Effect of Virtual Reality Distraction on Pain and Anxiety During Dental Treatment in 5 to 8 Year Old Children

Fernández

et al. 2020

JCM

Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations. Results: 31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies (n = 4), anxiety levels in three (n = 3) and anxiety and pain together in seven (n = 7). Our meta-analysis was based on ten studies (n = 10). The effect of VR was studied mainly in the pediatric population (for pain SMD = −0.82). In the adult population, only two studies (not significant) were considered. Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…All the studies complied with random sequence. Two of the studies included [25,28] did not comply with allocation concealment and only 35% complied with blinding of participants and personnel. It should be noted that none of the studies included complied with blinding of outcome assessment.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

RETRACTED: Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

Fernández

et al. 2020

JCM

“…A second screening, led to the removal of 14 studies, which left a total of 15 studies, and then we removed seven more: two for treating dental phobia through virtual reality exposure therapy (VRET) instead of distraction [ 8 , 9 ], one for being a protocol [ 20 ], one for not measuring DA/Pain as output, although DA is used as a predictor [ 11 ], two for being half-mouth [ 21 , 22 ], and one for lack of enough data for meta-analysis [ 23 ]. This yielded a final sample of eight studies for the analysis ( Figure 1 , Flowchart): seven in children [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ] and one in adults [ 31 ]. It should be noted that six studies in children refer to both anxiety and pain [ 24 , 25 , 26 , 27 , 29 , 30 ], one in children only to anxiety [ 28 ], and the study in adults only to pain [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…This yielded a final sample of eight studies for the analysis ( Figure 1 , Flowchart): seven in children [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ] and one in adults [ 31 ]. It should be noted that six studies in children refer to both anxiety and pain [ 24 , 25 , 26 , 27 , 29 , 30 ], one in children only to anxiety [ 28 ], and the study in adults only to pain [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

Muriel-Fernández

et al. 2020

JCM

(1) Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. (2) Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used and in standard care situations. (3) Results: 32 studies were identified, of which 8 met the inclusion criteria. The effect of VR in children was significant, both for anxiety (standardized mean difference (SMD) = −1.75) and pain (SMD = −1.46). (4) Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

International Journal of Clinical Pediatric Dentistry

“…The validity and reliability of the scales (WBFPS and FLACC) used in the present study was previously evaluated by many studies. [8][9][10] The result of the present study was in accordance to Shetty et al, 11 Chaturvedi et al, 12 Asl Aminabadi et al, 8 Wiederhold et al 13 and Sullivan et al, 14 where both the pain perception and anxiety were reduced. As both the pain perception and anxiety increase if the child focusses on the procedure or sight of instruments in dentistry; the child was taken into a different environment by applying VRD which is devoid of the operator's field and its sounds.…”

Section: Discussionsupporting

confidence: 89%

Assessment of Efficacy of Virtual Reality Distraction in Reducing Pain Perception and Anxiety in Children Aged 6–10 Years: A Behavioral Interventional Study

Rao

Havale

Nagaraj

et al. 2019

Aim:The aim of the present study was to assess the effectiveness of virtual reality distraction on pain perception and state anxiety levels undergoing restorative treatment in children. Materials and methods:This was an interventional study with 30 children of age 6-10 years came to the Department of Pedodontics and Preventive Dentistry. The intervention was distraction with virtual reality eyeglasses and the parameters considered includes pain perception analyzed subjectively by Wong Baker FACES pain rating scale and objectively by FLACC scale; anxiety was analyzed physiologically by measuring pulse rate and oxygen saturation levels using pulse oximeter. The parameters were recorded before the treatment, i.e., baseline, during and as well as after the restorative treatment procedure. The values noted were tabulated and subjected to appropriate statistical analysis with p value set at 0.05. Results:The study displayed a very high statistical significance in reduction of pain perception and anxiety levels in all the comparisons made at three time periods, i.e., baseline, during and after treatment procedure (p < 0.0001). Conclusion: Virtual reality distraction can be considered as a budding distraction tool in the arena of behavior management that helps adapt the child to dental environment and able to deliver qualitative dental care. Clinical significance: Managing an anxious child is one of the challenging tasks for a pediatric dentist in the day-to-day life. As the world progresses with newer interventions, virtual reality distraction is one among them that has the ability to reduce pain perception and anxiety in children with a positive approach.