Effectiveness of audiovisual distraction eyewear and computerized delivery of anesthesia during pulp therapy of primary molars in phobic child patients

Abstract

Objectives:The aim of this study is to assess the effectiveness of audiovisual distraction technique with video eyewear and computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in phobic pediatric patients undergoing pulp therapy of primary molars.Materials and Methods:This randomized, crossover clinical study includes 60 children, aged between 4 and 7-year-old (31 boys and 29 girls). Children were randomly distributed equally into two groups as A and B. This study involved two treatment sessions of pulp therapy, 1-week apart. During treatment session I, group A had an audiovisual distraction with video eyewear, whereas group B had audiovisual distraction using projector display only without video eyewear. During treatment session II, group A had undergone pulp therapy without video eyewear distraction, whereas group B had the pulp treatment using video eyewear distraction. Each session involved the pulp therapy of equivalent teeth in the opposite sides of the mouth. At each visit scores on the Modified Child Dental Anxiety Scale (MCDAS) (f) were used to evaluate the level of anxiety before treatment. After the procedure, children were instructed to rate their pain during treatment on the Wong Bakers’ faces pain scale. Changes in pulse oximeter and heart rate were recorded in every 10 min.Results:From preoperative treatment session I (with video eyewear) to preoperative treatment session II (without video eyewear) for the MCDAS (f), a significant (P > 0.03) change in the mean anxiety score was observed for group A. Self-reported mean pain score decreases dramatically after treatment sessions’ with video eyewear for both groups.Conclusion:The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.

Effectiveness of behavioral modification techniques with visual distraction using intrasulcular local anesthesia in hearing disabled children during pulp therapy

“…In contrast to our finding from the previous study[17] which demonstrated that the use of video eyewear may provide better distraction than watching video on a screen where occlusive eyewear projects, the images right in front of the eyes of the user, blocking out real world's visual and auditory stimuli; the present study demonstrated a significant increase in the heart rate for group who underwent pulp treatment while watching video using video eyewear. Furthermore, self-reported mean pain score increases during treatment sessions' with video eyewear for both groups.…”

“…[17] An effective pain control is important to achieve comfort, cooperation, and compliance in children during dental treatment. [18] In our study, we used CDS (Wand, Milestone Scientific, Inc., Deerfield, IL, USA) enabling slow-paced delivery of local anesthetic in small volume under a controlled low pressure of 165 pound/square inch.…”

Management of Dental Anxiety: Is There Scope Beyond Conscious Sedation?

“…In line with the present study Morris et al concluded that by diverting the attention from an unpleasant medical setting to a pleasant and absorbing virtual world, virtual reality can markedly diminish patient's subjective pain experience. [28] In the recent studies conducted by Asvanund et al, [29] Khotana et-al, [8] Fakhurdin et-al and Hoge et al, [1,6] the results are corresponding to the current study where a significant reduction in anxiety and positive behaviour was instilled via the videoeyeglass in pediatric dental patients. Moreover in the present study, sedated children with N2O/O2 showed reduction in anxiety as depicted by pulse rate and Venham's anxiety scores.…”

“…Numerous pharmacological and nonpharmacological techniques have been proposed for achieving non-disruptive behavior during the dental treatment. [6] Among the nonpharmacological methods distraction and among the pharmacological techniques conscious sedation with N2O/O2 seem very promising in managing anxious children during the dental treatment, but there is dearth in literature about the comparison between the two techniques. [7] Based on the theory of Mc-Caul and Mallot, a patient's pain perception is decreased when he is distracted from an unpleasant stimulus.…”

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder

“…Similar to our findings from a previous study which demonstrated that the use of video eyewear might provide better distraction than watching video projected on a conventional screen. [11] In this study, AV distraction also served as an effective behavior modification tool, resulting in a statistically significant decrease in anxiety and apprehension during dental procedures manifested by a significant decrease in pulse rates.…”