Behavior Guidance Techniques Research Articles

Comparative Evaluation of New Needleless Local Anesthetic System (INJEX) and Conventional Syringe Needle Technique during Pulpotomy Treatment: A Randomized Clinical Trial.

The dreaded sensation of pain in the dental chair has a significant impact on children's behavior. This study aimed to compare and contrast the perception of pain and patient behavior between the use of INJEX and the conventional syringe needle technique during pulpotomy among children. A randomized clinical trial was designed and conducted among pediatric dentistry patients aged 6-12 years old. Fifty-eight children were divided into two groups, conventional syringe needle and INJEX, using simple randomization method applying the sequentially numbered, opaque, sealed envelope method of allocation concealment. Anesthesia was administered to the groups as local infiltration by a single operator following routine behavior guidance techniques. After 3 min, pulpotomy was performed using the standard protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) scale and Wong-Baker FACES Pain Rating Scale (WBS) were used to assess the intensity of pain, while the Frankl behavior rating scale (FBRS) was used to assess the children's behavior. During anesthesia, most of the participants in the INJEX group (median = 3) had higher FBRS scores compared with the conventional syringe needle group (median = 2), and the difference was very highly significant (p-value < 0.001). Analyzing the FLACC scores during local anesthesia administration revealed a high statistical significance (p-value < 0.01) across the two groups. A very high statistically significant difference (p-values < 0.001) with higher WBS scores for pain intensity was seen in the group using conventional syringe needles. INJEX administration significantly reduced the intensity of pain experienced by the children and helped maintain a positive attitude among them during pulpotomy. It provided a positive and comfortable experience for both the child and the practitioner. Therefore, it can serve as an excellent alternative to conventional needle anesthesia.

To Restrain or Refrain: Determination of Parental Attitude towards the Child’s Experience with Protective Stabilization

ABSTRACT Background: To overcome disruptive behavior of children, pediatric dentists rely on various behavior management techniques. When dental therapy is pertinent and nonaversive techniques like tell-show-do, voice control, and positive reinforcement are ineffective; the role of advanced behavior guidance techniques like physical restraints and protective stabilization is of paramount importance. Aim: The study was carried out to elicit parents’ opinion and record their response to their children’s experience who underwent dental treatment with an extra assistant for protective stabilization. Materials and Methods: Response was elicited to a questionnaire from 50 parents of children lacking cooperative ability and were exposed to an extra assistant for protective stabilization during various dental procedures. Results: The dental assistant was most preferred as the extra assistant to provide active stabilization. An overwhelming 98% of the parents agreed to protective stabilization with an extra assistant as advantageous and a good 88% of the parents recommended its use for further appointments of their children. Conclusion: Majority of the parents approved protective stabilization with an extra assistant in future appointments of their children.

Parental Acceptance Towards Various Behavior Guidance Techniques Used in Pediatric Dentistry in Some Private and Governmental Dental Clinics in Bahrain – A Cross Sectional Study.

Parental Acceptance Towards Various Behavior Guidance Techniques Used in Pediatric Dentistry in Some Private and Governmental Dental Clinics in Bahrain – A Cross Sectional Study.

Students' perception of protective stabilization of pediatric dental patients: a qualitative study.

Protective stabilization (PS) has been utilized to safely perform examinations, make diagnoses and/or provide limited treatment of short duration to uncooperative children. The literature supports PS as an alternative technique when behavior management strategies are not sufficient to enable oral care. The use of PS in pediatric dentistry can be traumatic for patients, parents and the medical team and has sometimes been described as being non-compliant with standards of care. Semi-structured qualitative interviews on dental students' perception of PS were conducted in the pediatric department of dentistry at the University Hospital of Toulouse, France. A thematic analysis of the transcript of interviews was provided using the NViVo software. This analysis identified four main themes. The students described their first experience with physical restraint in pediatric dentistry and wondered about the definition of PS. The students' perception of PS showed that this procedure has a psychological impact and is disturbing. There is a lack of information on PS in dental curricula and didactic and clinical education which requires attention. Finally, the students took into consideration the role of PS in future practice. Dental students' perception of PS provides justification for the development and improvement of theoretical and clinical education in behavior guidance techniques for pediatric dental patients, in accordance with national and international guidelines.

Experiences of dentists and caregivers of patients with special care needs-A qualitative study.

Patients with special care needs (developmental disabilities) have unique and complex needs regarding their oral health and care. This qualitative study aimed to identify the experiences, preferences and challenges of dentists and caregivers regarding behavior guidance techniques for dental care in persons with special care needs. Relying on qualitative description as articulated by Sandelowski, we conducted telephone interviews with a purposeful sample of five special care dentists and seven caregivers. We analyzed the data using thematic analysis. Four themes were highlighted: (1) Neither pharmacological or non-pharmacological behavior guidance techniques was universally suitable, (2) A patient-centered approach was critical, (3) The dental environment triggered patients' behaviors and anxiety levels, (4) There was more demand for, than supply of, qualified dentists to treat patients with special care needs. Persons with special care needs are heterogeneous and respond to various behavioral techniques required to deliver their treatment. Behavior guidance planning should be negotiated carefully with patients and caregivers and then individualized based on patients' capabilities and needs for treatment. The necessity to manage complex behaviors has contributed to the limitation of access to dental care for persons with special care needs. Dentistry as a profession has the obligation to uphold the social contract and meet its responsibility to the dental care needs of this population.

Influence of past advanced behavior guidance experience on parental acceptance for autistic individuals in the dental setting

BackgroundAutism is a lifelong neurodevelopmental disorder that poses challenges during dental treatment. Advanced behavior guidance techniques (BGTs) have been used to provide dental care for autistic people who have specific characteristics and complex dental treatment. This study was conducted to evaluate parental acceptance and analyze parents’ opinions of advanced BGTs during dental treatment in autistic people.MethodsThis cross-sectional study was conducted on 141 parents of autistic people from the Mahidol Dental Hospital and the Autism online community. Informed consent was obtained before enrolling participants in the study. All parents were asked to rate their acceptance after watching VDO clips: passive restraint by device (PRBD), oral sedation (OS), and general anesthesia (GA) to evaluate parental acceptance of advanced BGTs through an online questionnaire survey. The online questionnaire included a visual analog scale (VAS) and open-ended questions to collect their opinions on each advanced BGT. Participants were categorized into two subgroups as follows: 81 in the “Experience group” and 60 in the “No experience group” according to their autistic people’ advanced BGT experience. Friedman’s two-way analysis of variance and the Mann–Whitney U test were used for statistical analyses. Open-ended questions were analyzed using quantitative content analysis.ResultsPRBD was ranked the highest, followed by GA and OS. Parents in the “Experience group” rated significantly higher acceptance of their BGT experience than parents in the “No experience group” in all the three advanced BGTs.ConclusionsAll advanced BGTs were particularly accepted in this study. Previous experience of advanced BGTs had an influence on parental acceptance. Parents commented on their opinions toward each advanced BGT with a variety of perspectives. Trial registration: The protocol was approved by the ethical committee of the Faculty of Dentistry/Faculty of Pharmacy, Mahidol University (COA.No.MU-DT/PY-IRB 2021/022.1702) and was registered with Thai Clinical Trials Registry (TCTR20220521001).

A Randomized Cross-over Trial of Behavior Guidance Techniques on Children with Special Needs during Dental Treatment: The Caregivers' Perceived Mannerisms.

To compare caregivers' acceptance, consent, and concern toward utilization of a combination of basic behavior guidance technique (CBBGT) and Papoose Board (PB) for their special needs children and to evaluate the impact of PB usage on the caregiver's attitude and the association between their education level, monthly household income, and previous dental experience. This cross-over study incorporated 90 special needs children who were recruited to receive dental treatment with two ways of behavior guidance exposures consecutively in the order of A-B/B-A design. Exposure A is CBBGT (distraction, tell-show-do, and positive reinforcement), while Exposure B is PB. The dental procedures were either dental prophylaxis or restoration with a handpiece. Caregivers need to answer a paper-based questionnaire before and after exposure. The Wilcoxon sign rank test and logistic regression were utilized in order to establish the comparability, impacts, and association. About 88 caregivers of special needs children aged between 2 and 15 years completed the sequence. Overall, 98.9% of the children presented with neurodevelopmental disorders. Twenty-seven caregivers were significantly concerned when the combination of basic BGT was applied to their children, and 14 caregivers felt the same for PB. However, the Wilcoxon sign rank test revealed insignificant caregiver scores on acceptance and consent for both methods but significantly improved attitudes towards the use of PB after observing the placement of their children. The studied caregiver demonstrated equivalent acceptance, consent, and concern toward the use of PB and a combination of basic BGT with improved attitudes after comprehensive explanation and real-time observation of PB usage during their children's dental treatment.

Comparative evaluation of anxiety level during restorative treatment using no music, monaural beats, and binaural auditory beats as audio distraction behavior guidance technique in children aged 6-12 years: A randomized clinical trial.

Binaural auditory beat is an auditory illusion perceived when two different pure-tone sine waves with less than a 30 Hz difference are presented to a listener dichotically. Monaural beat stimulation is achieved by the superposition of amplitude-modulated signals of nearby frequencies to both ears simultaneously. The study aims to evaluate and compare anxiety level during restorative treatment using no music, monaural beats, and binaural auditory beats as audio distraction behavior guidance techniques in children aged 6-12 years. Three-arm, parallel-group randomized study was conducted in the department of pediatric and preventive dentistry. The sample size of 45 participants was calculated and allocated into three groups as no music, monaural beats, and binaural auditory beats group. Teeth with Class I cavity in primary or permanent molars were prepared and restored. Anxiety was measured pre and postintervention using pulse oximeter and Venham's picture test. Data obtained were analyzed with SPSS software version 20.0 and were carried out using one-way analysis of variance and dependent t-test and significance value < 0.05 was considered. Binaural auditory beats and monaural beats showed a better reduction in anxiety levels as per Venham's picture test scores with statistically significant "P" value 0.0001 and 0.064, respectively. Likewise, binaural auditory beats showed better reduction in anxiety levels as per pulse rate scores with statistically significant "P" value 0.0001 as compared to conventional treatment technique. Binaural auditory beat was found to be the most effective followed by the monaural beat compared to the control group. Thus, binaural auditory beats and monaural beats can be used effectively as an essential aid to reduce anxiety in children.

Effectiveness of thaumaturgic distraction in alleviation of anxiety in 4-6-year-old children during inferior alveolar nerve block administration: a randomized controlled trial.

Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

Variation in the Use of Basic Behavioral Management Techniques in General and Pediatric Dental Practice: A Cross-sectional Study

Aim: Basic guidance on nonpharmacological behavioral management techniques in dental practice is fundamental for the effective treatment of pediatric patients. The aim of this study was to compare the use of basic nonpharmacological behavior guidance in general and specialist pediatric dentists and to evaluate the perceived difference in their effectiveness across hospital clinics in Jeddah, Saudi Arabia. Material and Methods: A cross-sectional study with a nonpurposive sample of 179 registered general and pediatric dentists in the Saudi Dental Society based in Jeddah in 2019. Participants were contacted and asked to complete a validated questionnaire. The first section of the questionnaire comprised questions on demographic data and the second section investigated the frequency of the use of various behavioral management techniques. Descriptive statistics (frequency and percentages) and inferential statistics were used. Results: A total of 109 participants completed the survey; 52 were general dentists and 57 were pediatric dentists. The techniques tell–show–do ( P = .018), positive reinforcement ( P = .004), distraction ( P = .001), and nonverbal communication ( P = .001) were used more frequently by pediatric dentists than general dentists, and there were statistically significant differences. Also, pediatric dentists reported that the techniques tell–show–do ( P = 0.035), positive reinforcement ( P = .026), distraction ( P = .011), and nonverbal communication ( P = .007) were highly effective more often than general dentists did. Conclusions: Statistically significant differences were found between general and pediatric dentists in the use of basic behavioral management techniques. Broadly, general dentists used fewer behavior guidance techniques compared to pediatric dentists. More pediatric dentists reported that behavioral management techniques were effective in comparison to general dentists.

The effect of parenthood on the clinician’s empathy and behavior guidance technique preferences among pediatric dentists

To assess the effect of parenthood on the clinician's empathy and behavior guidance practices among pediatric dentists. A web-based questionnaire was sent to all registered pediatric dentists in the American Academy of Pediatric Dentistry through the AAPD mailing list. The questionnaire consisted of three main components, the sociodemographic data of the participants including age, gender, years of clinical experience, marital status, having children and number of children if applicable. The second section was designed to assess the clinician's empathy. The final part contained multiple choice questions of the dentist's past and current behavior guidance technique utilization. A total of 432 responses were received. Parent pediatric dentists demonstrated significantly better compassionate care than non-parent dentists. Female participants showed statistically significantly higher scores in overall empathy, and compassionate care. Furthermore, pediatric dentists report better comfortability with behavior guidance techniques after having children. Parenthood may impact the pediatric dentists' compassionate care; however, it does not seem to have an effect on his/her overall empathy. Moreover, having children may increase the level of comfort in practicing behavior guidance techniques except for Tell, Show, Do.

Rehabilitation of Mandibular Dentition Under Conscious Sedation in A Pediatric Patient: a case report

Behavior management of younger children during dental treatment always has been a major challenging task for a pediatric dentist. The requirement of advanced behavior guidance techniques in the management of lacking cooperative behavior child is undeniable. Conscious sedation is considered to be one of the best suitable methods for delivering dental treatment in younger children. The procedure exhibits multiple advantages like extensive treatment in a single visit, aids in delivering optimum dental treatment, and prevention of developing psyche of a child. The combined use of pharmacological agents increases the potency of sedation as well as is associated with an analgesic, anxiolytic and amnestic effect. This report represents the first dental pediatric conscious sedation case in Bangladesh in 5.5 years old, anxious, and lacking cooperative behavior child.&#x0D; Update Dent. Coll. j: 2022; 12(1): 37-39

Parental acceptance toward behavior guidance techniques for pediatric dental visits: a meta-analysis.

This study aimed to answer the following question: What is the proportion of acceptance reported by parents toward pediatric behavior guidance techniques (BGTs)? Observational studies that evaluated parental acceptance of BGTs during pediatric dental visits among parents of non-special health care need (non-SHCN) and SHCN children were included. A search of the Cochrane Library, Latin American and Caribbean Health Sciences (LILACS), MedLine/PubMed, PsycINFO, Scopus, and Web of Science databases, in addition to gray literature, was performed until October 2021. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for quality assessment. The certainty of evidence was assessed using the Recommendation, Assessment, Development, and Evaluation (Grade). Fifty-three studies with 4868 participants were included, and 42 were retained for the random-effects proportion meta-analysis. The methodological quality varied from low to high. The agreement with the BGTs varied from 85.6% (95%CI: 77.5-92.1; p < 0.001; I 2 = 93.6%; 16 studies; n = 1399) for tell-show-do to 25.7% (95%CI: 17.8-34.4; p < 0.001; I 2 = 90.4%; 12 studies; n = 1129) for passive protective stabilization among non-SHCN children's parents; meanwhile, among the parents of SHCN children, it varied from 89.1% (95%CI: 56.1-99.7; p < 0.001; I 2 = 95.7%; 3 studies; n = 454) for tell-show-do to 29.1% (95%CI: 11.8-50.0; p = 0.001; I 2 = 84.8%; 3 studies; n = 263) for general anesthesia. The effect estimates varied greatly, as substantial heterogeneity across studies was observed, thus limiting the confidence in the results. Parents were more likely to agree with basic BGTs over advanced BGTs, with very low certainty of evidence. Dentists should discuss BGT options with parents. Protocol registration: PROSPERO CRD42018103834.

C.E. Credit. The Millennial Family: Adapting Behavior Guidance to Contemporary Parenting

Understanding the parent/child dynamic is important in the delivery of person-centered dental care to the child. However, the nature of parenting has changed and understanding of child development has continued to develop, affecting the ability of dentists to influence child behavior. The purpose of this paper is to review generational differences, the impact of parenting on child development and changes in approval of behavior guidance techniques to propose new approaches to child behavior.

IMPACT OF PARENTING STYLE ON CHILD BEHAVIOR AND GUIDANCE STRATEGIES DURING THE DENTAL TREATMENT

Behaviour guidance could be challenge in modern paediatric dentistry. A child’s behaviour towards dental treatment varies according to different parenting styles. Authoritative parenting utilizes warmth and nurturance, while at the same time maintaining firm control of the child’s behavior. The authoritarian category is a harsh parenting style in which power-assertive techniques are utilized, including physical punishment, commands and yelling, while lacking warmth and communication. Permissive parents are characterized as having little control over their children while exhibiting great warmth toward them. Behavior guidance techniques are used to alleviate anxiety, nurture a positive dental attitude, and perform quality oral health care safely and efficiently for children. The aim of this paper was to study the influence of parenting style on the child`s behaviour and some factors influenced guidance strategies during the dental treatment.&#x0D; Forty-nine children aged between 3 and 6 years with caries and its complications were examined during this study. These subjects presented to the Community paediatric dental clinic in Poltava. The Primary Caregivers’ Practices Report (PCPR) used in this study to assess the level of parenting style (authoritarian, permissive, and authoritative). The parent was asked to rank each behaviour on a Likert scale of 1-5 (1=Never and 5=Always) as to how often they and their spouse/significant other (if applicable) exhibited each behaviour. The scoring key of the PCPR used to classify parents into one of the three specific parenting styles. Also a child`s behaviour was investigated based on Frankle`s scale.&#x0D; Behaviour guidance strategies during the dental treatment based on recommendations of AAPD. Impact of parenting style on a child`s positive behaviour is evaluated with the Chi-square test months. The level of significance was p&lt;0.05.&#x0D; The dominant authoritarian style was not observed in parents; rate of forty-three parents (87,75%) categorized as predominantly authoritative was higher than rate of six permissive parents (22,25%) (p&lt;0,0001). A half of children of permissive parents showed positive behaviour during dental treatment. Majority of children of authoritative parents demonstrated positive behaviour (67,44%), followed by permissive (32,56%). There was statistically significant difference (р&lt;0,05) between parenting styles in positive behaviour.&#x0D; Strategies used for all children were «tell-show-do», distraction, enhancing control, positive reinforcement (gifts and toys). Voice control used in a case of local anaesthesia. Techniques used for children with negative behaviour were desensitization, parental absence, protective stabilization, and sedation. Enhancing control used to allow the patient with positive behaviour (3 score) to assume an active role in the dental experience; the dentist provides the patient a signal to use if he becomes uncomfortable.&#x0D; Parenting style and kind of dental aid (emergency or planned) have impact on choice of guidance strategy for children with negative behaviour. Authors started management of children of permissive parents with negative behaviour from parent absence, this strategy was successful in one case; desensitisation used if strategy was unsuccessful. 7 children with negative behaviour during the first visit got planned dental aid after psychological desensitisation next visit. Children exposed gradually through a series of sessions to components of the dental appointment: parents examined them at home and children made dental treatment with «Play-Doh Doctor drill and fill». This technique was effective in 6 children of authoritative parents and 1 patient of permissive parents.&#x0D; One child of permissive children and three children of authoritative children got emergency dental aid under sedation. Two children of authoritative parents who need emergency dental aid, have contraindications to general anaesthesia, therefore, protective stabilisation of the patients performed.&#x0D; Planned dental aid under sedation (3 children of authoritative parents), which is one of the methods of positive motivation for treatment, performed if other guidance strategies were unsuccessful.&#x0D; Thus, children of authoritative parents more often showed positive behaviour, whereas permissive parenting style had no impact on child`s behaviour during dental treatment. Choice of guidance strategy depends on the kind of dental aid (planned and emergency), parenting style and child`s behaviour during dental treatment.

Contemporary Behavior Guidance Techniques to Outsmart Child\'s Anxious Mind

Contemporary Behavior Guidance Techniques to Outsmart Child\'s Anxious Mind

Effects of Using Music Methods, 3D Glasses and Behavioral Control on Children’s Anxiety during Dental Treatment

Introduction: Dental anxiety in children is a challenge in managing patients. The effect of this anxiety may continue until adolescence and be a reason for avoiding dental treatments. The aim of this study was compare the effectiveness of using music, 3D glasses and behavioral control methods on children’s anxiety during dental treatments. Materials and Method: This Experimental cross sectional study carried out on 96 children aged between 5-8 years without any systemic. The children were divided into three groups; control (basic behavior guidance techniques without distraction), audio (basic techniques plus music) and AV (basic techniques plus 3D AV) distraction groups. The anxiety score was assessed by using MCDASf method, before local anesthesia, after LA and after restoration. Pain rate measured with VAS and the behavior of children during dental treatment measured with Houpt index. Data were analyzed by one-way ANOVA with the 0.05 level of significance. Results: The mean of anxiety in different stages before starting work, after anesthesia and after repair, was significantly different in the 3D glasses group (p value = 0.004), using music (p value = 0.018) and behavioral control (p value = 0.002). The lowest anxiety level in the 3D glasses group and the highest anxiety in the control group was. The best group in reducing the amount of pain after anesthesia and cooperation was the 3D glasses group. Conclusion: Use of 3D glasses in dental treatment can decrease dental anxiety in children. And children cooperation with 3D glasses was better than other methods.

Basic behavior guidance techniques: A survey of members of the Spanish Society of Paediatric Dentistry.

Over the last 20-30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs). To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences. A cross-sectional, descriptive, and correlational study was designed. One hundred and twenty-six dentists completed a previously validated survey. Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data. The most common BGTs were "Tell/Show/Do" (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: "hand-over-mouth" (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment. There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes.

Management of primary tooth luxation injuries

In children, traumatic dental injuries from a fall are more likely to result in a tooth being displaced than fractured, because the supporting bone is less dense than in the permanent dentition. The direction of the displacement and severity of the injury will influence the risk of injury to the developing permanent teeth. This manuscript will discuss each type of primary tooth luxation injury, how they should be managed, the prognosis and sequelae that are likely and what behavior guidance techniques may need to be used to provide safe treatment.

Effectiveness of different behavior guidance techniques in managing children with negative behavior in a dental setting: A randomized control study.

Dental fear is a common cause of uncooperative behavior among young children, which poses a challenge in providing effective dental treatment. With the advancements in technology, several behavior guidance techniques in the form of distraction have emerged over time for managing uncooperative pediatric dental patients. The aim of this study is to compare and evaluate the effectiveness of four different behavior guidance techniques in managing uncooperative pediatric patients by measuring pre- and post-operative dental fear/anxiety levels using physiological and nonphysiological parameters. Sixty systemically healthy children aged 5-8 years with negative behavior as per Frankl's Rating Scale, requiring restoration were included in the study and randomly divided into four equal groups (n = 15), based on the guidance techniques used: Tell-Show-Do (TSD) as a control group and audio distraction, audiovisual distraction (AVD) (virtual reality [VR]) and Mobile Phone Game Distraction as test groups. Pre- and post-intervention levels of the child's fear/anxiety were assessed using both physiological (blood pressure and pulse rate) and nonphysiological (facial image scale) parameters. The data were evaluated using t-test and one-way ANOVA test. A statistically significant difference was observed in both physiological and non-physiological parameters post-intervention in the groups with a maximum decrease in the AVD (VR) group. AVD (VR) was found to be the most effective while TSD alone as the least effective behavior guidance technique in reducing dental fear/anxiety in uncooperative pediatric dental patients.