Effects of audiovisual distraction on children’s behaviour during dental treatment: a randomized controlled clinical trial

Abstract

Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre™) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment. Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham’s clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken. Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p = 0.029), and the scores decreased significantly during treatment in the AV-group (p = 0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p = 0.02), but not in the AV-group. Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment.

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.…”

“…Younger children exhibit a higher level of fear and anxiety than the older children, and the distraction technique is helpful in those children who have low level of dental fear. [8] For this reason age group of 6-12 years was selected. All children were chosen with no past dental history as negative experience of the previous visit may lead to dental anxiety and fear.…”

“…[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. [8] By encouraging the patient to focus his/her attention on other things, less attention is available for pain. Previous techniques to distract a child include Section: Dentistry watching television, listening to music, counting the furniture in the room, story-telling and brief relaxation.…”

The Effect of the Pop-Up Book Aku Dan Gigiku on Blood Pressure in Children Aged 4–6 Years

“…A variety of behavioral interventions have been designed to reduce anxiety in children caused by dental procedures, such as the provision of information, live and filmed modeling, reinforcement of appropriate behavior, desensitization, tell-show-do, and many more [7]. The use of psychobehavioral approaches in medical and dental treatment situations is defined as a non-aversive approach aimed at modifying a child's discomfort by averting his or her attention away from the main task to accomplish successful treatment [1]. Intervention includes the provision of information; thus, giving information as a means of dental health education for children and doing so in a tell-show-do manner is likely to be more interesting for children.…”

“…Dental anxiety leads to undesirable distresses, such as avoidance of dental treatment, and tends to increase stress among caregivers, consequently affecting treatment quality [1]. Anxiety is an unpleasant inner emotional state characterized by uncertainty from the anticipation of a threatening event or situation [2].…”