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

López-Valverde, Nansi; Muriel-Fernández, Jorge; López-Valverde, Antonio; Juan, Luis Félix Valero; Ramı́rez, Juan M.; Flores-Fraile, Javier; Herrero-Payo, Julio; Blanco-Antona, Leticia Alejandra; Sousa, Bruno Macedo de; Bravo, Manuel

doi:10.3390/jcm9103086

Cited by 27 publications

(16 citation statements)

References 52 publications

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“…In the past few decades, the emergence of digital therapeutics (DTx) aimed at the use of informatic tools to aid the diagnosis and therapy of various pathologies has led to the creation of many new therapeutic devices [18]. Recently, multiple meta-analyses have specifically supported the efficacy of virtual reality (VR) in several type of acute and chronic pain conditions [19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial

Merlot¹,

Husson²,

Chanavaz-Lacheray³

et al. 2022

J Med Internet Res

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Background Chronic pelvic pain is a common and disabling condition in women living with endometriosis. Pharmacological and surgical treatments are not always effective at controlling pain and present important restrictions. Digital therapeutics (DTx) are emerging as major nonpharmacological alternatives that aim to extend the analgesic therapeutic arsenal of patients. Objective In this randomized controlled trial (RCT), we aimed to measure the immediate and 4-hour persisting effects of a single use 20-minute DTx (Endocare) on pain in women experiencing pelvic pain due to endometriosis. Methods A total of 45 women with endometriosis participated in a randomized controlled study comparing the analgesic effect of a single use of a virtual reality digital treatment named Endocare (n=23, 51%) to a 2D digital control (n=22, 49%). Perceived pain and pain relief were measured before the treatment and 15, 30, 45, 60, and 240 minutes after the end of the treatment. Results The clustered posttreatment pain was significantly reduced compared to the pretreatment for both Endocare and the control group (all P<.01). Endocare was significantly more effective than the control group (all P<.01). Endocare decreased the mean pain intensity from 6.0 (SD 1.31) before the treatment to 4.5 (SD 1.71) posttreatment, while the control only decreased it from 5.7 (SD 1.36) to 5.0 (SD 1.43). When comparing each posttreatment measures to the pretest, Endocare significantly reduced pain perception for all points in time up to 4 hours posttreatment. The differences did not reached significance for the control group. Moreover, Endocare was significantly superior to the control group 15, 30, and 45 minutes after the treatment (all P<.001). The mean perceived pain relief was significantly higher for Endocare at 28% (SD 2%) compared to the control, which was 15% (SD 1%) for all the posttreatment measurements (all P>.05). Conclusions Our study aimed to test the effects of a single use of a DTx treatment on reported pain at different time points in women diagnosed with endometriosis experiencing moderate-to-severe pelvic pain. Importantly, our results support that Endocare, a virtual reality immersive treatment, significantly reduce pain perception compared to a digital control in women living with endometriosis. Interestingly, we are the first to notice that the effect persisted up to 4 hours posttreatment. Trial Registration ClinicalTrials.gov NCT04650516; https://tinyurl.com/2a2eu9wv

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Section: Introductionmentioning

confidence: 99%

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial

Merlot¹,

Husson²,

Chanavaz-Lacheray³

et al. 2022

J Med Internet Res

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“…The VR distraction used nonintrusive methods; therefore, the children’s parents or caregivers have not been concerned that general anesthesia might affect intelligence and learning ability. The adverse effects on vision and hearing have not been reported in this study and literature [ 31 , 38 – 40 ]. Even with repeated dental treatments, parents and children are much more receptive to other methods.…”

Section: Discussionmentioning

confidence: 63%

Application of virtual reality on non-drug behavioral management of short-term dental procedure in children

Ran

Zhao

Fan

et al. 2021

Trials

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Background Due to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children. Methods A randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment. Results The average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min). Conclusion The use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029802. Registered on February 14, 2020

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“…Furthermore, the HMD changes the perception of the surrounding environment. A meta-analysis showed that VR is a useful distraction method in pediatrics (Eijlers et al, 2019 ) and dental procedures (Lopez-Valverde et al, 2020 ). Klassen et al ( 2008 ) and Uman et al ( 2013 ) indicated that distraction techniques, including VR, should be used in any needle-related procedures in children.…”

Section: Discussionmentioning

confidence: 99%

Effects of Virtual Reality-Based Distraction of Pain, Fear, and Anxiety During Needle-Related Procedures in Children and Adolescents

2022

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BackgroundNeedle-related pain, fear, and anxiety can be a deterrent to treatments in children and adolescents. Virtual reality (VR) can be used to manage the poor experience of needle procedures.ObjectiveThis meta-analysis aimed to examine the effects of VR on pain, fear, and anxiety related to needle procedures in children and adolescents.MethodsPubMed, EMBASE, and the Cochrane Library were searched for potentially eligible studies published up to June 2021. The outcomes were pain assessed by the Wong-Baker Faces Pain Scale (WBS) or Faces Pain Scale-Revised (FPS-R), and Visual Analog Scale (VAS), fear assessed by Children's Fear Scale (CFS), and anxiety assessed by Children's Anxiety Meter (CAM), VAS, or CFS. Because of expected heterogeneity among studies, all analyses were conducted using the random-effects model.ResultsTen studies were included (571 children in the VR group and 575 in the control group). Based on the WBS, VR reduced pain, either self-reported (WMD = −2.17, 95%CI: −3.37, −0.97), parent-reported (WMD = −3.52, 95%CI: −4.62, −2.42), nurse-reported (WMD = −3.29, 95%CI: −5.59, −0.99), and physician/investigator-reported (WMD = −3.48, 95%CI: −5.93, −1.04). Using the FPS-R, VR reduced needle-related pain compared with controls (WMD = −0.85, 95%CI: −1.64, −0.06). Similar results were observed for fear (children/adolescents: WMD = −1.52, 95%CI: −2.18, −0.86; parents: WMD = −1.71, 95%CI: −2.30, −1.13; nurses: WMD = −1.55, 95%CI: −2.47, −0.63; physicians/investigators: WMD = −0.59, 95%CI: −1.00, −0.18) and anxiety (self-reported: WMD = −2.79, 95%CI: −4.07, −1.54; parent-reported: WMD = −3.87, 95%CI: −5.58, −2.15; nurse-reported: WMD = −4.64, 95%CI: −6.56, −2.71; physician/investigator-reported: WMD = −2.06, 95%CI: −4.13, −0.00).ConclusionA VR-based intervention could reduce needle-related pain, fear, and anxiety in children and adolescents.

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

Cited by 27 publications

References 52 publications

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial

Application of virtual reality on non-drug behavioral management of short-term dental procedure in children

Effects of Virtual Reality-Based Distraction of Pain, Fear, and Anxiety During Needle-Related Procedures in Children and Adolescents

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