Effectiveness Of Magic Tricks Distraction Technique

Effectiveness Of Magic Tricks Distraction Technique In Reducing Anxiety In 3-7 Years-Old Children During Local Anesthesia Administration

Dental anxiety among children is a significant challenge in pediatric dentistry, often hindering effective dental care. This clinical study aims to evaluate the effectiveness of two magic tricks distraction techniques (magic rope and magic thumb sleeves) in reducing dental anxiety among children aged 3-7 years during local anesthesia administration, in comparison to the conventional Tell-Show-Do (TSD) technique. Anxiety will be measured using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS) and pulse oximeter for heart rate assessment

Study Overview

• Status: Completed
• Conditions: Dental Anxiety
• Intervention / Treatment: Behavioral: Magic Rope Trick; Behavioral: Magic Thumb Sleeves; Behavioral: Tell-Show-Do (TSD)

Detailed Description

Dental anxiety in children poses a persistent challenge in pediatric dental practice, often leading to behavioral management difficulties, compromised treatment outcomes, and long-term avoidance of dental care. One of the most anxiety-inducing procedures for young patients is the administration of local anesthesia (LA), primarily due to fear of needles, unfamiliar instruments, and perceived pain. Traditional behavioral management techniques such as the Tell-Show-Do (TSD) method have been widely used to familiarize children with the dental setting and reduce procedural anxiety. However, the effectiveness of TSD during high-stress interventions like LA injections remains under debate, especially among younger children with limited cognitive development.

In response to the need for more engaging and effective behavior guidance strategies, distraction-based techniques-particularly those involving visual and interactive elements-have gained increasing interest. Among them, thaumaturgy, or the use of magic tricks, has emerged as a novel, non-pharmacological method for anxiety reduction in pediatric patients. Magic-based interventions are believed to captivate the child's attention, stimulate curiosity, and shift focus away from the source of fear, thereby promoting relaxation and behavioral cooperation.

This randomized controlled clinical trial is designed to evaluate the efficacy of two magic trick-based distraction techniques-the magic rope and magic thumb sleeves-in reducing dental anxiety in children aged 3 to 7 years, during the administration of local anesthesia. The intervention groups will be compared to a control group managed with the conventional TSD technique.

To ensure a comprehensive and objective assessment of anxiety, the study will employ a dual-modal evaluation approach:

Subjective measurement using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS), which is specifically validated for young children and uses gender-specific real-life facial photographs to help participants express their emotional states accurately.

Objective physiological measurement using pulse oximetry to monitor heart rate (HR) continuously, as HR is a well-established indicator of sympathetic nervous system activation during stress and anxiety.

All procedures will follow standardized protocols, with a dual-operator design: one clinician will administer the behavioral intervention (magic trick or TSD), while a separate clinician, blinded to the intervention group, will perform the LA injection. This design ensures methodological rigor by minimizing operator bias and isolating the effect of the behavioral technique on anxiety.

The outcomes of this study will contribute to the growing body of evidence on non-pharmacological anxiety management strategies in pediatric dentistry and may support the integration of magic-based distraction techniques as effective alternatives or adjuncts to conventional methods such as TSD.

• Study Type: Interventional
• Enrollment (Actual): 102
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Dakahlia
    • Mansoura, Dakahlia, Egypt, 35516
      • Faculty of Dentistry, Mansoura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Children in the age group of 3 to 7 years old.
• Children without any past dental treatment experience under local anesthesia.

Exclusion Criteria:

• Children with a systemic diseases.
• Children with an extreme disruptive behavior.
• Children with acute dental pain or swelling.
• Children with problems in their intellectual functions.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Magic Rope Trick; Children will be distracted using a magic rope trick during local anesthesia administration.	Behavioral: Magic Rope Trick; Children will be distracted using a magic rope trick during local anesthesia administration.
Experimental: Magic Thumb Sleeves; Children will be distracted using light-up magic thumb sleeves during local anesthesia administration	Behavioral: Magic Thumb Sleeves; Children will be distracted using light-up magic thumb sleeves during local anesthesia administration
Experimental: Tell-Show-Do (TSD); Children will receive the conventional Tell-Show-Do behavior management technique during local anesthesia administration	Behavioral: Tell-Show-Do (TSD); Children will receive the conventional Tell-Show-Do behavior management technique during local anesthesia administration

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in dental anxiety level as measured by RMS-PS (Raghavendra, Madhuri, and Sujata Pictorial Scale)	Dental anxiety will be assessed using the RMS-PS scale immediately before local anesthesia administration.	Baseline immediately before local anesthesia administration at the same visit-periprocedural
Change in dental anxiety level as measured by RMS-PS (Raghavendra, Madhuri, and Sujata Pictorial Scale)	Dental anxiety will be assessed using the RMS-PS scale immediately after local anesthesia administration.	Immediately after local anesthesia administration at the same visit
heart rate using pulse oximeter		periprocedural

Collaborators and Investigators

• Sponsor: Mansoura University
• Investigators: Study Director: Nadia farrag, phd, Mansoura University

Publications and helpful links

General Publications

• Konde S, Sumaiyya S, Agarwal M, Peethambar P. "Thaumaturgy"- A Novel Behavior-shaping Technique. Int J Clin Pediatr Dent. 2020 Jul-Aug;13(4):318-321. doi: 10.5005/jp-journals-10005-1781.

Helpful Links

• Int J Clin Pediatr Dent . 2024 Dec 19;17(11):1296-1301. doi: 10.5005/jp-journals-10005-2998

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2024
• Primary Completion (Actual): October 1, 2024
• Study Completion (Actual): March 1, 2025

Study Registration Dates

• First Submitted: July 9, 2025
• First Submitted That Met QC Criteria: July 18, 2025
• First Posted (Actual): July 20, 2025

Study Record Updates

• Last Update Posted (Actual): July 20, 2025
• Last Update Submitted That Met QC Criteria: July 18, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: A0403024PP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All the data can be shared
• IPD Sharing Time Frame: Data can be available forever after I complete publication
• IPD Sharing Access Criteria: internet
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No