Which behavioral management technique is most evidence-based and recommended for children with ADHD undergoing dental procedures?

Children with ADHD require a structured, predictable dental environment. Tell-Show-Do (TSD) is the gold-standard behavioral management approach for pediatric dental patients and is specifically recommended for ADHD. TSD works by: TELL — explaining what will happen using simple, age-appropriate language; SHOW — demonstrating the procedure on a model; DO — completing the procedure as described. Additional strategies: schedule morning appointments when ADHD medication is most effective, keep appointments short, give one-step instructions, use positive reinforcement (praise, stickers), and consider nitrous oxide if needed. Video/audio distraction (video eyewear) has shown strong supporting evidence as an adjunct for ADHD patients. TSD reduces anticipatory anxiety and helps the child establish predictability and trust with the dental team.