title: Effectiveness of behavioral modification techniques with visual distraction using intrasulcular local anesthesia in hearing disabled children during pulp therapy.
abstract: OBJECTIVE
  Assessing the effectiveness of behavioral modification techniques in combination with visual distraction with/without video eyewear using computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in hearing-impaired pediatric patients undergoing pulp therapy of primary molars.
  
  
  METHODS
  This randomized, crossover clinical study includes 15 children (7 boys and 8 girls), mean age was 6.1 years. Children were randomly distributed into two groups (Group A,n= 7; Group B,n= 8). The study involved three sessions, 1-week apart. During Session I, employing Tell-Show-Do technique, prophylactic dental cleaning was done while participants were watching a movie with sign-language interpretation with/without visual eyewear. At the end of Session I, score on Smiley Faces Program was used for anxiety assessment. During Session II and III, respectively, both groups underwent pulp treatment of equivalent teeth in the opposite sides of the mouth with/without video eyewear vice versa. After the procedure, children were instructed to rate their pain during treatment on the Wong-Bakers' (WBs') Faces Pain Scale. Changes in pulse oximeter and heart rate were recorded every 5 min. Paired samplet-test and independent samplet-test were used to assess the significance of changes during each visit.
  
  
  RESULTS
  There was a significant (P> 0.04) change in the heart rate observed for Group A underwent pulp treatment while watching video using video eyewear. Self-reported mean pain score also increases during treatment sessions' with video eyewear, for both groups.
  
  
  CONCLUSIONS
  Routine psychological (Tell-Show-Do) intervention along with visual distraction with full visibility of the surrounding and use of CDS-IS system for anesthetic delivery is recommended as an effective behavior management technique for children with hearing impairment undergoing invasive dental treatment.
authors.affiliation: Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
authors.forename: Kausar Sadia
authors.initials: KS
authors.lastname: Fakhruddin
authors.affiliation: Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.|Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkiye.
authors.forename: Mehmet Omer
authors.initials: MO
authors.lastname: Gorduysus
authors.affiliation: Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
authors.forename: Hisham
authors.initials: H
authors.lastname: El Batawi
keywords: Computerized delivery system-intrasulcular; hearing disability; pulp therapy; visual distraction eyewear