The effect of dramatic play therapy and music therapy on dental anxiety in children undergoing tooth extraction

The Effect of Dramatic Play Therapy and Music Therapy on Dental Anxiety in Children Undergoing Tooth Extraction Aim: The aim of this study was to evaluate the effects of play therapy and music therapy on dental anxiety and pain levels in pediatric patients undergoing tooth extraction. Material and Method: This randomized controlled study included 126 patients aged 6–8 years who presented to the Department of Pediatric Dentistry at the Faculty of Dentistry, Recep Tayyip Erdoğan University, and had an indication for extraction of a maxillary molar tooth. Participants were randomly assigned into three equal groups (n=42): control group (Tell-Show-Do), music therapy group, and play therapy group. Vital signs, Modified Child Dental Anxiety Scale – faces version (MCDASf), and Facial Image Scale (FIS) scores were recorded before and after tooth extraction; Wong-Baker Faces Pain Rating Scale (WBS) scores were recorded after the procedure. Statistical analyses were performed using Pearson Chi-square Test, One-Way ANOVA, Kruskal-Wallis Test, Paired Sample t-Test, and Wilcoxon Signed-Rank Test. A significance level of p<0.05 was considered. Results: A significant difference was observed between pre- and post-treatment MCDASf and FIS scores in all groups (p<0.001; p<0.001). Compared to the control group, both the music therapy and play therapy groups showed a significant reduction in dental anxiety levels. Furthermore, dental anxiety scores were lower in the play therapy group than in the music therapy group. No statistically significant differences were found among groups in terms of physiological parameters. However, all three groups exhibited increases in systolic and diastolic blood pressure and pulse rate following the procedure. A significant difference was also observed in WBS scores among the groups (p<0.001), with the lowest pain scores recorded in the play therapy group. Conclusion: Within the limitations of this study, innovative behavior management techniques such as play therapy and music therapy were found to be effective in reducing dental anxiety and perceived pain in pediatric patients. The adoption of child-centered approaches may improve treatment compliance and contribute to a more comfortable and effective clinical process. Keywords: Anxiety, Behavior Management, Music Therapy, Play Therapy, Tell-Show-Do