Comparison of the effect of video glasses and nitrous oxide analgesia on the perceived intensity of pain and unpleasantness evoked by dental scaling

Abstract

The aim of this study was to evaluate whether distraction induced by video glasses had an effect on the perceived intensity of pain and unpleasantness during dental scaling compared with the effect of nitrous oxide (N(2)O) analgesia. The pain stimulus was dental scaling (removal of dental calculus) with an ultrasonic scaler. As a standardised, non-dental painful stimulus, Von Frey filaments were used. A total of 26 patients with superficial chronic periodontitis were enrolled in this randomised, controlled clinical study. The effect of video glasses was compared with N(2)O in one session and the effect of video glasses versus a control situation in another. The patients rated the intensity of pain and unpleasantness evoked by dental scaling and Von Frey filament stimulation on 100-mm visual analogue scales (VAS). For dental scaling, there was no effect of video glasses on the perceived pain (p=0.85) or unpleasantness (p=0.73) nor of N(2)O (p=0.69 and p=0.51, respectively) compared with the control situation. Similarly, no significant difference was found between VAS scores in the video glasses and N(2)O session (p=0.48, p=0.58). A significant effect of video glasses and N(2)O(p<0.008) was found on the perceived pain intensity produced by Von Frey filament stimulation compared with the control situation, but no significant difference was seen between these methods (p=0.07). Post-treatment interviews of the patients revealed that 81% of the patients in the video and 65% in the N(2)O session stated that the method had some beneficial effect on their overall experience of the treatment situation. In conclusion, administration of video glasses or N(2)O did not affect the perceived intensity of pain and unpleasantness evoked by dental scaling.

The use of virtual reality and audiovisual eyeglass systems as adjunct analgesic techniques: A review of the literature

“…VR was performed with burn patients (n = 5) (21-25); dental patients (n = 1) (26); cancer patients undergoing subcutaneous venous port access (n = 2) (27,28); a patient with cerebral palsy participating in a physiotherapy program following single-event, multilevel surgery (n = 1) (29); and healthy volunteers in a laboratory setting where pain was induced by a tourniquet (n = 1) (30). A/V distraction has been studied in patients undergoing gastric laboratory procedures (n = 2) (31,32), leg ulcer patients (n = 1) (33), cancer patients undergoing lumbar punctures (n = 1) (34), and dental patients (n = 3) (35)(36)(37). In addition, there are three reports of testing A/V distraction in the laboratory using a cold pressure test or a tourniquet (38)(39)(40).…”

“…A/V distraction has been studied in patients undergoing gastric laboratory procedures (n = 2) (31,32), leg ulcer patients (n = 1) (33), cancer patients undergoing lumbar punctures (n = 1) (34), and dental patients (n = 3) (35)(36)(37). In addition, there are three reports of testing A/V distraction in the laboratory using a cold pressure test or a tourniquet (38)(39)(40). It is remarkable that all but one (25) research report are published either in specific pain journals or in journals focused on the broader application of computer technology.…”

Management of fear and anxiety in the dental clinic: a review

“…While immersive virtual reality goggles have been found to reduce blood pressure, pulse rate and pain ratings in patients undergoing periodontal scaling and root planing procedures, 80,81 another series of studies by Benson and colleagues found that video glasses did not alter perceived pain intensity of either restorative dental treatment 82 or dental scaling. 83 More research is required to explore whether the effectiveness of this type of distraction is perhaps dependent on patientrelated factors, such as personality attributes related to desire for predictability or control. There is evidence, however, that audiovisual distraction might be beneficial for children who are anxious or uncooperative in the clinic.…”

Sex differences in endogenous pain modulation by distracting and painful conditioning stimulation

“…Both distraction and stress can independently reduce pain (Fernandez and Turk 1989;Fields and Basbaum 1999) and are likely to contribute to pain-evoked hypoalgesia, as painful stimuli are not only painful but also distracting and stressful. Sex differences in both distraction- (Weisenberg et al 1995;Bentsen et al 1999;Unrod et al 2004) and stress-evoked hypoalgesia (Koltyn et al 2001;Rhudy and Meagher 2001;Sternberg et al 2001;Girdler et al 2005) have been reported. Thus, pain-evoked hypoalgesia may represent the combined effects of multiple sex-sensitive factors.…”