Effectiveness of a Tactile Graphic Book with Braille and Audio in Reducing Dental Anxiety during Sealant Application among Visually Impaired Students (8–17 Years): A Matched Pair Cluster-Randomized Study

Abstract

Aim: To evaluate the effectiveness of a tactile graphic book with braille and audio (TBA) in reducing dental anxiety among visually impaired students. Materials and Methods: A total of 72 visually impaired students (8–17 years old) were assigned to intervention (preparation with tactile graphic book) or control (no preparation) groups using matched pair cluster randomization. Dental sealants were provided using the Tell-Feel-Do technique. Knowledge was assessed using the Dental Preoperative Information Test (DIT). Anxiety was measured using the Modified Dental Anxiety Scale (MDAS), heart rate (HR), and Venham’s Anxiety Rating Scale (VARS). Statistical analyses employed were Chi-square, t test, Fisher–Freeman–Halton exact test, Mann–Whitney U test, repeated measure analysis of variance, and Friedman test. Results: The intervention group showed significantly lower anxiety levels, with reduced MDAS scores at predental treatment (P = 0.039) and postdental treatment (P = 0.003). The control group experienced a significant HR increase from predental treatment to sitting on the dental unit (P = 0.009), whereas the intervention group did not show this significant change. VARS scores were not significantly different between groups (P = 0.926). The intervention group also demonstrated significantly higher DIT scores (P < 0.001). Conclusion: A TBA effectively reduced dental anxiety among visually impaired students, offering a promising approach for enhancing dental experiences in this population.