Comparative Evaluation of Reframing and Tell-show-do Behavior Guidance Technique in the Management of Dental Anxiety among Children Aged 6-12 Years Undergoing Dental Treatment without and with Administration of Local Anesthesia: A Single-Blind Randomized Clinical Study.

Background: Dental fear and anxiety are the major hurdles for providing successive treatment for children. Effective use of behavior guidance techniques is essential for addressing these challenges. Hence, this study aimed to evaluate the effectiveness of reframing and tell-show-do (TSD) behavior guidance technique in reducing anxiety in children during dental procedures without and with administration of local anesthesia (LA).

Subjects and methods: Fifty children of 6-12 years of age with no previous dental experience were randomly assigned to either the reframing group or the TSD group. They underwent dental procedures without (restoration) and with administration of LA. Subjective anxiety was evaluated using the Venham Picture Scale (VPS) and physiologically by measuring pulse rate (PR) before and after the procedures.

Results: The intragroup analysis was done using paired t-test and intergroup by independent t-test. For the procedure without LA (restoration), the intragroup analysis showed significant anxiety reduction in children both in TSD (P = 0.0404* VPS) and reframing group (P = 0.0289* VPS) postoperatively. However, intergroup analysis showed no significant difference. For the procedure with LA, higher anxiety was seen in the TSD group (P = 0.0042* VPS, P = 0.0005* PR) compared to reframing both in intragroup analysis (P = 0.0042* VPS, P = 0.0005* PR) as well as intergroup analysis (P = 0.0222*) compared to children in the reframing group.

Conclusion: This study showed both reframing and TSD are effective in reducing anxiety for restorative procedures in children. However, reframing is better suited when LA administration is required.