A Comparative Assessment of Three Different Behavior Modification Techniques Using Physiological and Psychological...

The principal emotions of a child entering the dental operatory are usually fear and anxiety, which have an impact on their behavior during all future appointments. Over the past couple of decades, there has been a significant shift in professional and societal perspectives on handling child behavior. Hence, many dentists are interested in additional noninvasive alternatives to conventional behavior management techniques. Therefore, the goal of this study was to assess and relate the efficacy of three such minimally invasive, nonpharmacological behavior management methods in reducing dental anxiety by using certain physiological variables and an anxiety assessment scale (i.e., psychological variable), before and after a dental procedure.

This single-blind, randomized clinical trial involved 88 subjects randomly allocated to four groups, who were treated under the influence of three different behavior management techniques (viz., audio distraction, aromatherapy, and clown therapy) and a conventional technique (control group). Anxiety levels were assessed using the Raghavendra Madhuri Sujata Pictorial Scale (RMS-PS), and measuring the changes in their hemodynamic variables and salivary biomarkers, prior to, and following treatment. The data were tabulated and statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 21.0 statistical software.

All three behavior management techniques assessed in this study were effective in lowering anxiety levels among the subjects. More specifically, audio distraction outperformed the other two techniques, followed by the aromatherapy technique, which was found to be better than clown therapy and control groups.

While all three methods are able to lower dental fear and anxiety in children, audio-distraction is better among the three at achieving the same.

Results of this study have the potential to guide pediatric dentists in selecting evidence-based, patient-friendly approaches to behavior guidance, thereby improving the overall quality of care, reducing appointment durations, and fostering a more positive dental experience for children.

Dey MK, Dhinsa K, Yadav G, et al. A Comparative Assessment of Three Different Behavior Modification Techniques Using Physiological and Psychological Parameters: An In Vivo Study. Int J Clin Pediatr Dent 2026;19(1):73-84.