Evidence map›Paper›PMID 40128690›Full record

Trial reportBMC oral health2025

Cartoon-assisted visual/auditory distraction usage in paediatric dental care, assessment of effects on patient anxiety, pain, and behaviour: a randomised crossover clinical trial.

Nilüfer Üstün, Beyza Ballı Akgöl, Merve Bayram

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04927754 (Cartoon-assisted Visual/Auditory Distraction Usage in Paediatric Dental Care, Assessment of Resulting Effects on Patient Anxiety, Pain, and Behaviour.), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04927754 nacompletednot on this map

Cartoon-assisted Visual/Auditory Distraction Usage in Paediatric Dental Care, Assessment of Resulting Effects on Patient Anxiety, Pain, and Behaviour.

TypeinterventionalSponsorIstanbul Medipol University HospitalRan2022 to 2022Enrolled72ConditionsBehavior, ChildArmsBehavioral guidance, Pain assessment, Dental anxiety assessment
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Nilüfer ÜstünFaculty of Dentistry, Department of Pediatric Dentistry, Istanbul Health and Technology University, Istanbul, Turkey.
Beyza Ballı AkgölSchool of Dentistry, Department of Pediatric Dentistry, Antalya Bilim University, Antalya, Turkey.
Merve BayramSchool of Dentistry, Department of Pedodontics, Istanbul Medipol University, Istanbul, 34093, DDS, Turkey. mbayram@medipol.edu.tr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis randomized crossover clinical trial designed to evaluate the impact of visual and auditory distraction techniques on pediatric patients' anxiety, pain perception, and behavior during dental treatment. The study specifically focuses on children, aiming to determine whether distraction methods can effectively reduce anxiety levels, alleviate pain experiences, and improve cooperative behavior in a clinical setting. METHOD AND MATERIALS: Children aged 4 to 9 years receiving routine dental care at the Pediatric Dentistry Clinic, Istanbul Medipol University, were randomly assigned to Group 1 (distraction first, then tell-show-do) or Group 2 (tell-show-do first, then distraction), with a two-week washout period before switching interventions. Anxiety was assessed using the Venham Picture Test and pulse rate, pain perception with the Sounds, Eyes, and Motor Scale during local anesthesia and the Wong-Baker FACES Pain Rating Scale during treatment, while cooperation and behavior were evaluated using the Houpt Scale. Statistical analysis was conducted using Mann-Whitney U, Student's t-test, Paired t-test, and Wilcoxon test, with the significance level set at 0.025 using the Bonferroni correction.

resultsSixty-eight patients (37 female, 31 male) with a mean age of 6.69 ± 1.08 years completed the study (Group 1: n = 32, Group 2: n = 36). The cartoon-assisted distraction technique did not significantly reduce anxiety compared to the tell-show-do method. A non-significant reduction in pain perception was observed during local anesthesia with distraction. However, this technique significantly reduced self-reported pain during treatment (p < 0.025) and improved child cooperation and behavior.

conclusionCartoon-assisted visual and auditory distraction can alleviate pain perception and improve behavior during pediatric dental procedures. However, it does not appear to reduce dental anxiety or pain perception during local anesthesia. Integrating this technique with the traditional tell-show-do approach may enhance the pediatric dental experience.

trial registrationThe trial was registered at ClinicalTrials.gov, number NCT04927754, 06/01/2021.

Indexed as

Cartoons as TopicChild BehaviorDental AnxietyDental Care for ChildrenAttentionChildChild, PreschoolCross-Over StudiesFemaleHumansMalePain MeasurementPain PerceptionBehaviour guidanceCrossover clinical trialDental anxietyDistractionPaediatric patientsPain

Identifiers

PMID40128690
PMCPMC11931860

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.