Using flavour in your favour: does giving children an element of control help them engage more positively with the...

Karim R, Splieth C H, Schmoeckel J. Effect of choice of flavour of fluoride varnish on behaviour in dental visits in schoolchildren. Clin Exp Dent Res. 2025; https://doi.org/10.1002/cre2.70069 .

To assess the efficacy of giving children choice within the dental surgery to improve behaviour outcomes, investigated by letting them choose the flavour of fluoride varnish (FV). This single-blinded, randomised control trial recruited children attending the specialised paediatric dental service within the Greifswald University Hospital for a dental check-up and preventative FV application. Upon attendance, children were randomly assigned to one of two groups: the control group, where the flavour of FV was predetermined, or the test group, where the children selected their preferred flavour. A blinded observer used Frankl behaviour rating scale (FBRS) to assess behaviour during the appointment, and taste acceptance was assessed using the Facial image scale (FIS).

70 participants were recruited at the time of their appointment. These were healthy (ASA I or ASA II) German children aged 5 to 10. Exclusion criteria included their first dental experience, experiencing dental pain or an allergy to FV. 35 children were randomly allocated to both groups.

Most children, regardless of their allocation, were assessed as positive, or definitely positive according to FBRS (n = 58, 82.8%), though results on behaviour outcomes were statistically insignificant (p = 0.376). There were no significant differences between the control group or the test group on flavour ratings of the FV, with most children (n = 53, 75.7%) scoring happy, or very happy according to FIS. History of negative dental behaviour was also taken into consideration (n = 27), and whilst it appeared children with history of negative experience displayed more positive behaviour in the test group vs the control group (75% vs 54.5%), results were not statistically significant (p = 0.244).

This study shows that allowing children a sense of control by permitting them to choose their flavour of FV may be a useful behaviour management tool, though the results are not statistically significant.