Scenario-based experiential behavior techniques -- a type of learning that immerses people in real, problem-solving situations -- may reduce dental fear in preschoolers more effectively than traditional methods, according to a study published in BMC Oral Health.
Furthermore, one-on-one interactive games that include both children and their parents, along with clear explanations of dental procedures, may help improve children’s cooperation during dental visits, the authors wrote.
“The findings of this study indicated that compared to traditional behavioral management techniques, scenario-experiential behavior management techniques showed significant advantages in alleviating dental fear in preschool children and improving their compliance during visits,” wrote the authors, led by Yan Wang of Sichuan University in China (BMC Oral Health, December 7, 2025).
A total of 93 children ages 3 to 6 with mild to moderate caries were recruited between July 2021 and June 2022 and randomly assigned to either a control or intervention group. All children attended two treatment visits, starting with fluoride varnish or sealant placement and followed by a composite resin restoration. Children in the intervention group received scenario-experiential behavior management techniques before their first visit, while the control group received conventional methods like positive reinforcement and small rewards, they wrote.
The intervention centered on an immersive role-play experience that simulated real diagnostic procedures using child-safe instruments and visual teaching tools. Researchers introduced tools with models, videos, and illustrations to help children understand procedures and reduce fear through hands-on participation. Outcomes were measured by Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) scores, Frankl Rating Scale (FRS) scores, and parental satisfaction to evaluate differences between the two groups.
The intervention group showed significantly lower CFSS-DS scores than the control group (t = 2.287, 95% confidence interval [CI] = 0.545 to 7.742). In the intervention group, 34 children (73.91%) reached FRS Level 3, and eight participants (17.39%) reached Level 4 compared with 25 children (53.19%) at Level 3 and six children (12.77%) at Level 4 in the control group, they wrote.
Additionally, children in the intervention group demonstrated better treatment cooperation (p = 0.015, z = -2.444, 95% CI = 0.009 to 0.012). By the end of the study, 36 parents (78.3%) in the intervention group reported being very satisfied versus 31 parents (66%) in the control group. Parental satisfaction was significantly higher in the intervention group (p = 0.027, χ² = 9.151, 95% CI = 0.018-0.024).
The study, however, was limited by its short-term assessment. Future research should include larger randomized controlled trials with a longer follow-up to produce stronger clinical evidence, the authors noted.
“Through one-on-one interactive games, both children and their parents receive clear explanations of dental procedures, which helps improve their overall satisfaction,” Wang and colleagues wrote.
