The Effect of Immersive Virtual Reality on Dental Anxiety and Intraoperative Pain in Adults Undergoing Local Anesthesia: A Randomized Clinical Trial

Abstract

Aims: This study assessed the effect of immersive virtual reality (IVR) on anxiety and intraoperative pain in adult patients undergoing dental extractions with local anesthesia. Methods: In a single-blind, randomized clinical trial from September 2022 to December 2023 at a private dental clinic, 190 patients with dental anxiety were randomly assigned to either an IVR or a control group. Primary outcomes—dental anxiety and perioperative pain—were measured using the State-Trait Anxiety Inventory (STAI), Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS) before and after the procedure. Secondary outcomes included heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP), recorded at various stages. Results: The IVR group showed significant reductions in total anxiety, state anxiety, and MDAS scores compared to the control group (p < 0.001). Pain intensity was also lower in the IVR group (p = 0.03). Additionally, heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were consistently lower in the IVR group across different stages. Post anesthesia, the IVR group showed notably lower mean SBP and DBP values (p < 0.001). After surgery, the IVR group also showed lower HR (p = 0.01), SBP (p < 0.001), and DBP (p < 0.001) compared to the control group. Conclusions: IVR significantly reduced STAI, STAI-S, and MDAS scores and decreased intraoperative pain compared to the control group.