International Journal of Clinical Pediatric Dentistry

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VOLUME 12 , ISSUE 5 ( September-October, 2019 ) > List of Articles


Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children

Sandaka Raja Rajeswari, Manumanthu Venkata Ramesh

Keywords : Audiovisual distraction, Cognitive behavioral therapy, Dental anxiety, Pediatric patients

Citation Information : Rajeswari SR, Ramesh MV. Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children. Int J Clin Pediatr Dent 2019; 12 (5):419-422.

DOI: 10.5005/jp-journals-10005-1661

License: CC BY-NC 4.0

Published Online: 01-02-2020

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


Background: Children with high level of preoperative anxiety during their visit to dental office are more likely to develop maladaptive behavior postoperatively. First dental experience is always critical in molding child's attitude toward dentistry. Various behavior management methods are being employed during dental treatment to complete anticipated treatment in children. Aim: The aim of the study was to evaluate the effectiveness of cognitive behavioral play therapy and audiovisual distraction for management of preoperative anxiety in children. Materials and methods: A total of 45 children of age 6–10 years with moderate-to-severe anxiety were allocated into three groups: group I—cognitive behavioral play therapy (CBT), group II—audiovisual (AV) distraction, and group III—tell-show-do technique (control group). Children in the CBT group were allowed to play with building blocks, asked to draw a picture and then showed a modeling video of co-operative child undergoing dental treatment. Children in group II were subjected to passive distraction with audiovisual aids, whereas group III (control) children were managed with the conventional TSD technique. Baseline and postintervention objective and subjective anxiety scores were measured with a pulse oximeter and facial image scale (FIS), respectively. Results: A statistically significant reduction in the subjective and objective anxiety scores is observed in all the three groups (p = 0.001) in both intragroup and intergroup comparisons. On intergroup comparison, the reduction in subjective and objective anxiety scores was higher in CBT (p = 0.0) than in AV distraction and TSD groups (p = 0.05). Conclusion: Active distraction with cognitive behavioral play therapy is found to be more effective in reducing the preoperative anxiety in children compared to audiovisual distraction and tell-show-do technique. Clinical significance: Identification and management of preoperative anxiety in children is most critical for successful dental treatment. Active distraction is an effective psychological approach for behavior management in anxious children.

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