Weighted Stuffed Animals and Dental Anxiety in Pediatric Patients: A Randomized Controlled Trial

Background: Dental anxiety is a common barrier to effective care in pediatric patients. Deep touch pressure (DTP) interventions, such as weighted sensory tools, have demonstrated calming effects in various clinical settings, but their role in pediatric dentistry remains underexplored. Methods: This randomized controlled trial evaluated the effect of a weighted stuffed animal on anxiety and behavior in children aged 4 to 14 years receiving restorative dental treatment under nitrous oxide sedation. Seventy-seven participants were randomly assigned to an intervention group (received a 5-lb weighted stuffed animal) or a control group (no item provided). Behavioral outcomes were assessed using the Frankl Behavior Rating Scale, and post-treatment anxiety was measured using the Venham Picture Test (VPT). Statistical analyses were performed using the Mann-Whitney U test. Results: Children in the intervention group demonstrated significantly higher Frankl behavior scores (median = 4) than those in the control group (median = 3; P < 0.001), indicating greater cooperation. Self-reported anxiety was also significantly lower in the intervention group as measured by VPT scores (P = 0.02). No adverse events were reported. Conclusions: Use of a weighted stuffed animal during dental treatment was associated with improved behavioral cooperation and reduced anxiety in pediatric patients under nitrous oxide. This sensory-based intervention was well tolerated and easily integrated into routine care. Practical Implications: Weighted stuffed animals offer a non-invasive, low-cost adjunct to conventional behavior guidance techniques in pediatric dentistry. Incorporating DTP tools may enhance the patient experience and facilitate more successful clinical outcomes, particularly in anxious children.