Effectiveness of guided imagery and neuro-linguistic programming for reducing dental anxiety in children aged 6–13 years undergoing local anaesthesia: A randomised clinical trial

Aim: This study aimed to compare the effectiveness of GI, NLP, and conventional behavioural management techniques in reducing dental anxiety among children aged 6–13 years receiving local anaesthesia. Methods: A triple-blind, randomised clinical trial was conducted with 132 healthy children. Participants were allocated to GI (n = 44), NLP (n = 46), or conventional management (n = 42). Physiological parameters (blood pressure, heart rate, respiratory rate, temperature, and oxygen saturation) and behavioural responses (Modified Yale Preoperative Anxiety Scale, mYPAS) were assessed before and after intervention. Data were analysed using one-way ANOVA with Tukey’s post-hoc test, and a p-value <0.05 was considered statistically significant. Results: Both GI and NLP produced significantly greater reductions in anxiety-related physiological and behavioural measures compared with the conventional group (e.g., systolic blood pressure: GI Δ = −3.82 mmHg, NLP Δ = −2.24 mmHg, control Δ = +0.47 mmHg; F (2,129) = 14.8). GI achieved the greatest improvement in heart rate (Δ = −3.48 bpm) and mYPAS scores (mean reduction = 3.1; 95% CI: −3.7 to −2.5), with particularly strong effects in younger children (6–9 years). NLP was effective across all age groups. The conventional group showed only modest improvement. Conclusions: GI and NLP are effective, non-invasive strategies for managing dental anxiety in pediatric patients. Their application in routine practice could enhance cooperation and reduce the need for pharmacological sedation. Large-scale, multi-centre trials are recommended to confirm these findings and explore long-term benefits.