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Anchala K, Tirumala V, Saikiran KV, Elicherla NR, Rahul S, Nuvvula S. Efficacy of kaleidoscope, virtual reality, and video games to alleviate dental anxiety during local anesthesia in children: a randomized clinical trial. J Dent Anesth Pain Med 2024; 24:195-204. [PMID: 38840651 PMCID: PMC11148416 DOI: 10.17245/jdapm.2024.24.3.195] [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: 04/16/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024] Open
Abstract
Background Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. Methods Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests. Results In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. Conclusion Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.
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Affiliation(s)
- Karthik Anchala
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Voppathotty Tirumala
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | | | - Niharika Reddy Elicherla
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Shaik Rahul
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Sivakumar Nuvvula
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Hamdy SF, Farag MSMS, Helmy YS, Abo-Elsoud AA. Enhancing Pediatric Dental Care: The Influence of Virtual Reality. Eur J Dent 2024. [PMID: 38744327 DOI: 10.1055/s-0044-1782193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children. MATERIAL AND METHODS The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB. RESULTS The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety. CONCLUSION This study concluded that VR reduced pain and anxiety levels in its passive and active forms.
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Affiliation(s)
- Sara Faisal Hamdy
- Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry, Suez Canal University, Ismaillia, Egypt
| | - Mohamed Sherif Mohamed Salah Farag
- Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry, Suez Canal University, Ismaillia, Egypt
| | - Yousra Samir Helmy
- Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry, Suez Canal University, Ismaillia, Egypt
| | - Asmaa Ali Abo-Elsoud
- Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry, Suez Canal University, Ismaillia, Egypt
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Chandran LS, Issac JS, Girija P, Thomas PT, Shirli AD, Jalal SA. Effectiveness of Two Types of Distraction Techniques in the Management of Pain and Anxiety during Dental Treatment in 6-9-year-old Children. Int J Clin Pediatr Dent 2024; 17:291-296. [PMID: 39144506 PMCID: PMC11320797 DOI: 10.5005/jp-journals-10005-2794] [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] [Indexed: 08/16/2024] Open
Abstract
Aim To determine the effectiveness of distraction with virtual reality (VR) distraction devices in comparison with mobile phone video games in the management of pain and anxiety during dental treatment in 6-9-year-old children. Materials and methods It was a comparative observational study. A total of 33 children aged 6-9 years who reported to the department for their first dental visit were selected and the subjects were divided into three groups. Group I patients were in a normal clinical environment without any distractions. Group II patients were given mobile phone video games. Group III patients were given a VR distraction device as a means of distraction.The anxiety levels of patients before treatment, after using a distraction device preoperatively, during local anesthesia injection, and after dental treatment were assessed. Pain after local anesthesia injection in each group was assessed. The easability of handling the patient and carrying out the procedure was assessed using a questionnaire. All data were collected and analyzed. Results The results showed when compared to the children in groups I and II, children in group III obtained significantly lower anxiety scores after treatment, and they also reported significantly decreased pain perception during dental treatment (p < 0.001). The pain while administering local anesthesia was greater for the control group and lowest for the VR group. It was observed that VR group patients were easier to handle and easier to carry out procedures than those in the mobile phone group. Conclusion Virtual reality distraction is an effective distraction technique for reducing pain and anxiety in children during various treatment procedures. Clinical significance Virtual reality distraction can be used effectively in clinics.It is a patient-friendly technique and is more comfortable for both patients and dentists during treatment.It does not require any previous education and training and has a positive impact on memories of the treatment, leading to behavior modification. How to cite this article Chandran LS, Issac JS, Girija P, et al. Effectiveness of Two Types of Distraction Techniques in the Management of Pain and Anxiety during Dental Treatment in 6-9-year-old Children. Int J Clin Pediatr Dent 2024;17(3):291-296.
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Affiliation(s)
- Lekshmi Shobana Chandran
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Jyoti Sumi Issac
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Parvathy Girija
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Pinku Thekkemelathethil Thomas
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Arjun Dileep Shirli
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Siddik Abdul Jalal
- Department of Pediatric and Preventive Dentistry, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
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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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Almajed OS, Alhujhuj R, Alshaheen E, Almujhim A, Albutayh M, Raghunath RG, Lele G. The Effectiveness of Virtual Reality in Controlling Pain and Anxiety Levels in Four-to-Six-Year-Old Children During Dental Treatment. Cureus 2023; 15:e51099. [PMID: 38274902 PMCID: PMC10809031 DOI: 10.7759/cureus.51099] [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] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background and objective Oral health is critical for children's overall well-being; however, dental anxiety often leads to the avoidance of necessary dental care among children. Virtual reality (VR) has emerged as a successful adjunctive tool in various clinical settings, including pain management. This cohort study explores the use of VR technology in reducing anxiety and pain perception during dental procedures for children. The primary objective of this study was to assess the efficacy of VR distraction in managing pain and anxiety levels in children aged four to six years during dental procedures. Additionally, the study aimed to compare children's anxiety levels with and without VR eyeglasses. Methodology This single-blind, crossover clinical trial was conducted at the Dental Complex of King Faisal University, Al Ahsa, Kingdom of Saudi Arabia. Of the 200 children screened initially, 20 aged four to six years who met the inclusion criteria were selected, and ethical approval for the study was obtained. The study comprised two groups: a control group and an experimental group. Dental procedures were conducted both with and without the use of VR, employing a split-mouth design. Results Our findings provide important insights into the clinical impact of using VR technology to alleviate children's anxiety during dental clinic visits. In our study, we used ANOVA and Tukey's post hoc test to evaluate the effect of VR glasses on vital metrics in children during dental procedures. Our results showed no significant differences before and after using the VR glasses, indicating limited effectiveness in reducing anxiety in this context. Conclusion Based on our findings, we reject the assumption that VR devices are highly effective in diverting children's attention and reducing their anxiety and pain during dental procedures; we recommend further investigations to identify potential confounding factors that could modulate the utility of VR in medical settings.
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Affiliation(s)
- Omar S Almajed
- Pediatric Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
- Dental Public Health, King's College London, London, GBR
| | - Rakan Alhujhuj
- Dental Department, King Abdulaziz National Guard Hospital, Al Hofuf, SAU
| | | | | | | | - Ravi G Raghunath
- Department of Preventive Dental Sciences, King Faisal University, Al Ahsa, SAU
| | - Gauri Lele
- Pediatric and Preventive Dentistry, Navrachana University, Gujarat, IND
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Candan M, Kutlu E, Yilmaz Karaman İG. Predictors of Parental Acceptance towards Contemporary Behavior Management Techniques Used in Pediatric Dentistry: A Preliminary Study on Turkish Population. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1592. [PMID: 37892255 PMCID: PMC10605559 DOI: 10.3390/children10101592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Parents, who make the final decision regarding their child's treatment, play a significant role in their dental care. Parental approval is important for each stage of treatment and may affect the physician's approach to the treatment. Therefore, it is essential for pediatric dentists to comprehend which behavior management techniques (BMTs) are acceptable to parents and to identify the factors that influence their acceptability. METHODS Parents who were bringing their children for dental treatment answered a survey on the acceptance of twenty contemporary BMTs. The sociodemographic data of the parents and the age, gender, and Frankl behavior rating scale (Frankl) scores of their children were recorded. Parents were asked to indicate their level of acceptance of each BMT. Binary logistic regression analysis was designed to see the predictors of "accepted" and "declined" answers. RESULTS According to acceptance frequencies, the most accepted technique was communication and communicative guidance. The most declined technique was parental absence. The child's age, gender, Frankl score, parental educational status, and parent type predict the acceptability of some BMTs. CONCLUSION This study revealed that pediatric dentists must consider parent and child factors when selecting BMTs for children. We believe that this study can provide a basis for determining which factors pediatric dentists should consider when selecting individualized BMTs.
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Affiliation(s)
- Merve Candan
- Department of Pedodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir 26040, Turkey
| | - Elifcan Kutlu
- Department of Pedodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir 26040, Turkey
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Yan X, Yan Y, Cao M, Xie W, O'Connor S, Lee JJ, Ho MH. Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: A systematic review and meta-analysis. J Dent 2023; 132:104455. [PMID: 36842625 DOI: 10.1016/j.jdent.2023.104455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/28/2023] Open
Abstract
OBJECTIVES To analyse the effectiveness of virtual reality (VR) distraction intervention for the management of dental anxiety in paediatric patients. DATA Randomised controlled trials (RCTs) of VR distraction interventions for reducing anxiety in paediatric patients, published in English were included. SOURCES Seven databases, including PubMed, Web of Science, Scopus, MEDLINE via ProQuest, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials, covering the period between January 2000 and September 2022 were searched. STUDY SELECTION A total of 12 RCTs involving 818 participants were included. Quality appraisal was undertaken using the Cochrane risk-of-bias tool for randomised trials by two authors independently. Random-effects model was used to summarise the effects of the interventions and pool data. CONCLUSIONS Results showed that VR distraction interventions were effective in reducing the dental anxiety of paediatric patients. In meta-analysis, the VR distraction interventions had a significant effect on reducing paediatric patients' anxiety (SMD = -1.74, 95%CI = -2.46, -1.02, p < 0.001, I² = 95%), pain (SMD = -1.57, 95%CI = -2.22, -0.91, p < 0.001, I² = 91%) and heart rate (MD = -10.54, 95%CI = -20.26, -0.81, p = 0.03, I² = 99%) during dental treatment. However, the evidence of VR in managing dental anxiety would become weak because of the publication bias. CLINICAL SIGNIFICANCE VR distraction interventions could be an effective approach to alleviate the dental anxiety of paediatric patients. Additional well-designed and high-quality RCTs with larger sample sizes are needed to determine the optimal way to deliver VR interventions in paediatric dental clinics.
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Affiliation(s)
- Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Yongyang Yan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
| | - Siobhán O'Connor
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester, United Kingdom
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China.
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China
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