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Original Research

Open Access

Effectiveness of oral simulation games and ``tell-show-do'' behavioral management in alleviating dental fear in children: a randomized controlled study

  • Yue Zhang1,2
  • Chen-xi Li3,4,5
  • Yang Zhou1
  • Yin-fu Jia1
  • Ying Yu1
  • Dan-yang Li1
  • Tao Guo1,*,
  • Le Chang2,6,*,

1Department of Stomatology, The Fifth Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, Xinjiang Uyghur Autonomous Region, China

2Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, 710004 Xi’an, Shannxi, China

3Department of Oral and Maxillofacial Oncology & Surgery, School/Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang Uyghur Autonomous Region, China

4Stomatological Research Institute of Xinjiang Uygur Autonomous Region, 830054 Urumqi, Xinjiang Uyghur Autonomous Region, China

5Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China

6Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, 710004 Xi’an, Shannxi, China

DOI: 10.22514/jocpd.2025.035 Vol.49,Issue 2,March 2025 pp.154-160

Submitted: 08 February 2024 Accepted: 20 May 2024

Published: 03 March 2025

*Corresponding Author(s): Tao Guo E-mail: guotao0706@xjmu.edu.cn
*Corresponding Author(s): Le Chang E-mail: changle66@xjtu.edu.cn

Abstract

Background: This study aimed to evaluate the efficacy of Oral Simulation Games and the “Tell-Show-Do” (TSD) behavioral management technique in reducing dental fear among children aged 4 to 6 years. Methods: Two hundred fifty-five children aged between 4 and 6 years, experiencing initial dental fear and scheduled for a single deep caries tooth treatment under local anesthesia, were randomly assigned to either the “Tell-Show-Do” group or the Oral Simulation Games group, and their physiological stress, fear intensity, pain and anxiety levels, and compliance were compared between the two groups. Physiological stress was assessed through heart rate, respiration, and blood oxygen saturation. Fear intensity was evaluated using the Child Fear Survey Schedule-Dental Subscale (CFSS-DS), while pain and anxiety levels were measured using the Wong-Baker FACES Pain Rating Scale and Venham’s Scale, respectively. Compliance was assessed using the Frankl Behavior Rating Scale. Between-group comparisons were conducted using the Wilcoxon signed-rank test. Results: Significant improvements were observed in pain reduction, fear alleviation, and enhanced compliance among children utilizing oral simulation games for behavior management. In addition, the oral simulation game group exhibited a lower Q value compared to the TSD (Tell-show-do) group (p < 0.01), with no significant differences observed in respiration and blood oxygen saturation. Conclusions: Both approaches were found to effectively alleviate children’s anxiety. Compared to the TSD method, oral simulation games were more effective in reducing dental fear in children undergoing treatment for deep caries under local anesthesia. Clinical Trial Registration: The trail was registered on Chinese Clinical Trial Registry, the identification number is ChiCTR2400089734.


Keywords

Children dental fear; Pain; Oral simulation puzzle game; Tell-show-do


Cite and Share

Yue Zhang,Chen-xi Li, Yang Zhou,Yin-fu Jia,Ying Yu,Dan-yang Li,Tao Guo,Le Chang. Effectiveness of oral simulation games and ``tell-show-do'' behavioral management in alleviating dental fear in children: a randomized controlled study. Journal of Clinical Pediatric Dentistry. 2025. 49(2);154-160.

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