ArticleInternational journal of dentistry2026
Effectiveness of Thumb Sleeve Distraction and Pop-It Therapeutic Play in Reducing Dental Anxiety and Pain in Children Aged 4-6 Years Undergoing Mandibular Alveolar Nerve Block: A Randomized Controlled Trial.
Article in International journal of dentistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
Background: Distraction is a safe and effective technique that diverts a child's attention from anxiety-provoking stimuli. This study aimed to evaluate the efficacy of thumb sleeves as a visual distraction and Pop-It toys as therapeutic play in reducing dental anxiety and pain in children aged 4-6 years undergoing mandibular alveolar nerve block. Materials and Methods: This double-blind trial included 100 children aged 4-6 years, randomly allocated into four parallel groups: Group I (Control)-Tell-Show-Do (TSD) alone; Group II-TSD with visual distraction (thumb sleeve); Group III-TSD with sensory distraction (Pop-It toy); Group IV-TSD with both visual and sensory distractions. Pulse rate was measured at baseline (T0), after behavior management (T1), and 2 min after local anesthesia (T3). Dental anxiety was assessed using the Facial Image Scale at T0 and T3, and pain was measured using the Face, Legs, Activity, Cry, Consolability (FLACC) scale at T2. Statistical significance was set at Results: Anxiety and pain scores varied among the groups. Based on pulse rate, Group III (TSD with sensory distraction) showed the lowest anxiety after behavior management, while Group I (TSD alone) showed the highest. After 2 min of anesthesia, Group IV (combined visual and sensory distraction) demonstrated the lowest anxiety, whereas Group II showed the highest. According to the Facial Image Scale, Group IV recorded the lowest anxiety and Group III the highest at T3. In terms of pain (FLACC), Group IV showed the lowest scores, while Group I recorded the highest during anesthesia administration. However, the Kruskal-Wallis test revealed no statistically significant differences between groups in pulse rate, Facial Image Scale, or FLACC scores ( Conclusion: Although no statistically significant differences were found between the studied groups, the use of distraction techniques combined with TSD showed a trend toward greater reduction in dental anxiety and pain compared with TSD alone. These approaches may be considered as supportive behavior management tools during inferior alveolar nerve block (IANB) in young children.
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