFSS-DS, SCAN Index
- Medical subject headings
- Child Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Tell-Show-DoBehavioural
The conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them.
Storybook PreparationBehavioural
Home-based preparation using a child-friendly storybook that introduces the dental visit, instruments, and procedures in simple language and illustrations.
Animation Video PreparationBehavioural
The conventional behavior guidance method where the dentist explains and demonstrates dental procedures before performing them, to reduce anxiety and improve cooperation.
| Study group | Role | What they receive |
|---|---|---|
| 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. Receives: 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. Receives: 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. Receives: Behavioral: Tell-Show-Do; Behavioral: Animation Video Preparation |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: 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
The Jeet Wheel Scale will be assessed immediately after preparation (storybook/video vs. Tell-Show-Do only). Group differences will be analyzed using adjusted statistical models. Scores range from 1 to 8, with higher scores indicating greater anxiety.
Measured: Day 1 (Immediately after preparation, before treatment)
Proportion of children with high anxiety at post-treatment (Jeet Wheel score ≥ 4)
The percentage of participants with a Jeet Wheel score of ≥ 4 will be compared between groups. A higher proportion indicates a greater number of children with clinically relevant anxiety.
Measured: Day 1 (Immediately after completion of dental treatment, post-treatment).
Safety and acceptability of behavioral preparations
Any adverse events or intolerance related to the behavioral preparation (storybook or video) will be recorded. Examples include refusal to proceed with treatment or discontinuation. Such events are expected to be rare.
Measured: Throughout the dental visit(s) on Day 1.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Oct 2025
- Study start1 Oct 2025
- Primary completion28 Nov 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Dental AnxietyStudies of the same condition, open and under way.
- More trials run by Inonu UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 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.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Inonu University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Merve Bilmez Selen, Inonu University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07209696
- Sponsor's protocol ID
- 2024-162
- Status last verified
- Jul 2026
- First submitted
- 17 Sep 2025
- Last updated
- 20 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared due to privacy and confidentiality concerns in pediatric participants.
Publications
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.
PubMed 35327700Barrera-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.
PubMed 35387187Wang 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.
PubMed 26603167Wiley 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.
PubMed 12060873Thyne 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.
PubMed 17935573
Study at a glance
From the registry record, last updated by the sponsor on 20 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Controlled Evaluation of Storybook and Animation Video as Adjuncts to the Tell-Show-Do Technique in Pediatric Dentistry
- ClinicalTrials.gov ID
- NCT07209696
- Acronym / sponsor ID
- 2024-162
- Keywords
- Pediatric Dentistry, Behavior Guidance, Tell-Show-Do, Animation Video Intervention, Jeet Wheel Scale, CFSS-DS, SCAN Index
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Inonu UniversityUniversity, hospital or other
- Study start
- 1 Oct 2025 (actual)
- Primary completion
- 28 Nov 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 7 Oct 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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
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.
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.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- 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.
| Arm | Type | Receives |
|---|---|---|
| Tell-Show-Do Only (Control) | Active comparator | Behavioral: Tell-Show-DoChildren 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. |
| Storybook + Tell-Show-Do | Experimental | Behavioral: Tell-Show-Do, Behavioral: Storybook PreparationChildren 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. |
| Animation Video + Tell-Show-Do | Experimental | Behavioral: Tell-Show-Do, Behavioral: Animation Video PreparationChildren 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. |
Who may qualify
- Ages
- 4 to 8 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- 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 -
Key exclusion criteria (5 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Tell-Show-DoThe conventional behavior guidance technique in pediatric dentistry, where the dentist explains and demonstrates dental procedures before performing them. | Behavioural | Animation Video + Tell-Show-Do, Storybook + Tell-Show-Do, Tell-Show-Do Only (Control) |
| Storybook PreparationHome-based preparation using a child-friendly storybook that introduces the dental visit, instruments, and procedures in simple language and illustrations. | Behavioural | Storybook + Tell-Show-Do |
| Animation Video PreparationThe conventional behavior guidance method where the dentist explains and demonstrates dental procedures before performing them, to reduce anxiety and improve cooperation. | Behavioural | Animation Video + Tell-Show-Do |
Primary outcome
Change in dental anxiety and cooperation measured by the Jeet Wheel Scale
Time frame: 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)
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.
3 secondary outcomes
Between-group differences in Jeet Wheel scores after behavioral preparation
Time frame: Day 1 (Immediately after preparation, before treatment)
Proportion of children with high anxiety at post-treatment (Jeet Wheel score ≥ 4)
Time frame: Day 1 (Immediately after completion of dental treatment, post-treatment).
Safety and acceptability of behavioral preparations
Time frame: Throughout the dental visit(s) on Day 1.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jul 2026.
- Background: PubMed 35327700Alsaadoon 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.
- Background: PubMed 35387187Barrera-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.
- Background: PubMed 26603167Wang 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.
- Background: PubMed 12060873Wiley 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.
- Results publication: PubMed 17935573Thyne 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.
- Individual participant dataSharing planned: No. Individual participant data will not be shared due to privacy and confidentiality concerns in pediatric participants.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Tell-Show-Do, Storybook Preparation and Animation Video Preparation in people with Dental Anxiety and Dental Fear, run by Inonu University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 20 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in dental anxiety and cooperation measured by the Jeet Wheel Scale (time frame: 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)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07209696, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jul 2026.