International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 12 , ISSUE 1 ( January-February, 2019 ) > List of Articles

Original Article

Effectiveness of Distraction Techniques in Managing Pediatric Dental Patients

Madhuri Khandelwal, Sujata Rath

Keywords : Behavior management, Dental anxiety, Distraction

Citation Information : Khandelwal M, Rath S. Effectiveness of Distraction Techniques in Managing Pediatric Dental Patients. Int J Clin Pediatr Dent 2019; 12 (1):18-24.

DOI: 10.5005/jp-journals-10005-1582

License: CC BY-NC 4.0

Published Online: 01-09-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: Children having dental anxiety usually hesitate to seek dental care which can result in poor oral health and may lead to expensive and complex dental treatment in the future. The aim of the present study is to compare and evaluate the effectiveness of various distraction techniques in managing pediatric dental patients. Materials and methods: Eighty healthy children selected for the study were randomly divided into 4 groups with 20 children in each group. Group I was termed as the control group; in group II, the audio distraction technique was used. Group III received audio-video distraction (AVD) by means of a chair-mounted audio-video device and group IV received AVD by means of a ceiling-mounted television. Each child had four dental visits. Child's anxiety in each visit was assessed using four parameters: RMS pictorial scale (RMS-PS), Venham picture test (VPT), pulse rate, and oxygen saturation. Results: Ceiling-mounted AVD was found to be the most effective in reducing the anxiety followed by chair-mounted AVD. Audio distraction was found to be the least effective but was better than the control group. Conclusion: The AVD technique is simple, passive, and noninvasive means of behavior management and can be used alternatively in managing anxious pediatric dental patients.

PDF Share
  1. Venham LL, Goldstein M, et al. Effectivenes of a distraction technique in managing young dental patients. Pediatr Dent 1981;3(1):7–11.
  2. American Academy of Pediatric Dentistry (AAPD). Clinical Affairs Committee-Behavior Management Subcommittee, American Academy of Pediatric Dentistry. Guideline on Behavior Guidance for the Pediatric Dental Patient. Pediatr Dent 2015;37(5):57–70.
  3. Shetty RM, Khandelwal M, et al. RMS Pictorial Scale (RMS-PS) – An innovative scale for the assessment of child's dental anxiety. J Indian Soc Pedod Prevent Dent 2015;33(1):48–52. DOI: 10.4103/0970- 4388.149006.
  4. Venham LL, Gaulin-Kremer E. A self-report measure of situational anxiety for young children. Pediatr Dent 1979;1(2):91–96.
  5. Porrit J, Marshman Z, et al. Understanding children's dental anxiety and psychological approaches to its reduction. Int J Paediatr Dent 2012;22(6):397–405. DOI: 10.1111/j.1365-263X.2011.01208.x.
  6. Wogelius P, Poulsen S, et al. Prevalence of dental anxiety and behaviour management problems among six to eight years old Danish children. Acta Odontol Scand 2003;61:178–183. DOI: 10.1080/00016350310003468.
  7. Klingberg G, Berggren U, et al. Dental fear in an urban Swedish child population: prevalence and concomitant factors. Community Dent Health 1994;11:208–214.
  8. Alwin N, Murray JJ, et al. An assessment of dental anxiety in children. Br Dent J 1991;17(7):201–207. DOI: 10.1038/sj.bdj.4807661.
  9. Buchanan H, Niven N. Validation of a Facial Image Scale to assess child dental anxiety. Int J Paediatr Dent 2002;12(1):47–52. DOI: 10.1046/j.0960-7439.2001.00322.x.
  10. Prabhakar AR, Marwah N, et al. A comparison between audio and audio visual distraction techniques in managing anxious pediatric dental patients. J Indian Soc Pedod Prevent Dent 2007;25(4):177–182. DOI: 10.4103/0970-4388.37014.
  11. Yelderman M, William N. Evaluation of pulse oximetry. J Anesth 1983;59:349–352. DOI: 10.1097/00000542-198310000-00015.
  12. Aka W, Jedrychowski JR. Intra operative and postoperative physiologic monitoring practices by pediatric dentists. J Clin Pediatr Dent 1995;19:91–98.
  13. Venham L, Bengston D, et al. Children's response to sequential dental visits. J Dent Res 1977;56:454–459. DOI: 10.1177/00220345770560050101.
  14. Baldwin Jr DC. An investigation of psychologic and behavioral response of dental extractions in children. J Dent Res 1966;45:1637–
  15. DOI: 10.1177/00220345660450061101.
  16. Sowjanya V, Tondon S, et al. Physiological response to dental anxiety in children. J Indian Soc Pedod Prevent Dent 1995;13:13–17.
  17. Myers DR, Kramer WS, et al. A study of the heart action of the child dental patient. ASDC J Dent Child 1972;39(2):99–106.
  18. Messer JG. Stress in dental patients undergoing routine procedures. J Dent Res 1977;56(4):362–367. DOI: 10.1177/00220345770560040301.
  19. Marwah N, Prabhakar AR, et al. Music distraction-its efficacy in management of anxious pediatric dental patients. J Indian Soc Pedod Prev Dent 2005;23(4):168–170. DOI: 10.4103/0970-4388.19003.
  20. Yamini V, Bailwad SA, et al. Effectiveness of music distraction in the management of anxious pediatric dental patients. Ann Essences Dent 2010;2(2):1–5. DOI: 10.5368/aedj.2010.2.2.1-5.pdf.
  21. Anderson R, Baron RS, et al. Distraction, control, and dental stress. J Appl Soc Psychol 1991;21:156–171. DOI: 10.1111/j.1559-1816.1991. tb00494.x.
  22. Seyrek SK, Corah NL, et al. Comparison of three distraction techniques in reducing stress in dental patients. J Am Dent Assoc 1984;108(3):327–329. DOI: 10.14219/jada.archive.1984.0034.
  23. Gardner W, Licklider J. Auditory analgesia in dental operation. J Am Dent Assoc 1959;59:1144–1149. DOI: 10.14219/jada.archive. 1959.0251.
  24. Ingersoll BD, Nash DA, et al. The use of contingent audiotaped material with pediatric dental patients. J Am Dent Assoc 1984;109(5):717–719. DOI: 10.14219/jada.archive.1984.0170.
  25. Corah NL, Gale EN, et al. Psychological stress reduction during dental procedures. J Dent Res 1979;58(4):1347–1351. DOI: 10.1177/00220345790580040801.
  26. Hoffman HG, Patterson DR, et al. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain 2000;16(3):244–250. DOI: 10.1097/00002508- 200009000-00010.
  27. Frere LC, Crout R, et al. Effects of audiovisual distraction during dental prophylaxis. J Am Dent Assoc 2001;132(7):1031–1038. DOI: 10.14219/jada.archive.2001.0309.
  28. Ram D, Shapira J, et al. Audiovisual video eyeglass distraction during dental treatment in children. Quintessence Int 2010;41(8): 673–679.
  29. Magora F, Ram D. Audiovisual iatrosedation with video eyeglasses distraction methodin pediatric dentistry: case history. J Int Dent Med Res 2010;3(3):133–136.
  30. Satoh Y, Nagai E, et al. Relaxation effect of an audiovisual system on dental patients. J Nihon Univ Sch Dent 1995;37(3):138–145. DOI: 10.2334/josnusd1959.37.138.
  31. Baghdadi ZD. Evaluation of audio analgesia for restorative care in children treated using electronic dental anaesthesia. J Clin Pediatr Dent 2000;25(1):9–12.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.