Storybook and Animation Video Adjuncts to Tell-Show-Do in Pediatric Dentistry

Dental anxiety is a frequent challenge in pediatric dentistry and can complicate patientcooperation, lead to incomplete treatment, or necessitate the use of general anesthesia.Among the available behavior guidance techniques, the Tell‐Show‐Do (TSD) method is themost widely applied and has been shown to facilitate children's acceptance of dentalprocedures. However, recent approaches suggest that additional child‐friendly strategies,such as storybooks and animation videos, may further enhance its effectiveness inreducing anxiety and improving cooperation.This randomized controlled trial aims to evaluate the impact of incorporating a storybookor an animation video in addition to the TSD method on children's dental anxiety andcooperative 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 dentalvisit, followed by Tell‐Show‐Do.Animation video group: Children will be prepared at home with an animation video prior tothe dental visit, followed by Tell‐Show‐Do.Children's anxiety and cooperation will be assessed at three time points: baseline (firstexamination), after preparation (before treatment), and after completion of dentaltreatment. The primary outcome measure will be the Jeet Wheel behavioral observationscale, which provides standardized ratings of children's anxiety and cooperation duringdental procedures. In addition, baseline dental fear will be assessed using theChildren's Fear Survey Schedule‐Dental Subscale (CFSS‐DS), and the potential need forgeneral 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‐DSand SCAN Index scores. This design will enable comparisons of the relative effectivenessof each intervention independent of baseline differences.The study is expected to provide new evidence on whether storybook and animation videoadjuncts can enhance the effectiveness of the Tell‐Show‐Do method, offering morechild‐friendly approaches to reducing dental anxiety in pediatric dental practice.