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Almarzouq SSFS, Chua H, Yiu CKY, Lam PPY. Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:537. [PMID: 38470648 PMCID: PMC10931341 DOI: 10.3390/healthcare12050537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. METHOD A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. RESULT A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children. CONCLUSIONS The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.
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Affiliation(s)
| | - Helene Chua
- National Healthcare Group Polyclinics, Singapore 308433, Singapore
| | - Cynthia K. Y. Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
| | - Phoebe P. Y. Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
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Petrović D, Cicvarić O, Šimunović-Erpušina M, Ivančić Jokić N, Bakarčić D, Bučević Sojčić P, Jurić H. The Role of Family Factors in the Development of Dental Anxiety in Children. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:180. [PMID: 38276059 PMCID: PMC10818455 DOI: 10.3390/medicina60010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Background and Objectives: In the literature, the influence of parents who suffer from dental anxiety and a previous unpleasant experience at the dentist are cited as the two most common causes of dental anxiety in children. The aim of this study is to investigate the relationship between socioeconomic factors and the development of dental anxiety in children aged 9 to 12 years. Materials and Methods: A total of 131 children and their accompanying parents/guardians participated in the cross-sectional study. The children were divided into an experimental group, which visited a specialised office for paediatric and preventive dentistry for the examination, and a control group, which visited a primary care dental office. During the visit, the children completed questionnaires on dental anxiety (CFSS-DS). Parents completed a socioeconomic questionnaire and a dental anxiety questionnaire for adults (CDAS). Results: The results showed a statistically significant positive predictor: parental dental anxiety as measured by the CDAS. In addition, the t-test showed that children who visited a specialised dental office did not show a statistically significant increase in dental anxiety compared to children who visited a primary care dental office. Conclusions: With this study, we confirm the influence of parental dental anxiety on the development of dental anxiety in children. The socioeconomic status of the family and the type of dental office do not play a statistically significant role in the development of dental anxiety in children.
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Affiliation(s)
- Dorotea Petrović
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
| | - Odri Cicvarić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
| | - Marija Šimunović-Erpušina
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Nataša Ivančić Jokić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Danko Bakarčić
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.P.); (M.Š.-E.); (N.I.J.); (D.B.)
- Dental Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Petra Bučević Sojčić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Hrvoje Jurić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- University Dental Clinic, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
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Barros Padilha DXD, Veiga NJ, Mello-Moura ACV, Nunes Correia P. Virtual reality and behaviour management in paediatric dentistry: a systematic review. BMC Oral Health 2023; 23:995. [PMID: 38087294 PMCID: PMC10717698 DOI: 10.1186/s12903-023-03595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. METHODS A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. RESULTS A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. CONCLUSIONS VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.
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Grants
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- UIDB/04279/2020. This work is financially supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project
- This work is financially supported by National Funds through FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project
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Affiliation(s)
| | - Nélio Jorge Veiga
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
| | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal
| | - Patrícia Nunes Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505, Viseu, Portugal.
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505, Viseu, Portugal.
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Fan L, Zeng J, Ran L, Zhang C, Wang J, Yu C, Zhao N. Virtual reality in managing dental pain and anxiety: a comprehensive review. Front Med (Lausanne) 2023; 10:1285142. [PMID: 38131048 PMCID: PMC10736194 DOI: 10.3389/fmed.2023.1285142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to identify, analyze, and summarize the clinical efficacy of virtual reality (VR) distraction therapy for oral treatment in different hospital settings in contrast to medical interventions that induce anxiety and pain. Furthermore, this review aimed to determine the implications for research and clinical practice of VR distraction therapy. Data This review investigated the clinical efficacy of VR in the oral treatment of procedural pain or anxiety. Quality assessment of the included studies was conducted. A narrative synthesis of the collected data was performed. Sources Literature studies from six electronic databases were searched for a comprehensive review, namely, the Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (Central), MEDLINE (PubMed), EMBASE, Scopus, and Web of Science. Study selection One thousand five hundred twenty-two patients aged between 0 and 60 years who used VR during dental treatment were included in this review. Among these studies, 8 and 14 studies comprised adult and pediatric patients. Conclusion Overall, the reviewed studies underscore the efficacy of VR to mitigate pain and anxiety in the context of dental treatment. VR is an innovative pain and anxiety management approach that facilitates dental treatment patients to immerse themselves in a virtual world while using distractions to reduce pain and anxiety. Clinical significance VR is an effective and novel non-pharmacological method of behavioral management that contributes to improving medication safety for dental patients. VR as a distractive approach can reduce the fear associated with medical interventions and prevent severe pain sensitivity, anxiety, and medical avoidance among adults and children.
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Affiliation(s)
- Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Longkuan Ran
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Zhang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jing Wang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Cong Yu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Zhao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Hao T, Pang J, Liu Q, Xin P. A systematic review and network meta-analysis of virtual reality, audiovisuals and music interventions for reducing dental anxiety related to tooth extraction. BMC Oral Health 2023; 23:684. [PMID: 37735362 PMCID: PMC10515077 DOI: 10.1186/s12903-023-03407-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction. METHODS Four electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA. RESULTS A total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis. CONCLUSIONS Relaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.
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Affiliation(s)
- Tiedan Hao
- Department of Operating Room, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Pang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Qingmei Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Stomatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Pengfei Xin
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Department of Stomatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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Carroll SL, Sykes BW, Mills PC. Moving toward Fear-Free Husbandry and Veterinary Care for Horses. Animals (Basel) 2022; 12:2907. [PMID: 36359031 PMCID: PMC9653666 DOI: 10.3390/ani12212907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 07/30/2023] Open
Abstract
Husbandry and veterinary procedures have the potential to generate fear and stress in animals. In horses, the associated responses can pose a significant safety risk to the human personnel involved in the procedure, as well as to the animal itself. Traditionally, physical restraint, punishment, and/or threat of an aversive, have been the most common strategies used to achieve compliance from the horse. However, from a welfare perspective, this is less than ideal. This approach also has the potential for creating a more dangerous response from the horse in future similar situations. When caring for companion animals, and captive animals within zoological facilities, there has been a steady transition away from this approach, and toward strategies aimed at reducing fear and stress during veterinary visits and when undertaking routine husbandry procedures. This review discusses the current approaches to horse care and training, the strategies being used in other animal sectors, and potential strategies for improving human safety, as well as the horse's experience, during husbandry and veterinary procedures.
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Affiliation(s)
- Sharon L. Carroll
- School of Veterinary Science, University of Queensland, Gatton, QLD 4343, Australia
| | - Benjamin W. Sykes
- School of Veterinary Science, University of Queensland, Gatton, QLD 4343, Australia
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand
| | - Paul C. Mills
- School of Veterinary Science, University of Queensland, Gatton, QLD 4343, Australia
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Muacevic A, Adler JR. A Systematic Review of Randomized Controlled Trials on Virtual Reality Application in Pediatric Patients. Cureus 2022; 14:e30543. [PMID: 36320795 PMCID: PMC9614389 DOI: 10.7759/cureus.30543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Virtual reality is a novel approach for distracting and alleviating anxiety, pain, and other complications during medical procedures, and it can be more effective than conventional methods. In virtual reality, the patient is completely immersed in the virtual environment, which is used to make patients feel more comfortable and can provide a positive prognosis. The data were searched by using the Boolean operator "AND" between the search phrases "Virtual reality," and "Pediatrics" and the relevant literature was extracted. The inclusion criteria were the free full text, randomized controlled trials, studies between 2016 and 2022 and pediatric patients. This systematic review was conducted to compare randomized controlled trials of virtual reality applications in pediatric patients in different clinical settings. Of the included 15 randomized controlled trials, 12 studies were on pain and anxiety, two on brain injury and cerebral palsy, and one on awareness among asthmatic patients. This review concluded that virtual reality exposure has a beneficial effect on pediatric patients in reducing pain and anxiety, improving muscle strength and dexterity, and awareness among asthmatic patients.
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