Medical Play for Dental Anxiety

Overseen By Chaitanya P Puranik, BDS,MS,PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Colorado, Denver

Disqualifiers: Frankl 3 or 4, Autism, others

Compensation: Varies

Number of Visits: 4

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether playing with medical-themed toys before a dental visit can help children feel more comfortable and cooperate better during exams. The study compares children who engage in this medical play (also known as Therapeutic Play or Dental Play Therapy) to those who do regular activities like coloring before seeing the dentist. It aims to determine if medical play reduces anxiety and improves behavior. Neurotypical children aged 5-10 who have experienced trouble during past dental visits might be a good fit for this trial. As an unphased trial, it offers a unique opportunity for children to potentially reduce dental anxiety through innovative play techniques.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that medical play is safe for improving dental visit experiences?

Research has shown that therapeutic play, including medical play, is generally safe for children. This type of play helps reduce anxiety in medical settings. Studies have also found that playing dental simulation games before a dental visit can lower anxiety during procedures.

No major reports of problems linked to medical play have emerged, indicating it is well-tolerated by children. The goal is to make dental visits less stressful without any risks. Therefore, considering a trial involving medical play, current evidence suggests it is a safe option for children. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using medical play to tackle dental anxiety because it offers a creative and interactive way for kids to engage with dental scenarios in a stress-free environment. Unlike traditional methods such as cognitive-behavioral therapy or sedation, medical play involves kids in role-playing and hands-on activities, which can make the dentist's office feel less intimidating and more familiar. This approach not only reduces anxiety but could also foster a more positive attitude toward dental care in the long run, potentially leading to better oral health habits. By making the dental experience fun and educational, medical play has the potential to transform how young patients perceive dental visits.

What evidence suggests that medical play is effective for improving dental visit experiences?

Research has shown that play activities can effectively reduce anxiety and improve cooperation in children during dental visits. In this trial, participants will engage in either Medical Play or Routine Play before their dental exam. For example, bubble breath play therapy has calmed children during routine dental procedures. Fun activities that distract children also help reduce anxiety before surgery. Studies indicate that engaging in play before dental exams leads to better behavior and cooperation compared to not using this approach. These findings suggest that play activities may help children feel more comfortable and less anxious during dental exams. ^{1 4 6 7 8}

Who Is on the Research Team?

Chaitanya P Puranik, BDS,MS,PhD

Principal Investigator

University of Colorado, Denver

Are You a Good Fit for This Trial?

This trial is for neurotypical children aged 5-10 who have shown significant dental anxiety or aversion during past visits to the Children's Hospital Colorado Dental Center. They must be patients of record at this center and accompanied by their legal guardian.

Inclusion Criteria

Previously identified as Frankl 1 or Frankl 2 per the electronic dental record during dental exam visits (Epic)

My child is between 5 and 10 years old.

Child subject is neurotypical

Exclusion Criteria

My child is not between 5 to 10 years old.

Adult in attendance to dental visit with child is not the legal guardian

Previously identified as Frankl 3 or Frankl 4 per the electronic dental record during dental exam visits (Epic)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Intervention

Participants engage in either medical play or routine play before their dental exam visit

1 day

1 visit (in-person)

Dental Exam

Participants undergo a routine dental exam visit with or without medical play intervention

1 day

1 visit (in-person)

Follow-up

Participants are monitored for behavior and cooperation improvements post-intervention

Immediately after dental visit

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Medical Play
• Routine Play

Trial Overview The study tests if 'medical play' before a dental exam can help improve cooperation and reduce anxiety in children, compared to routine play or no special preparation. It also assesses perceptions of behavior from providers, caregivers, and the patients themselves.

How Is the Trial Designed?

Group I: Medical Play Intervention Active Control 1 Intervention

This group of participants will be engaged in medical play before the dental exam visit.

Group II: Routine Play Intervention Placebo Group 1 Intervention

This group of participants be engaged in routine play (coloring exercise) before the dental exam visit.

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials

1,842

Recruited

3,028,000+

Published Research Related to This Trial

Therapeutic play was tested as a treatment for hospital-induced anxiety in children aged 5 to 11 over a four-year study in two hospital settings, showing promising results.

The study indicates that therapeutic play is an effective intervention for reducing anxiety in hospitalized children, highlighting its potential as a valuable therapeutic approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapeutic play: effects on hospitalized children. Clatworthy, S.[2004]

A study involving 50 children aged 5-10 years showed that participating in a group medical play session significantly reduced preoperative fear and anxiety, indicating its effectiveness as an intervention.

Facilitated by a Certified Child Life Specialist, the group medical play allowed children to explore medical equipment, which helped improve their coping skills and overall experience before surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploration of the Relationship Between a Group Medical Play Intervention and Children's Preoperative Fear and Anxiety. Jones, MT., Kirkendall, M., Grissim, L., et al.[2021]

Therapeutic play has been shown to reduce anxiety and improve cooperative behavior in children undergoing invasive procedures, based on a systematic review of 12 studies conducted across various countries.

However, the overall evidence is considered questionable due to methodological issues in the studies, such as lack of randomization and blinding, indicating a need for more rigorously designed research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapeutic play to prepare children for invasive procedures: a systematic review. Silva, RD., Austregésilo, SC., Ithamar, L., et al.[2022]

In a study of 45 children aged 3 to 4 years undergoing dental surgery, related play therapy significantly reduced stress and improved cooperation compared to unrelated play therapy and no preparation at all.

The related play therapy group showed less upset behavior during various stress points of the surgical process, indicating that preparing children with relevant play can effectively alleviate anxiety before surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of psychological preparation on children hospitalized for dental operations. Schwartz, BH., Albino, JE., Tedesco, LA.[2019]

Therapeutic play significantly reduces anxiety levels in children aged 3-7 undergoing cast-removal procedures, with a mean difference of -20.1 compared to the control group.

Both parents and cast technicians reported higher satisfaction levels with the therapeutic play intervention, indicating its positive impact on the overall experience of the procedure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of therapeutic play on children undergoing cast-removal procedures: a randomised controlled trial. Wong, CL., Ip, WY., Kwok, BMC., et al.[2019]

A 90-minute process drama workshop involving 63 children revealed that dental anxiety stems from fears related to the unknown, unpleasant sensory experiences, societal perceptions of dentists, and learned negative associations.

This innovative approach allows children to explore and express their feelings about dental anxiety, providing valuable insights that could inform pediatric dentistry and potentially other health-related fields.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inside the waiting room: process drama and dramatic distancing for involving children in research on dental anxiety. O'Grady, A., Gray-Burrows, K., Tahmassebi, J.[2022]

The study evaluated the effects of the Dramatic Therapeutic Play (DTP) technique on anxiety levels in 28 hospitalized school-age children, but found no significant difference in anxiety scores between the DTP group and the control group.

Despite the lack of significant results, the study suggests that further research with a larger sample size and varied hospitalization contexts is needed to better understand the potential benefits of DTP in reducing anxiety in children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Therapeutic Play on the anxiety of hospitalized school-age children: Clinical trial. Silva, SGTD., Santos, MA., Floriano, CMF., et al.[2022]

Children's behavior in dental settings can be predicted by their play behavior in a simulated environment, suggesting that play may be a reliable indicator of how they will act during dental visits.

Incorporating a play dental area in dental offices could help identify and manage potential problem patients, as it may desensitize them to aspects of dental treatment that cause anxiety, leading to better experiences during actual appointments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between children's dental behavior and play behavior. McTigue, DJ., Pinkham, J.[2009]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6379523/

Evaluation of the Efficacy of Play Therapy among Children ... Bubble breath play therapy was found to be highly significant in reducing anxiety and distress among children undergoing the routine dental procedure.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7229371/

Effectiveness of Cognitive Behavioral Play Therapy and ... Active distraction with cognitive behavioral play therapy is found to be more effective in reducing the preoperative anxiety in children.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT07112092

Therapeutic Play and Music Therapy in Dental Anxiety The primary outcomes of this study were assessed through evaluation of dental pain perception (The Wong-Baker Faces Pain Rating Scale). The Wong-Baker Faces ...

4. withpower.com withpower.com/trial/medical-play-for-dental-anxiety-2a368

Medical Play for Dental Anxiety Research shows that play therapy related to medical procedures can help reduce stress and anxiety in children, as seen in studies where children were more ...

5. bmcpediatr.biomedcentral.com bmcpediatr.biomedcentral.com/articles/10.1186/s12887-025-05849-5

Puppet play therapy in emergency pediatric dental clinic. A ... This study presents a behavior modification method demonstrating efficacy in reducing anxiety among young children who had no previous dental exposure.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6218467/

Effects of Pretreatment Exposure to Dental Practice Using a ... Conclusions: Based on the results, playing certain dental simulation games before the first dental visit might reduce the anxiety felt during anesthetic ...

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39085005/

The effects of preoperative therapeutic play on anxiety and ... The aim of this study is to examine the effects of preoperative therapeutic play on fear and anxiety levels in preschool children.

8. researchgate.net researchgate.net/publication/331264597_Evaluation_of_the_Efficacy_of_Play_Therapy_among_Children_Undergoing_Dental_Procedure_through_Drawings_Assessed_by_Graphological_Method_A_Clinical_Study

Evaluation of the Efficacy of Play Therapy among Children ... The study aimed to evaluate the efficacy of play therapy among children undergoing dental treatment by the graphological method. Materials and ...