Does Virtual Reality Affect Children’s Dental Anxiety, Pain, And Behaviour? A Randomised, Placebo-Controlled, Cross-Over Trial

Abstract

Objective: To evaluate the effect of virtual reality (VR) on dental anxiety, pain, and behaviour at different time points among children undergoing dental treatment under local anaesthesia. Material and Methods: This randomised, two-armed, within-subject, cross-over, placebo-controlled trial included 76 children. Eligible participants were treated in two dental visits using the following methods: with protective glasses only, without distraction (attention placebo-controlled -APC); and with the treatment condition (i.e., VR). Primary outcomes were dental anxiety and pain; secondary outcome was dental visit behaviour. Heart rate scores were recorded as an objective measure to evaluate dental anxiety and pain. Subjective measurements for each variable were also performed. Results: Significant reduction in dental pain and anxiety was observed in the VR group, according to the heart rate scores; however, no statistical differences were observed according to the self-reported measures. Decreased dental anxiety and pain were associated with the first visit sequence with VR. Dental pain and anxiety scores were lower during local anaesthesia in the VR group than in the APC group. Conclusion: Virtual reality significantly reduced pain and anxiety during local anaesthesia in children undergoing dental treatment; therefore, it may be recommended during dental treatment in school-age children.

The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics: A Systematic Review and Meta-Analysis

“…Two unpublished studies were acquired by contacting authors identified in the trial registries (Gerceker et al, 2021;Osmanlliu et al, 2021). Another two published manuscripts were received from contacted authors after the final database search was conducted (Buldur and Candan, 2020;Litwin et al, 2020). The process of study selection is illustrated in Figure 1.…”

“…The SOC conditions were also diverse, with some involving no intervention at all and others a combination of several interventions. Three dental studies used sunglasses or protective eyeglasses, either as part of standard care (Hoge et al, 2012), as a behavior management technique (Bagattoni et al, 2018) or as a form of placebo (Buldur and Candan, 2020).…”

Use of Virtual Reality (VR) as an Audio-Visual Distraction Tool in the Reduction of Dental Anxiety during Local Anesthesia

“…This might inturn have a positive effect on the patient's attendance in a dental clinic and reduce the number of missed appointments. A study conducted by Buldur and Candan involving children receiving Local Anaesthesia during dental treatment concluded that virtual reality was effective in significantly reducing the pain and anxiety among children [18]. Birang E et al conducted a study on patients requiring scaling and root planing using VR technology during treatment.…”

“…Several studies have reported the use of VR to have a desirable effect on pain, anxiety and behaviour during procedures such as treatment of burns, traumatic injuries, dental procedures and injections [15][16][17][18][19]. The mechanism of using the VR system is based on the assumption that pain perception has a large psychological component, and that focusing one's attention on pain would amplify these sensations to the point of feeling extra painful [16].…”

Effect of virtual reality experience on distress in children admitted to the intensive care unit: a randomized controlled trial

“…Virtual Reality (VR) has been utilized in medicine for more than two decades and has been linked to improvements in functions of motor, cognition and psychological systems 3 . VR has been used as an effective treatment as an analgesic for children with burns during physiotherapy 10 , for procedural pain management 11 , to reduce anxiety in cancer patients 12 and during dental procedures 13 . In a study by Ong TL, et al the VR intervention was shown to improve patients' ICU experience by decreasing the levels of anxiety and depression 14 .…”