Positive Pre-Visit Imagery Does Not Reduce Dental Anxiety in Children: A Randomized, Triple-Blind, Controlled Trial

Purpose: To evaluate the effectiveness of positive pre-visit imagery in reducing dental anxiety (DA) in children undergoing procedures requiring local anesthesia. Methods: A triple-blind, randomized controlled clinical trial was conducted with 69 children aged 7 to 12 years of age at a university pediatric dental clinic in Brazil. Participants were randomly assigned to either an experimental group (positive dental images) or a control group (neutral nature images). Images were shown 2 minutes prior to receiving local anesthesia. DA was assessed before and after treatment using the Venham picture test (VPT). Statistical analyses included the Mann-Whitney U test, Wilcoxon signed-rank test and ordinal logistic regression to identify predictors of post-procedure anxiety. Results: No significant differences in VPT scores were found within or between groups before and after treatment (P>0.05). Baseline anxiety, age, sex and group allocation did not predict post-treatment anxiety. Conclusion: Positive pre-visit imagery was not effective in reducing DA when measured by the VPT.