Comparison of Tell-Play-Do and filmed modeling with Tell-Show-Do versus Tell-Show-Do alone on child behavior among 4-7-year-old children: A randomized clinical trial

Background: Early dental experiences play an important role in shaping a child's attitude toward dentistry. Non-pharmacological behavior management techniques such as Tell-Play-Do (TPD), modeling, and Tell-Show-Do (TSD) aim to reduce dental anxiety and improve cooperation during treatment. Aim: To compare the effectiveness of Tell-Play-Do and Filmed Modeling, integrated with the Tell-Show-Do method, with Tell-Show-Do alone among children aged 4-7 year during restorative treatment. Materials & method: This randomized clinical trial included 99 children (Frankl rating 2 or 3) requiring restorative treatment. Participants were randomly allocated to three groups: Group 1 (TPD), Group 2 (Filmed Modeling), and Group 3 (TSD). Behavior was assessed using the Facial Image Scale (FIS), and anxiety levels were measured using pulse rate at four different intervals: before intervention, after intervention, during the procedure, and at the end of the procedure. Data were analyzed using ANOVA, the Kruskal-Wallis test, paired t-tests, and the Wilcoxon signed-rank test. Results: All three groups showed a reduction in anxiety over time, as indicated by decreasing FIS scores and pulse rates. Significant reduction was observed in TPD and filmed modeling groups in within-group comparisons. Pulse rate analysis demonstrated a statistically significant decrease from baseline to the end of the procedure in the TPD and Filmed Modeling groups. Conclusion: Tell-Play-Do and Filmed Modeling are more effective than the TSD technique in reducing dental anxiety among children.The study protocol was registered on the Central Trials Registry - India (CTRI/2023/08/057068).