J Dent Anesth Pain Med.  2019 Oct;19(5):277-288. 10.17245/jdapm.2019.19.5.277.

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

Affiliations
  • 1Department of Paedodontics and Preventive Dentistry, Narayana Dental College, Nellore, India. drmallineni@gmail.com
  • 2Department of Paedodontics and Preventive Dentistry, Priyadarshini Dental College and Hospital, Thiruvallur, India.
  • 3Pediatric Dentistry, Preventive Dental Science, College of Dentistry, Majmaah University, Kingdom of Saudi Arabia.

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.

Keyword

Counter-Stimulation; Dental Anxiety; Distraction; Pain Perception; Virtual Reality

MeSH Terms

Anesthesia, Local
Anxiety
Child*
Dental Anxiety*
Eyeglasses
Glass
Heart Rate
Humans
Needles
Pain Perception*
Prospective Studies
Pulpectomy
Tooth Extraction
Visual Analog Scale

Figure

  • Fig. 1 CONSORT flow diagram of the study design.

  • Fig. 2 Materials used for virtual reality distraction (Lenovo smartphone, Sennheiser earphones, and ANTVR glasses).

  • Fig. 3 (a) Stroking the cheek and the extraoral mucosa (Counter-stimulation) and (b) local anesthesia administration with virtual reality distraction.


Cited by  1 articles

Comparative evaluation of the effectiveness of a mobile app (Little Lovely Dentist) and the tell-show-do technique in the management of dental anxiety and fear: a randomized controlled trial
Sainath Reddy Elicherla, Sujatha Bandi, Sivakumar Nuvvula, Rama subbareddy Challa, Kanamarlapudi Venkata Saikiran, Vaka Jeevan Priyanka
J Dent Anesth Pain Med. 2019;19(6):369-378.    doi: 10.17245/jdapm.2019.19.6.369.


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