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The goal of this clinical trial is to evaluate the overall effect of an artificial intelligence-generated, instrument-specific animated video series compared with the conventional Tell-Show-Do (TSD) technique on dental anxiety in children aged 4 to 8 years. The study will also investigate whether the anxiety-reducing effect differs according to the dental instrument introduced.
Researchers will compare the animated video series with the conventional Tell-Show-Do technique across four dental instruments: dental mirror, dental probe, micromotor handpiece, and saliva ejector.
Participants will be randomly assigned to one of the study groups. Children will either watch an instrument-specific animated educational video or receive the Tell-Show-Do technique related to a specific dental instrument. Dental anxiety levels will be evaluated using the Facial Image Scale (FIS), Venham Picture Test (VPT) and Modified Child Dental Anxiety Scale-Faces version (MCDASf), together with pulse rate and oxygen saturation levels, before and after the application procedure.
This prospective, single-center, randomized controlled clinical trial will evaluate the effectiveness of an artificial intelligence-generated animated educational video series in reducing dental anxiety among children aged 4 to 8 years. The study uses a 2×4 factorial design to compare the animated video series with the conventional Tell-Show-Do (TSD) technique across four commonly used dental instruments: dental mirror, dental probe, micromotor handpiece, and saliva ejector.
Participants will be randomly assigned to one of eight study groups according to intervention type and dental instrument. Only healthy children with no previous dental treatment experience and a Frankl Behavior Rating Scale score of 3 or 4 will be included in the study. Children in the animation groups will watch an instrument-specific animated educational video, while children in the control groups will receive the conventional Tell-Show-Do technique for the same instrument.
Dental anxiety will be assessed using the Facial Image Scale (FIS), Venham Picture Test (VPT), and Modified Child Dental Anxiety Scale-Faces version (MCDASf). Physiological parameters including pulse rate and oxygen saturation levels will also be recorded before and after the application procedure.
The study aims to investigate both the overall effectiveness of the animated educational video series and the instrument-specific differences in anxiety reduction among pediatric dental patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Animated Series - Dental Mirror | Experimental | Children in this arm viewed a single episode of the AI-generated animated video series (~60 seconds) corresponding to the dental mirror, presented on a 10-inch tablet at 60 dB SPL in the dental waiting area prior to clinical examination. The episode features a recurring maternal character and anthropomorphic dental germ characters that hide among tooth surfaces and are revealed and removed by the dental mirror. |
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| Tell-Show-Do - Dental Mirror | Active Comparator | Children in this arm received the standard Tell-Show-Do technique (~4 minutes) applied specifically to the dental mirror, following a standardised script. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). |
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| Animated Series - Dental Probe | Experimental | Children in this arm viewed a single episode of the AI-generated animated video series (~60 seconds) corresponding to the dental probe. The episode features a recurring maternal character and anthropomorphic dental germ characters that jump between teeth and become wedged in interproximal spaces, then are dislodged and removed by the dental probe. |
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| Tell-Show-Do - Dental Probe | Active Comparator | Children in this arm received the standard Tell-Show-Do technique (~4 minutes) applied specifically to the dental probe, following a standardised script. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AI-Generated Animated Video Series | Behavioral | An original four-episode animated video series produced using AI-assisted animation tools. Each episode is approximately 60 seconds in duration and is designed around a single dental instrument, featuring a recurring maternal character and anthropomorphic dental germ characters whose mischievous behaviour is resolved through the action of the featured instrument. Each child viewed only the single episode corresponding to the instrument assigned to their group. |
| Measure | Description | Time Frame |
|---|---|---|
| Venham's Picture Test (VPT) | An eight-item pictorial anxiety measure requiring children to select the image (anxious or non-anxious figure) that best represents their feelings (score range 0-8). | Baseline (T0) and immediately post-intervention (T1) |
| Facial Image Scale (FIS) | A five-item pictorial self-report scale depicting faces ranging from very happy (1) to very unhappy (5), validated for use in children aged ≥ 4 years with limited literacy. | Baseline (T0) and immediately post-intervention (T1) |
| Measure | Description | Time Frame |
|---|---|---|
| Modified Child Dental Anxiety Scale - Faces Version (MCDASf) | A six-item self-report scale using facial images (score range 6-30), validated for the paediatric dental setting. | Baseline (T0) and immediately post-intervention (T1) |
| Heart Rate (HR) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Alanya Alaaddin Keykubat University Faculty of Dentistry | Alanya | Antalya | 07425 | Turkey (Türkiye) |
Individual participant data will not be shared publicly due to ethical considerations related to pediatric participants and institutional data protection policies. De-identified aggregate data may be reported in publications.
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| ID | Term |
|---|---|
| D054818 | Hexosaminidase A |
| D008722 | Methods |
| ID | Term |
|---|---|
| D001619 | beta-N-Acetylhexosaminidases |
| D006596 | Hexosaminidases |
| D006026 | Glycoside Hydrolases |
| D006867 | Hydrolases |
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Participants will be randomized into factorial groups based on behavioral management technique and dental instrument exposure.
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| Animated Series - Micromotor Handpiece | Experimental | Children in this arm viewed a single episode of the AI-generated animated video series (~60 seconds) corresponding to the micromotor handpiece. The episode features a recurring maternal character and anthropomorphic dental germ characters that eat and rest on a tooth surface, then are tickled and removed by the micromotor handpiece. |
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| Tell-Show-Do - Micromotor Handpiece | Active Comparator | Children in this arm received the standard Tell-Show-Do technique (~4 minutes) applied specifically to the micromotor handpiece, following a standardised script. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). |
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| Animated Series - Saliva Ejector | Experimental | Children in this arm viewed a single episode of the AI-generated animated video series (~60 seconds) corresponding to the saliva ejector. The episode features a recurring maternal character and anthropomorphic dental germ characters that flood the mouth with water and swim freely, then are eliminated by the suction of the saliva ejector. |
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| Tell-Show-Do - Saliva Ejector | Active Comparator | Children in this arm received the standard Tell-Show-Do technique (~4 minutes) applied specifically to the saliva ejector, following a standardised script. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). |
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| Tell-Show-Do (TSD) Technique | Behavioral | The standard Tell-Show-Do technique applied specifically to the instrument assigned to each group. The clinician verbally described the instrument's name, appearance, and function using age-appropriate language (Tell); demonstrated it on the child's hand before approaching the mouth (Show); and applied it intra-orally (Do). Each TSD session lasted approximately 4 minutes, matching the viewing time of the single animated episode in the intervention condition. |
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Measured using a paediatric pulse oximeter positioned on the index finger of the non-dominant hand. The mean of two consecutive readings was used for analysis.
| Baseline (T0) and immediately post-intervention (T1) |
| Peripheral Oxygen Saturation (SpO₂) | Measured using a paediatric pulse oximeter positioned on the index finger of the non-dominant hand. The mean of two consecutive readings was used for analysis. | Baseline (T0) and immediately post-intervention (T1) |
| D004798 |
| Enzymes |
| D045762 | Enzymes and Coenzymes |
| D008919 | Investigative Techniques |