An evaluation of the PALS after treatment modelling intervention to reduce dental anxiety in child dental patients

Int J Paediatr Dent. 2009 Jul;19(4):233-42. doi: 10.1111/j.1365-263X.2009.00977.x. Epub 2009 Mar 30.


Aim: The aim of this study was to assess the effectiveness of the passivity to activity through live symbolic (PALS) after treatment modelling intervention to reduce child dental anxiety.

Methods: A convenience sample of consecutive 5- to 10-year-old dental patients were randomly assigned to intervention or control groups. Self-reported child dental anxiety was assessed at the start of each visit. At the end of each visit, children in the intervention group were introduced to a glove puppet, which acted as the PALS model. The intervention group children re-enacted the treatment they had just received on the puppet's teeth. At the end of each visit, the control children received motivational rewards only. The change in dental anxiety scores was examined by t-tests and analysis of covariance.

Results: The final analysis included 27 intervention children and 26 control children. For the intervention group, there were no statistically significant changes in dental anxiety over a course of treatment, between first and second preventive visits, between first and second invasive treatment visits, or between first attendance and subsequent recall attendance. For the control group, a statistically significant decrease in dental anxiety was observed between the first and second invasive dental treatment visits.

Conclusion: The PALS after treatment modelling intervention was ineffective in reducing child dental anxiety.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological*
  • Behavior Therapy / methods*
  • Child
  • Child, Preschool
  • Dental Anxiety / prevention & control*
  • Dental Care for Children / methods*
  • Dental Care for Children / psychology
  • Female
  • Humans
  • Imitative Behavior*
  • Male
  • Play and Playthings
  • Preventive Dentistry / methods
  • Psychology, Child
  • Treatment Outcome