The Effect of Cartoon and Music Applications on Dental Pain (Pain Relief)

The Effect of Showing Cartoons and Playing Music During Dental Treatment on Pain and Treatment Anxiety in Children: A Randomized Controlled Trial

This study investigated the effect of showing cartoons or playing music during the procedure on the physiological parameters of pain and fear experienced by children aged 6-12 undergoing tooth extraction treatment.

Study Overview

• Status: Completed
• Conditions: Pain Management; Dental Anxiety; Dental Extraction; Distraction
• Intervention / Treatment: Other: Cartoon viewing app; Other: Music intervention; Other: control group

Detailed Description

Pediatric patients are frequently exposed to medical procedures that can cause pain and anxiety. While pharmacological interventions may be used, distraction is a simple and effective technique that diverts children's attention away from distressing stimuli. Distraction is a non-pharmacological pain management technique widely used by healthcare professionals during procedures to reduce pain and distress. It is based on the assumption that by shifting the child's attention to something interesting, their ability to pay attention to painful stimuli is inhibited, thereby reducing pain, distress, and anxiety. However, there are no published studies examining the effect of watching cartoons, listening to music, and the tell-show-do approach during tooth extraction on the physiological parameters, pain, and anxiety of children aged 6-12 years.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Konya, Turkey (Türkiye), 42130
    • Selcuk University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Be between 6 and 12 years of age,
• Have no systemic, neurological, or chronic diseases,
• Agree to sit in the patient chair (according to the Frankl scale: 2, 3, or 4),
• Have no mental or neurological problems,
• Understand and speak Turkish,
• Have an indication for tooth extraction
• Willingness to participate in the study,
• No visual or auditory impairments

Exclusion Criteria:

• Being a foreign national,
• Not wanting to participate in the study,
• Not agreeing to sit in the patient chair (1 on the Frankl scale)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimantal Group: Cartoon Group; In this group of 20 children, cartoons were shown during the tooth extraction procedure. Before the procedure began, the child's vital signs (heart rate and blood oxygen level), pain level, and fear level were measured. The child watched their chosen cartoon during the procedure. Vital signs and pain level were measured again during the procedure. One minute after the procedure was completed, the child's vital signs, pain level, and fear level were measured again.	Other: Cartoon viewing app; Before starting the study, a compilation of children's favorite cartoons specific to their age group was prepared. Based on randomization, children in this group were asked before the procedure which cartoon they would like to watch. During the procedure, a tablet was placed in a position where the child could easily see it. The cartoon started being shown one minute before the procedure. Uninterrupted viewing was ensured throughout the procedure.
Experimental: Experimantal Group: Music Group; In this group of 20 children, music was played during the tooth extraction procedure. Before the procedure began, the child's vital signs (heart rate and blood oxygen level), pain level, and fear level were measured. The music chosen by the child was played during the procedure. Vital signs and pain level were measured again during the procedure, and again 1 minute after the procedure was completed.	Other: Music intervention; Before starting the study, a list of children's favorite music specific to their age group was compiled. Children in this group were randomly assigned to listen to which music from this list before the procedure. Wireless headphones were placed on the child before the procedure. Music began playing one minute prior to the procedure. The child was allowed to listen to music continuously throughout the procedure.
Other: Control Group; The control group consisted of 20 children who underwent the routine procedure. One minute before the procedure, the child's vital signs (heart rate and blood oxygen level), pain level, and fear level were measured. Vital signs and pain level were measured again during the procedure. One minute after the procedure was completed, the child's vital signs, pain level, and fear level were measured again.	Other: control group; No interventions were performed on the children in this group outside of routine practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Child Identification Information Form	This form was created by researchers based on the literature to determine the identifying characteristics (age, gender, type and duration of treatment, etc.) of a child undergoing dental treatment.	Five minutes before the procedure
Physiological Parameter Follow-up Form (Heart rate-min)	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	Tooth extraction 1 minute ago
Physiological Parameter Follow-up Form (oxygen saturation -SpO2%)	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	Tooth extraction 1 minute ago
Wong Baker Facial Pain Rating Scale	The Wong Baker Facial Rating Scale is one of the scales used to assess pain. This scale consists of six facial expressions, rated from 0 to 10 according to the severity of the pain.	Tooth extraction 1 minute ago
Child Fear Assessment Scale-Dental Subscale (CFSS-DS)	The CFSS-DS scale consists of 15 questions covering different aspects of dental treatment. It can be used with children aged 4-14 years. It is used to determine children's fear of tooth extraction.	Tooth extraction 1 minute ago

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physiological Parameter Follow-up Form (Heart rate-min	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	5th minute of the process
Physiological Parameter Follow-up Form (oxygen saturation -SpO2%)	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	5th minute of the process
Wong Baker Facial Pain Rating Scale	The Wong Baker Facial Rating Scale is one of the scales used to assess pain. This scale consists of six facial expressions, rated from 0 to 10 according to the severity of the pain.	5th minute of the process
Physiological Parameter Follow-up Form (Heart rate-min)	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	1 minute after the procedure
Physiological Parameter Follow-up Form (oxygen saturation -SpO2%)	This is a form developed by researchers to assess the pulse and oxygen saturation of a child undergoing treatment.	1 minute after the procedure
Wong Baker Facial Pain Rating Scale	The Wong Baker Facial Rating Scale is one of the scales used to assess pain. This scale consists of six facial expressions, rated from 0 to 10 according to the severity of the pain.	1 minute after the procedure
Child Fear Assessment Scale-Dental Subscale (CFSS-DS)	The CFSS-DS scale consists of 15 questions covering different aspects of dental treatment. It can be used with children aged 4-14 years. It is used to determine a child's fear of tooth extraction.	1 minute after the procedure

Collaborators and Investigators

• Sponsor: Selcuk University
• Investigators: Study Director: Sibel Kucukoglu, Selcuk University

Publications and helpful links

General Publications

• Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012 Dec;27(6):652-81. doi: 10.1016/j.pedn.2011.08.001. Epub 2011 Oct 13.

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2025
• Primary Completion (Actual): December 15, 2025
• Study Completion (Actual): December 15, 2025

Study Registration Dates

• First Submitted: January 2, 2026
• First Submitted That Met QC Criteria: January 2, 2026
• First Posted (Actual): January 13, 2026

Study Record Updates

• Last Update Posted (Actual): January 13, 2026
• Last Update Submitted That Met QC Criteria: January 2, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: anxiety; pain management; distraction; dental extraction; nursing care
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Mental Disorders; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Anxiety Disorders; Agnosia; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Research Design; Methods; Control Groups
• Other Study ID Numbers: 02-SU.01-2026SA/2025

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