Virtual Reality and Point-of-View Video Modeling for Dental Anxiety in Children

November 4, 2026 updated by: Didem ATABEK

Comparison of "Virtual Reality" (VR) and "Point-of-View" (POV) Video Modeling Techniques for Reducing Dental Anxiety in Children

Dental anxiety is common among children and may make dental treatment more difficult. This study aims to compare three non-pharmacological behavior guidance techniques for reducing dental anxiety and improving cooperation during invasive fissure sealant treatment in children aged 6-10 years.

Children who require an invasive fissure sealant on a mandibular first molar and meet the study eligibility criteria will be included. Participants will be randomly assigned to one of three groups. The first group will watch a 1.5-2-minute Point-of-View (POV) video showing the dental examination and treatment process from a child's perspective before the dental procedure. The second group will use virtual reality (VR) glasses during the procedure and watch age-appropriate animation or cartoon content as an active distraction technique. The control group will receive the standard Tell-Show-Do behavior guidance technique.

Dental anxiety, behavior, physiological responses, and pain will be assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Facial Image Scale (FIS), Frankl Behavior Rating Scale, pulse rate, oxygen saturation, and Wong-Baker FACES Pain Rating Scale. A post-intervention satisfaction and experience questionnaire will also be administered to assess the children's experiences with the behavior guidance techniques.

The study is expected to provide comparative evidence regarding the effectiveness of POV video modeling and VR distraction compared with the standard Tell-Show-Do technique in managing dental anxiety and improving children's cooperation during dental treatment.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The Facial Image Scale (FIS) will be used to evaluate the child's anxiety at four predefined time points: while the child is waiting in the waiting area, after sitting in the dental unit before the behavior guidance technique, after application of the assigned behavior guidance technique, and after completion of the invasive fissure sealant procedure.

Pulse rate and oxygen saturation will also be recorded at the same four assessment time points using a pulse oximeter. The Frankl Behavior Rating Scale will be used to assess behavioral cooperation before and during the dental procedure. Immediately after completion of the invasive fissure sealant procedure, pain will be assessed using the Wong-Baker FACES Pain Rating Scale. A post-intervention satisfaction and experience questionnaire will also be administered to evaluate the child's experience and perceived comfort with the assigned behavior guidance technique.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
69

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

6 years to 10 years (Child)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children aged 6-10 years.
  • Children without any systemic or psychiatric disorder or special needs.
  • Children who do not require emergency dental treatment.
  • Children whose parent(s) provide written and/or verbal informed consent for participation in the study.
  • Children who agree to participate in the assigned intervention, including watching the POV video or using virtual reality (VR) glasses, as applicable.

Exclusion Criteria:

  • Children with a systemic or psychiatric disorder or special needs.
  • Children who require emergency dental treatment.
  • Children who refuse to use virtual reality (VR) glasses.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: POV Video Modeling Group

Participants in this group will watch a 1.5-2-minute Point-of-View (POV) video before the dental procedure. The video presents the dental examination and treatment process from a child's perspective and is designed to familiarize the child with the dental procedure before invasive fissure sealant treatment.
Behavioral: Point-of-View (POV) Video Modeling

Participants will watch a 1.5-2-minute Point-of-View (POV) video before the dental procedure. The video presents the dental examination and treatment process from a child's perspective and is intended to familiarize the child with the dental procedure before invasive fissure sealant treatment.
Experimental: Virtual Reality (VR) Group

Participants in this group will use virtual reality (VR) glasses during the dental procedure. Age-appropriate animation or cartoon content will be presented through the VR glasses as an active distraction technique during invasive fissure sealant treatment.
Behavioral: irtual Reality (VR) Distraction

Participants will use virtual reality (VR) glasses during the dental procedure. Age-appropriate animation or cartoon content will be presented through the VR glasses as an active distraction technique during invasive fissure sealant treatment.
Active Comparator: Tell-Show-Do Control Group

Participants in this group will receive the standard Tell-Show-Do behavior guidance technique before and during the invasive fissure sealant procedure. The child will be introduced to the dental procedure using the standard Tell-Show-Do approach.
Behavioral: Tell-Show-Do

Participants in the control group will receive the standard Tell-Show-Do behavior guidance technique before and during the invasive fissure sealant procedure. The child will be introduced to the dental procedure using the standard Tell-Show-Do approach.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Facial Image Scale (FIS) Score
Time Frame: Visit 1: Within 1 min after dental examination. Visit 2 (2 weeks later): (1) Before dental examination; (2) within 1 min after seating; (3) within 1 min after behavior guidance; (4) within 1 min after fissure sealant.

The Facial Image Scale (FIS) is a self-report measure used to assess dental anxiety in children. It consists of five facial images representing increasing levels of anxiety, scored from 1 to 5. A score of 1 indicates the least anxiety, whereas a score of 5 indicates the highest anxiety. Higher scores indicate greater dental anxiety and therefore a worse outcome.

FIS scores will be recorded at five time points. During the first visit, the FIS will be administered within 1 minute after completion of the dental examination. During the second visit, which will take place 2 weeks after the initial visit, FIS scores will be recorded at four time points: (1) in the waiting area immediately before the dental examination; (2) within 1 minute after the child is seated in the dental chair; (3) within 1 minute after completion of the assigned behavior guidance technique and before dental treatment; and (4) within 1 minute after completion of the invasive fissure sealant procedure.
Visit 1: Within 1 min after dental examination. Visit 2 (2 weeks later): (1) Before dental examination; (2) within 1 min after seating; (3) within 1 min after behavior guidance; (4) within 1 min after fissure sealant.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) Score
Time Frame: Visit 1: Within 5 min after dental examination. Visit 2 (2 weeks later): Within 5 min after fissure sealant procedure.

Dental fear and anxiety will be assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), a 15-item scale scored from 15 to 75. Higher scores indicate greater dental fear and anxiety and a worse outcome. Scores are categorized as low (≤32), moderate (33-37), and high (≥38) dental anxiety. CFSS-DS scores will be recorded within 5 minutes after completion of the dental examination during the first visit and within 5 minutes after completion of the fissure sealant procedure during the second visit, which will take place 2 weeks after the initial visit.
Visit 1: Within 5 min after dental examination. Visit 2 (2 weeks later): Within 5 min after fissure sealant procedure.
Frankl Behavior Rating Scale Score
Time Frame: Visit 1: During the dental examination. Visit 2: Before the behavior guidance technique: during the dental examination; after the behavior guidance technique: Throughout the fissure sealant procedure, including at treatment completion.

The child's behavior will be assessed using the Frankl Behavior Rating Scale, which consists of four categories scored from 1 to 4: definitely negative (1), negative (2), positive (3), and definitely positive (4). Higher scores indicate more positive behavior and a better outcome.The child's behavior will be observed during the dental examination at the first visit and, at the second visit, during the dental examination before the behavior guidance technique and throughout the fissure sealant procedure, including at treatment completion. The second visit will take place 2 weeks after the initial visit.
Visit 1: During the dental examination. Visit 2: Before the behavior guidance technique: during the dental examination; after the behavior guidance technique: Throughout the fissure sealant procedure, including at treatment completion.
Pulse Rate
Time Frame: Visit 2: (1) In the waiting area, before dental examination; (2) within 1 min after seating in dental unit; (3) within 1 min after behavior guidance, before dental treatment; (4) within 1 min after fissure sealant.

Pulse rate (beats per minute, bpm) will be measured at four time points during the second visit: (1) in the waiting area immediately before the dental examination; (2) within 1 minute after the child is seated in the dental chair; (3) within 1 minute after completion of the assigned behavior guidance technique and before dental treatment; and (4) within 1 minute after completion of the invasive fissure sealant procedure.
Visit 2: (1) In the waiting area, before dental examination; (2) within 1 min after seating in dental unit; (3) within 1 min after behavior guidance, before dental treatment; (4) within 1 min after fissure sealant.
Oxygen Saturation (SpO2)
Time Frame: Visit 2: (1) In the waiting area, before dental examination; (2) within 1 min after seating in dental unit; (3) within 1 min after behavior guidance, before dental treatment; (4) within 1 min after fissure sealant.

Oxygen saturation (SpO₂), expressed as a percentage (%), will be measured at four time points during the second visit: (1) in the waiting area immediately before the dental examination; (2) within 1 minute after the child is seated in the dental chair; (3) within 1 minute after completion of the assigned behavior guidance technique and before dental treatment; and (4) within 1 minute after completion of the invasive fissure sealant procedure. Changes in SpO₂ will be evaluated across these time points.
Visit 2: (1) In the waiting area, before dental examination; (2) within 1 min after seating in dental unit; (3) within 1 min after behavior guidance, before dental treatment; (4) within 1 min after fissure sealant.
Wong-Baker FACES Pain Rating Scale Score
Time Frame: Visit 2: Within 1 min after completion of the fissure sealant procedure.

Pain intensity will be assessed using the Wong-Baker FACES Pain Rating Scale, scored from 0 to 10 in increments of 2 (0, 2, 4, 6, 8, and 10). A score of 0 indicates no pain, while 10 indicates the worst pain. Higher scores indicate greater pain intensity and a worse outcome. Pain will be assessed within 1 minute after completion of the invasive fissure sealant procedure during the second visit.
Visit 2: Within 1 min after completion of the fissure sealant procedure.
Satisfaction and Experience Questionnaire
Time Frame: Visit 2: Within 5 min after completion of the fissure sealant procedure (POV and VR groups only).

A post-intervention Satisfaction and Experience Questionnaire will be administered to participants in the POV Video Modeling and Virtual Reality (VR) groups within 5 minutes after completion of the fissure sealant procedure to assess their satisfaction, perceptions, and comfort regarding the assigned behavior guidance technique. Items will be answered with "Yes" or "No."
Visit 2: Within 5 min after completion of the fissure sealant procedure (POV and VR groups only).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Didem ATABEK

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Gazi University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Didem Atabek, Prof. Dr., Gazi University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 20, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 19, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 19, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 26, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025-2098

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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