Effect of Regular Piano Playing on Dental Anxiety and Stress

Evaluation of the Effects of Regular Piano Training on Dental Anxiety and Stress Levels in Children During Preventive Dental Treatment

This study aims to evaluate dental anxiety and stress levels in children receiving regular piano training compared with children without piano training during preventive dental treatment. A total of 80 children aged 7-11 years, including 40 children receiving piano education and 40 controls, were included in the study. All participants underwent fissure sealant application using the Tell-Show-Do behavioral guidance technique. Dental anxiety was assessed before and after treatment using the Modified Child Dental Anxiety Scale-Faces Version (MCDASf), Facial Image Scale (FIS), and physiological parameters including pulse rate, blood pressure, oxygen saturation, and body temperature. Stress levels were evaluated using the PeSSKi scale. The study investigates whether regular piano education contributes to reduced dental anxiety and stress responses in pediatric dental patients.

Study Overview

• Status: Completed
• Conditions: Dental Anxiety in Children
• Intervention / Treatment: Behavioral: Regular Piano Training; Other: No Piano Training

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Rize Province
    • Merkez, Rize Province, Turkey (Türkiye), 53020
      • Recep Tayyip Erdogan University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Children aged between 7 and 11 years
• Patients attending the Department of Pediatric Dentistry, Faculty of Dentistry,
• Recep Tayyip Erdoğan University, and participants invited from two different art schools
• Voluntary participation in the study
• Presence of fissure sealant indication in the mandibular permanent first molars
• Systemically healthy children (ASA I) with no known history of allergy
• No hearing impairment
• Cognitive ability sufficient to understand and answer questionnaire items
• Cooperative behavior classified as "Positive" or "Definitely Positive" according to the Frankl Behavior Rating Scale

Exclusion Criteria:

• Presence of any systemic disease or history of allergy
• Children classified as "Negative" or "Definitely Negative" according to the Frankl Behavior Rating Scale
• Active psychological and/or psychiatric treatment
• Physical or mental disability preventing communication or questionnaire completion

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Regular Piano Training Group; Children aged 7-11 years who received regular piano training and underwent fissure sealant application.	Behavioral: Regular Piano Training; Regular piano education received by children prior to preventive dental treatment. Children in this group had ongoing piano training and were evaluated for dental anxiety, stress levels, and physiological responses during fissure sealant application using the Tell-Show-Do technique.
Other: Control Group; Children aged 7-11 years without regular piano training who underwent fissure sealant application.	Other: No Piano Training; Children without regular piano training who underwent preventive dental treatment and fissure sealant application using the Tell-Show-Do technique. Dental anxiety, stress levels, and physiological parameters were evaluated before and after treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dental Anxiety Level Measured by the Modified Child Dental Anxiety Scale-Faces Version	Dental anxiety levels during preventive dental treatment will be assessed using the Modified Child Dental Anxiety Scale-Faces Version (MCDASf). The MCDASf score ranges from 8 to 40 points, with higher scores indicating greater dental anxiety.	Before and immediately after fissure sealant application
Dental Anxiety Level Measured by the Facial Image Scale	Dental anxiety levels during preventive dental treatment will be assessed using the Facial Image Scale (FIS). The FIS score ranges from 1 to 5 points, with higher scores indicating greater dental anxiety.	Before and immediately after fissure sealant application

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stress Level Measured by the Pediatric Emotional Stress Scale in Kindergarten Intervention (PeSSKI)	Stress levels will be assessed using the Pediatric Emotional Stress Scale in Kindergarten Intervention (PeSSKI) during preventive dental treatment. The PeSSKi total score ranges from 10 to 50 points, with higher scores indicating higher perceived stress levels in children.	Before and immediately after fissure sealant application
Pulse Rate During Preventive Dental Treatment	Pulse rate will be measured in beats per minute (bpm) before and immediately after fissure sealant application during preventive dental treatment. Higher values indicate increased physiological arousal/anxiety.	Before and immediately after fissure sealant application
Systolic Blood Pressure	Systolic blood pressure will be measured in millimeters of mercury (mmHg) before and immediately after fissure sealant application during preventive dental treatment. Higher values indicate increased physiological stress response.	Before and immediately after fissure sealant application.
Diastolic Blood Pressure	Diastolic blood pressure will be measured in millimeters of mercury (mmHg) before and immediately after fissure sealant application during preventive dental treatment. Higher values indicate increased physiological stress response.	Before and immediately after fissure sealant application
Oxygen Saturation	Peripheral oxygen saturation (SpO₂) will be measured as percentage (%) before and immediately after fissure sealant application during preventive dental treatment. Higher values indicate better oxygenation status.	Before and immediately after fissure sealant application
Body Temperature	Body temperature will be measured in degrees Celsius (°C) before and immediately after fissure sealant application during preventive dental treatment.	Before and immediately after fissure sealant application

Collaborators and Investigators

• Sponsor: Recep Tayyip Erdogan University Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2025
• Primary Completion (Actual): March 25, 2026
• Study Completion (Actual): April 1, 2026

Study Registration Dates

• First Submitted: May 10, 2026
• First Submitted That Met QC Criteria: May 15, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 15, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2025/348

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