Efficacy of structured art therapy interventions in reducing dental anxiety in children: Evidence from a controlled clinical study

Abstract

Background: Dental anxiety is one of the most frequently encountered behavioral challenges in pediatric dentistry. Art therapy has been proposed as a means of alleviating pediatric anxiety. Aim: To evaluate the effectiveness of structured art therapy in reducing dental anxiety among children aged 6-12 years attending a pediatric dental clinic. Materials and Methods: A randomized controlled clinical trial was conducted on 150 children (87 females, 63 males) aged 6-12 years. Participants were randomly assigned into two groups: Study Group (n=75) received structured art therapy (drawing, coloring, collage) for 15 minutes before each dental visit, while Control Group (n=75) underwent routine tell-show-do behavior management. Anxiety levels were assessed using the Frankl Behavior Rating Scale (FBRS), Five-Facial Anxiety Scale (FFAS), and Child Drawing: Hospital (CD:H) scale at baseline and after three visits. Data were analyzed using paired t-test, chi-square test, and Pearson correlation, with p<0.05 considered significant. Results: At baseline, 58.6% of participants demonstrated high or very high anxiety. Post-intervention, the study group exhibited significant reduction: 68% had little or no anxiety compared to 14.6% in controls (P<0.001). Strong correlations were observed between CD:H and FFAS (r=0.29, P<0.01) and between CD:H and Frankl scores (r=-0.32, P<0.01). Conclusion: Art therapy is a simple, cost-effective adjunct that significantly reduces dental anxiety and improves cooperation in children.