Evaluation of tell show do technique, audio distraction technique, and audio visual distraction technique in managing anxious pediatric patients aged 5–8 years old undergoing dental treatment: A randomized controlled trial

Background: The use of music as an adjunct therapy has gained recognition in pediatric dentistry for its ability to modulate stress responses during clinical procedures. When implemented alongside other behavioural guidance methods, musical intervention demonstrates enhanced efficacy in creating positive dental experiences for young patients. Aim: This investigation compares three behavioral management approaches conventional Tell-Show-Do method, auditory distraction through music, and combined audiovisual distraction, for their effectiveness in alleviating procedural anxiety in children aged 5–8 years receiving dental care. Materials and Methods: Our randomized controlled trial enrolled 54 pediatric subjects (5–8 years old) distributed equally across three intervention arms. The control group received standard Tell-Show-Do preparation, while experimental groups were provided with either musical auditory stimulation or a multimodal distraction approach incorporating personalized rhyme selections with visual engagement through mascot toys. Pre- and postprocedural anxiety quantification was performed using the validated Animated Emoji Scale assessment tool. Nonparametric tests (Kruskal–Wallis and Wilcoxon signed rank) were employed for intergroup and intragroup comparisons at a = 0.05 significance threshold. Results: The analysis revealed significantly greater anxiety reduction ( P < 0.01) in the audiovisual cohort compared to both musical-only and control groups. The auditory distraction group also showed statistically meaningful improvement over the conventional Tell-Show-Do approach ( P < 0.01). Conclusion: Our findings demonstrate that multimodal audiovisual distraction techniques, when properly customized to patient preferences, offer superior anxiety mitigation compared to unimodal approaches in pediatric dental settings. This evidence supports the incorporation of combined sensory distraction protocols in clinical practice for managing young patients.