Comparative Evaluation of the Effectiveness of Custom‑designed Dental Storybook versus Tell-Show-Do Technique on Dental Anxiety and Behavior of Children: A Randomized Controlled Trial

Background: Dental anxiety disorders are common in dentistry and can be significant barriers to maintaining oral health. This study aimed to evaluate and compare the effectiveness of a custom-designed dental storybook versus the tell-show-do technique on children's dental anxiety and behavior during cavity preparation and composite restoration procedures. Methods: Forty-eight children aged 4 to 8 years were randomly divided into two equal groups: Group A, which received the custom-designed dental storybook, and Group B, which received the tell-show-do technique (TSD) before cavity preparation and composite restoration. Anxiety was assessed using the Venham Picture Scale (VPS) and pulse rate, while behavior was assessed using the Frankl Behavior Rating Scale (FBRS). Results: There were no statistically significant differences in VPS and FBRS scores between the two groups at any time points, with P-values of 0.096 and 0.097 for Group A, and P-values of 1 and 0.223 for Group B. However, a statistically significant difference in pulse rate was observed at different times in both groups, with P-values of 0.001 for Group A and <0.001 for Group B. Additionally, no statistically significant differences were found between Group A and Group B regarding VPS, FBRS, or pulse rate at different periods. Conclusions: Both the custom-designed dental storybook and the tell-show-do technique effectively reduced dental anxiety, as indicated by a decrease in pulse rate. However, there were no significant differences in dental anxiety levels or child behavior between the two techniques.