Reducing dental anxiety in children through tell-show-do technique vs. additional instructions with an artificial intelligence-based animated video: randomized clinical trial

Background: Dental anxiety has always been a problem for practitioners, particularly among children. This research aimed to use artificial intelligence (AI) to create personalised cartoons that would positively engage and desensitise paediatric patients. Methods: The use of AI was evaluated as an adjunct to the traditional tell-show-do (TSD) method and compared versus TSD technique alone. A total of 42 paediatric patients, aged 5–10 years, classified as with high dental anxiety based on the Modified Dental Anxiety Scale (MDAS) and the Face, Legs, Activity, Cry, Consolability scale (FLACC), were randomly assigned to the Trial group (AI animated video plus TSD) or the Control group (TSD only). Dental anxiety levels were measured at baseline (T0) and after 14 days (T1) using the MDAS and FLACC. Oral hygiene was assessed using the Oral Hygiene Index-Simplified (OHI-S) and Bleeding on Probing (BoP). The International Caries Detection and Assessment System (ICDAS) was recorded at T0. Data normality was assessed using the D’Agostino-Pearson test, and the data were analysed with Analysis of Variance (ANOVA) test followed by a Tukey’s multiple comparisons test. Linear regressions were also performed (significance threshold: p < 0.05). Results: At T1, both groups exhibited significantly lower anxiety scores and non-verbal responses, as well as lower oral hygiene scores (p < 0.05). In the intergroup comparison, significantly lower MDAS scores were found in the Trial group (p > 0.05). Linear regression analysis revealed a significant effect of group on MDAS, with lower values observed in the Trial group (p < 0.05). Conclusions: These results confirm the positive role of AI-based instructions in addition to the standard TSD technique. Further studies should evaluate the implementation of AI interventions in dental settings as a complementary approach. Clinical Trial Registration: NCT06276478.

Dental anxiety; Artificial intelligence (AI); Patient compliance; Oral hygiene; Dental care for children

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