Children's Perceptions of Dental Experiences and Ways to Improve Them

A Comparative Study of the CARD™ System and Tell-show-do Technique in the Behavior Management of 6-10-year-old Children

Background

Dental fear and anxiety are common issues affecting pediatric dental care, leading to challenges in treatment delivery and patient compliance. Nonpharmacological techniques such as the tell-show-do (TSD) method and CARD™ system have emerged as effective strategies for managing child dental anxiety.

Aim

This study aims to compare the effectiveness of the CARD™ system and TSD technique in managing the behavior of 6-10-year-old children during dental procedures.

Methods

Forty children requiring invasive dental treatments were randomly assigned to either the TSD technique (group 1, n = 20) or CARD™ system (group 2, n = 20) groups. Physiological parameters (oxygen saturation and pulse rate) and behavioral responses (evaluated using the Facial Image Scale) were assessed before and after procedures. Data were analyzed using t-tests and Mann-Whitney U tests as appropriate.

Results

No statistically significant differences were found between the techniques regarding physiological parameters or behavioral responses. Both groups exhibited comparable oxygen saturation levels (CARD™: 98.00 ± 1.02; TSD: 98.00 ± 1.12) and pulse rates (CARD™: 87.45 ± 7.28 bpm; TSD: 90.30 ± 10.26 bpm) before procedures, with minimal changes observed postprocedure. Similarly, there were no significant differences in emotional responses assessed by the Facial Image Scale before (CARD™: 1.90 ± 0.85; TSD: 1.80 ± 0.76) or after procedures (CARD™: 2.80 ± 1.60; TSD: 2.95 ± 1.50).

Conclusion

This study suggests that the CARD™ system and TSD technique are equally effective in managing child dental anxiety. Both methods offer viable options for reducing anxiety and enhancing cooperation during dental procedures.

How to cite this article

Babu A, Eagappan SAR, Srinivasan D, et al. A Comparative Study of the CARD™ System and Tell-show-do Technique in the Behavior Management of 6-10-year-old Children. Int J Clin Pediatr Dent 2025;18(1):53-57.

Experiences of dental behaviour support techniques: A qualitative systematic review

BACKGROUND

Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences.

AIM

To explore and synthesize qualitative literature related to patient experience of dental behaviour support.

METHODS

A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified.

RESULTS

Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision.

CONCLUSION

Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.

Effect of age-related extended high frequency hearing loss on the subjective impressions of dental drill noise

Fear and anxiety among patients are sometimes evoked in dental clinics due to the sound of dental drills. This study aimed to explore the impact of age-related hearing loss in the extended high frequency (EHF) range above 8 kHz on individuals' subjective discomfort towards dental drill noise. After measuring pure-tone audiometric thresholds at both conventional and extended high frequencies, we used a psychoacoustic approach to evaluate subjective impressions of four dental drill sound stimuli, which featured varying frequency components, in 62 participants (aged 12-67 years). We found a significant decrease in hearing sensitivity within the EHF range as age increased, with notable differences in hearing thresholds at 14 kHz between teenage and older adults exceeding 65 dB. Furthermore, significant differences were observed between younger and older (above 40 years) participants in the subjective impressions of dental drill noise, emphasizing age as a critical factor in the perception of high frequency components. Consequently, age may influence the unpleasantness of dental drilling noise. Compared to older individuals, young participants may exhibit increased fear of dental procedures owing to physiological factors. These results underscore the need for age-appropriate noise control strategies in dental clinics to mitigate anxiety and improve patient comfort.