European Archives of Paediatric Dentistry

, Volume 19, Issue 4, pp 239–244 | Cite as

Effect of visual distraction on children’s anxiety during dental treatment: a crossover randomized clinical trial

  • S. Ghadimi
  • Z. EstakiEmail author
  • P. Rahbar
  • A. R. Shamshiri
Original Scientific Article



This was to evaluate the effect of visual distraction on anxiety of children during dental treatment.

Materials and Methods

This randomized, crossover clinical trial study was conducted on 28 children (aged 4–5 years) randomly divided into two groups of 14 each. Group 1, treatment procedure in the first visit was completed while the patients were watching a cartoon as a visual distraction tool, at the second visit, the procedure was carried out with conventional tell-show-do. Group 2, had visual distraction in their second visit and conventional tell-show-do during the first visit. Treatment procedures were similar in both groups during two sessions. The anxiety level was determined using Venham picture test and pulse rate (PR) at the beginning and the end of each appointment. Patient behaviour was also scored using Frankl behaviour rating scale (FBRS).


Self-reported dental anxiety was reduced significantly by visual distraction (p-value < 0.001) compared to conventional tell-show-do, but it did not change FBRS scores significantly (p-value = 0.24).


Use of visual distraction improves self-reported anxiety and decreases PR of children but does not change their behaviour.


Child management Visual distraction Behaviour Dental anxiety Crossover Clinical trial 



No funding has been received for the conduct of this study and/or preparation of this manuscript. The authors are grateful to the children and parents for their participation in the study.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.


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Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  • S. Ghadimi
    • 1
  • Z. Estaki
    • 2
    Email author
  • P. Rahbar
    • 3
  • A. R. Shamshiri
    • 4
  1. 1.Laser Research Centre of Dentistry, Dental Research Institute, Department of Paediatric Dentistry, School of DentistryTehran University of Medical SciencesTehranIran
  2. 2.Department of Paediatric Dentistry, School of DentistryTehran University of Medical SciencesTehranIran
  3. 3.Department of Paediatric Dentistry, School of DentistryAhvaz Jundishapur University of Medical SciencesAhvazIran
  4. 4.Research Centre for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of DentistryTehran University of Medical SciencesTehranIran

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