Effectiveness of Traditional Music Distraction, Music of Choice, and Tell-Show-Do for the Management of Anxious Children Undergoing Invasive Dental Procedures: A Randomized Clinical Trial

Objectives: Dental anxiety is a significant concern among children, often leading to avoidance of dental care and subsequent deterioration in oral health. A noninvasive and cost-effective approach to managing anxiety is music distraction. The present study investigates the therapeutic potential of music-based interventions like traditional music and music of choice as alternatives to the conventional Tell‐Show‐Do (TSD) technique to alleviate anxiety. This study aimed to evaluate the effectiveness of traditional music distraction, music of choice, and TSD for the management of anxious children undergoing invasive dental procedures. Methods: The present study was a single-blinded, three-arm, randomized clinical trial conducted among 75 children aged 6–12 years and allocated into three groups as follows: Group I—Tell-Show-Do, Group II—music of choice, and Group III—traditional music distraction. The dental treatment included invasive procedures such as restorations of deep carious lesions, pulp therapy, and extraction of primary molars. Anxiety was evaluated for Pulse Rate (PR) and Venham’s Picture Test (VPT) before and after the procedure. The child’s behavior was also determined by Frankl’s Behavior Rating Scale before and after the procedure. The analysis of covariance and Kruskal–Wallis test was used for intergroup comparison, the Wilcoxon matched pairs test for intragroup comparison, and the Mann–Whitney U test for pair-wise comparison among the groups. The level of significance was set at a P value of <0.05. Results: With the intercomparison of all three groups, VPT and PR scores were statistically significant with P <0.001* and P = 0.0120*, respectively. The before and after difference scores were also statistically significant ( P <0.001*). In the intragroup comparison, Group II (music of choice) showed a statistically significant reduction in both VPT scores ( P <0.001*, effect size = 0.839) and PR ( P = 0.008*, effect size = 0.237). Group III (traditional music) demonstrated statistically significant reductions in both VPT scores and PR ( P <0.001*), with effect sizes of 0.929 and 0.892, respectively. In contrast, Group I (TSD) did not show any statistically significant changes in either VPT scores ( P = 0.4432, effect size = 0.043) or PR ( P = 0.6542, effect size = 0.024). Intergroup and intragroup comparisons demonstrated a reduction in anxiety in both music intervention groups. However, a statistically significantly greater reduction ( P <0.05) was observed in the traditional music distraction, followed by the music of choice. Furthermore, the highest anxiety scores were observed in the TSD group. A marked and noticeable change was observed in the behavior of the children, with a reduction in negative behavior and a strategic shift toward positive behavior among all three groups. Conclusion: Traditional music distraction was found to be significantly more effective in reducing anxiety than music of choice. Nonetheless, both forms of music distraction represent safe and cost-effective adjuncts to behavior guidance techniques in the management of anxious children during invasive dental procedures.