Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children

Abstract

Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

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

“…A second detection led to the removal of 14 studies, which left a total of 14 full-text studies for the final selection [2,6,7,9,[19][20][21][22][23][24][25][26][27][28] ( Figure 2). Pain levels were assessed in four studies, two in children [20,28] and two in adults [2,21]; anxiety levels in three, two in adults [9,19] and one in children [26]; and anxiety and pain together in seven studies, five in children [22][23][24][25]27] and two in adults [6,7]. Table 2 provides a general description of the details of each study.…”

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

“…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 ].…”

“…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 ].…”

Effect of warming local anesthesia solutions before intraoral administration in dentistry: a systematic review

“…Psychological methods include distraction [22][23][24][25][26][27][28], technical changes, such as changing the needle diameter [29,30], and warming and buffering the local anesthesia solution. These methods reduce the discomfort associated with intraoral local anesthesia administration [31][32][33].…”