Pre-Visit Positive Imagery for Dental Anxiety

Overseen By Arusha Bhatia

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Southern California

Disqualifiers: Visual impairment, Developmental delays, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 1 day

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to determine if a picture book with positive images, used before a dental visit, can reduce anxiety and fear in children, leading to smoother visits. Children requiring at least one filling, along with a local anesthetic and nitrous oxide, will either receive the Previsit Imagery Picturebook or proceed with the visit as usual. The trial will collect feedback from both children and parents through surveys conducted before and after the treatment. Children who are generally healthy, have not undergone previous dental treatments, and can speak and understand English are suitable for this study. As an unphased trial, this study offers a unique opportunity for children to potentially experience reduced anxiety during dental visits.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this pre-visit positive imagery is safe for pediatric dental patients?

Research has shown that using positive images, such as picture books, safely reduces dental anxiety in children. No reports indicate any negative effects from using picture books. This method involves showing children happy pictures of dental visits before their appointment. It is well-tolerated because it avoids medicines or physical treatments. Essentially, it provides children with a fun preview of what to expect, helping them feel more comfortable. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Previsit Imagery Picturebook because it offers a fresh approach to tackling dental anxiety. Unlike traditional methods, which might involve medications or cognitive-behavioral therapy, this treatment uses positive imagery to help patients feel more at ease before their dental visits. By engaging patients with calming and reassuring pictures, this technique aims to reduce anxiety in a non-invasive and easy-to-understand way. If successful, it could provide a simple and accessible tool to make dental visits less intimidating for everyone.

What evidence suggests that pre-visit positive imagery is effective for reducing dental anxiety in children?

Research has shown that using positive images before a dental visit can reduce anxiety and fear in children. For example, one study found that digital images shown beforehand calmed anxious kids before entering the dental office. Another study noted that children who viewed positive pictures of dental care before appointments felt less anxious. Additionally, research suggests that storybooks about dental visits can significantly lower dental anxiety. In this trial, participants in the Previsit Imagery Group will receive a picture book with positive images before their visit, which might make children feel less scared about going to the dentist and help them cooperate better during treatment. ^{1 2 3 4 6}

Who Is on the Research Team?

Arusha Bhatia

Principal Investigator

Herman Ostrow School of Dentistry of USC

Are You a Good Fit for This Trial?

This trial is for healthy children needing a dental filling, who have never had dental treatment before and will use nitrous oxide and local anesthetic. They must be able to understand English. Children with visual impairments, developmental delays that affect reading or picture interpretation, or those who refuse nitrous are excluded.

Inclusion Criteria

Patients that are healthy with no systemic conditions and are considered ASA I or ASA II

Patients who have never had any form of dental treatment before

I need a filling for a cavity and will require local anesthesia and laughing gas.

Exclusion Criteria

You have difficulty understanding pictures or reading at your age level.

I have a visual impairment.

Patients who are unable to read and comprehend English

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive dental treatment with or without pre-visit positive imagery

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in dental anxiety and behavior post-treatment

1 day

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Previsit Imagery Picturebook

Trial Overview

The study tests if a pre-visit picture book can reduce dental anxiety in kids during treatment visits. Participants are split into two groups: one receives the picture book (experimental group), while the other does not (control group). Both groups fill out surveys about their feelings towards treatment.

How Is the Trial Designed?

Group I: Previsit Imagery Group Experimental Treatment 1 Intervention

This group will be given previsit imagery (picture book) before treatment visit.

Group II: Control Group Active Control 1 Intervention

No intervention will be given to this group. Each treatment visit will move forward as routine.

Who Is Running the Clinical Trial?

University of Southern California

Lead Sponsor

Trials

956

Recruited

1,609,000+

Published Research Related to This Trial

A study involving 40 children aged 4-8 years showed that using a digitalized previsit imagery technique significantly reduced anticipatory dental anxiety compared to traditional communication methods (p<0.001).

The digitalized approach, which included a customized cartoon video and the dentist's voice, proved to be an effective and time-saving strategy for managing anxiety in children before dental visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Digitalized Previsit Imagery on Behavior of Children in the Dental Operatory. Reddy, RE., Merum, K., Mudusu, SP., et al.[2023]

In a study of 60 children aged 4 to 6 undergoing dental procedures, viewing positive images significantly improved overall behavior during treatment compared to neutral images, as measured by the Frankl rating scale.

Despite the behavioral improvements, neither positive nor neutral images affected the children's anticipatory anxiety levels before or after the dental procedures, indicating that while imagery can help with behavior, it may not reduce anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison between Positive Dental Images and Neutral Images in Managing Anticipatory Anxiety of Children. Kamel, DO., Wahba, NA., Talaat, DM.[2017]

A study involving 60 children aged 7 to 12 showed that viewing positive images of dentistry significantly reduced anticipatory dental anxiety compared to viewing neutral images, as measured by Venham's picture test.

The results indicate that using positive imagery in dental settings can be an effective strategy to help alleviate anxiety in young patients before treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Exposure to Positive Images of Dentistry on Dental Anxiety among 7 to 12 Years Old Children. Gangwal, RR., Rameshchandra Badjatia, S., Harish Dave, B.[2020]

A study involving 306 survey participants and 18 interviewees found that vivid sensory images related to dental experiences are common among individuals, but those with higher dental anxiety reported more distressing and fear-provoking imagery linked to negative past experiences.

Participants with lower anxiety levels tended to have more positive and reassuring imagery, suggesting that focusing on positive outcomes could help reduce dental anxiety and improve attendance at dental appointments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental imagery in dentistry: Phenomenology and role in dental anxiety. Schneider, A., Andrade, J., Tanja-Dijkstra, K., et al.[2019]

A study involving 38 children showed that viewing positive images of dentistry before a dental appointment significantly reduced anticipatory dental anxiety compared to viewing neutral images, with a notable difference in anxiety levels (P < 0.001).

The reduction in anxiety was consistent across different ages and genders, indicating that this intervention could be a safe and effective strategy to help children feel more comfortable before dental treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A controlled trial of the impact of exposure to positive images of dentistry on anticipatory dental fear in children. Fox, C., Newton, JT.[2015]

In a study of 1303 French children aged 5-11, 75.7% reported low dental fear, indicating that most children are not overly anxious about dental visits.

Prior dental experiences significantly influenced dental fear levels; children with previous visits reported lower anxiety, while those with decayed teeth had higher fear levels, suggesting that early exposure to dental care can help reduce anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors affecting dental fear in French children aged 5-12 years. Nicolas, E., Bessadet, M., Collado, V., et al.[2022]

A study involving 64 patients showed that watching a tooth extraction video significantly reduced dental fear and anxiety compared to just receiving verbal information before the procedure.

Patients who viewed the video reported greater comfort and lower anxiety levels after the extraction, indicating that visual information can be an effective tool for managing dental distress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized control trial comparing the visual and verbal communication methods for reducing fear and anxiety during tooth extraction. Gazal, G., Tola, AW., Fareed, WM., et al.[2020]

Citations

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withpower.com

withpower.com/trial/phase-anxiety-disorders-9-2023-f2a02

Pre-Visit Positive Imagery for Dental Anxiety · Info for Participants

The purpose of this study is to determine whether pre-visit positive imagery has an impact in decreasing dental anxiety and fear in pediatric patients as ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9108805/

Effect of Digitalized Previsit Imagery on Behavior ...

The idea of digitalizing previsit imagery can be a time saving approach which is helpful in managing anxious children before entering the dental operatory.

3.

centerwatch.com

centerwatch.com/clinical-trials/listings/NCT06058533/pre-visit-positive-imagery-in-reducing-dental-anxiety

Pre-Visit Positive Imagery in Reducing Dental Anxiety

The purpose of this study is to determine whether pre-visit positive imagery has an impact in decreasing dental anxiety and fear in pediatric patients.

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aapd.org

aapd.org/globalassets/media/policies_guidelines/bp_behavguide.pdf

Behavior Guidance for the Pediatric Dental Patient

Positive previsit imagery. • Description: Patients preview positive photographs or images of dentistry and dental treatment before the dental ap- pointment.93.

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12532237/

Evaluating the Impact of Self-designed Dental Storybooks on ...

The results of this study state that the implementation of a self-designed dental storybook in early dental visits will significantly reduce dental anxiety ...

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jchr.org

jchr.org/index.php/JCHR/article/view/7219

Evaluating the Effect of Previsit Guided Imagery as a ...

A significant difference in anticipatory dental anxiety was found between the two groups ( p < 0.001) using SPSS software. Conclusion. Pre-visit ...