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Heena A, Malik M, Chauhan P, Arora P, Singh K, Moniya M. Comparison of different behaviour management techniques while administering injectable la with minimum pain perception and anxiety in children. J Clin Exp Dent 2024; 16:e1021-e1026. [PMID: 39281799 PMCID: PMC11392443 DOI: 10.4317/jced.61736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 09/18/2024] Open
Abstract
Background Dental anxiety is a frequent reason for reluctance in young children, leading to challenges in delivering effective dental treatment due to their uncooperative behavior. Aim: The aim of this study was to evaluate and compare the efficacy of different behaviour management techniques while administrating injectable LA with minimum pain perception and anxiety in children. Material and Methods One hundred and twenty children, aged 4 to 10 years, were equally and randomly assigned to four groups. In Group I, local anesthesia was administered while using wireless headphones. For Group II, local anesthesia was administered using a mobile phone with earpieces. Group III received local anesthesia while incorporating the 3D virtual reality eyewear method and Group IV received local anesthesia while utilizing the stress ball technique. Pain and anxiety assessments were conducted using various scales and Physiological parameters such as pulse rate and oxygen saturation levels were recorded and the resultant data were systematically tabulated for subsequent statistical analysis. Results Virtual reality group showed highly significant result in terms of lowering anxiety and pain scores compared to audio, audio visual, stress ball groups (p<0.001). Virtual group (5.10) also displays significantly highest behavior scores than the audio (1.70), audio visual group (3.96) and Stress Ball groups (2.66). Conclusions The virtual reality group emerged as the most effective method in alleviating anxiety and pain experienced by pediatric dental patients. Key words:Pain management, Anxiety, Distraction, Virtual reality device, Stress ball, Audiovisual, Audio.
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Affiliation(s)
- Ansari Heena
- MDS (P.G. 3rd Year Student), Department of Pediatric and Preventive Dentistry, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh
| | - Manvi Malik
- MDS, Professor and Head, Department of Pediatric and Preventive Dentistry, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh
| | - Prabhav Chauhan
- MDS, Associate Professor, Department of Pediatric and Preventive Dentistry, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh
| | - Prachi Arora
- MDS, Senior Lecturer, Department of Pediatric and Preventive Dentistry, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh
| | - Kopal Singh
- MDS, Senior Lecturer, Department of Pediatric and Preventive Dentistry, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh
| | - Mudang Moniya
- MDS Student, Shree Bankey Bihari Dental College and Research Centre Ghaizabad, Uttar Pradesh
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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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Pawar M, Pandya P, Rimple CM, Agrawal K, Dasarraju RK, Jain S. Virtual Reality Distraction: A Novel Behaviour Management Technique. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S53-S55. [PMID: 38595521 PMCID: PMC11000880 DOI: 10.4103/jpbs.jpbs_965_23] [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: 09/29/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 04/11/2024] Open
Abstract
Virtual reality distraction (VRD) is developing technologies for behavior management that can assist a child in adjusting to the dental setting and provide high-quality dental care. The purpose of this literature is to shed light on VRD and its application to the treatment of pediatric dental patients.
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Affiliation(s)
- Madhura Pawar
- Department of Pediatric and Preventive Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Parth Pandya
- Department of Public Health Dentistry, Government Dental College and Hospital, Ahmedabad, Gujarat, India
| | | | - Kinjalk Agrawal
- Intern, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Rupak Kumar Dasarraju
- Department of Pedodontics and Preventive Dentistry, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India
| | - Shrinidhi Jain
- Department of Prosthodontics and Crown and Bridge, AB Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India
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Bahrololoomi Z, Zein Al-Din J, Maghsoudi N, Sajedi S. Efficacy of Virtual Reality Distraction in Reduction of Pain and Anxiety of Pediatric Dental Patients in an Iranian Population: A Split-Mouth Randomized Crossover Clinical Trial. Int J Dent 2024; 2024:1290410. [PMID: 38250512 PMCID: PMC10798833 DOI: 10.1155/2024/1290410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 11/08/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024] Open
Abstract
Materials and Methods This crossover clinical trial was conducted with eligible 6-8-year-old children requiring bilateral mandibular molar pulpotomy. At the first treatment visit, pulpotomy was performed for 15 children using VR glasses distraction while the other 15 children received a pulpotomy without any VR glasses; this trend was reversed at the second session and pulpotomy was performed for the contralateral tooth. Pulse rate (PR) and Modified Child Dental Anxiety Scale (MCDAS) measured the anxiety levels. Wong-Baker Faces Pain Scale (WBFP) assessed the pain perception before and after the intervention. Data were analyzed by Statistical Package for the Social Sciences version 25 using the Mann-Whitney and χ2 tests. Results The mean PR was not significantly different between the two groups. However, the test group showed significantly lower scores of MCDAS (P value = 0.02) and WBFP (P value = 0.001) compared with the control group. Conclusion The present results suggest that VR headsets can decrease the level of pain and anxiety of patients during primary mandibular pulpotomy. This trial is registered with IRCT20200315046782N1.
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Affiliation(s)
- Zahra Bahrololoomi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zein Al-Din
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Maghsoudi
- Department of Pediatrics, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samira Sajedi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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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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Camacho-Cruz J, Palacios-Ariza MA, Orrego-Celestino L, Valbuena-Velandia N, Paez-Castellanos L, Bolaños JM, Pradilla I. Effectiveness of non-immersive virtual reality in the management of procedure-related pain in preschool children: a randomized clinical trial. Eur J Pediatr 2023; 182:4103-4112. [PMID: 37407711 DOI: 10.1007/s00431-023-05070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
The objective of this study is to assess the effectiveness of non-immersive virtual reality as a pain-distraction measure in children between the ages of 3 and 5 years undergoing painful injection procedures in an outpatient setting. We carried out a randomized, unmasked clinical trial in children undergoing venipuncture or intramuscular injection procedures. Patients were randomized to a distraction virtual reality video or standard care. After the procedure, three independent observers (parents, researchers, nursing staff) rated pain on the LLANTO pain scale. We recruited 122 subjects, half of which were randomized to virtual reality. The median age was of approximately 60 months (IQR: 15 months), and the sample was balanced with regard to sex. There were significant differences in LLANTO scales scores between the VR subjects and controls of - 3.34 (95% CI - 4.15; - 2.54), - 3.02 (95% CI - 3.90; - 2.14), and - 2.98 (95% CI - 3.87; - 2.09), as rated by parents, researchers, and nursing staff, respectively. Agreement between raters was high for all three types of observers, with Cohen Kappas over 0.79 in all cases. Bivariate analysis showed reductions in the risk of obtaining higher scores in the LLANTO scale. Linear regression models showed a reduction of approximately 3 points in the scale, regardless of the type of observer. These models were adjusted for sex, age, kind of procedure, use of prior analgesia, and recruitment center. CONCLUSIONS Non-immersive virtual reality is an effective adjunctive therapy for the reduction of pain in children undergoing painful injection procedures in an outpatient setting. This strategy may be used to improve the quality of care in pediatric outpatient services. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03985930 (Registered June 14, 2019). WHAT IS KNOWN •The use of immersive virtual reality (VR) has been described as an effective adjunctive distraction method during painful procedures in children over 5 years. WHAT IS NEW •The utility of non-immersive VR in children below that age is not yet clear. This randomized clinical trial comparing non-immersive VR vs. standard care showed an average reduction of three points in the LLANTO pain scale favoring non-immersive VR. Non-immersive VR is an effective and inexpensive non-pharmacological technique that reduces fear and pain in pediatric patients.
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Affiliation(s)
- Jhon Camacho-Cruz
- School of Medicine, Salud de la Infancia Research Group, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia
| | - María A Palacios-Ariza
- Research Unit, Fundación Universitaria Sanitas, Sede Salitre, Ninth Floor, Bogotá, D.C., 111321, Colombia.
| | | | | | | | - Johanna M Bolaños
- School of Medicine, Salud de la Infancia Research Group, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia
| | - Iván Pradilla
- Neuroscience Research Group (NeURos), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, D.C., Colombia
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Gao F, Wu Y. Procedural sedation in pediatric dentistry: a narrative review. Front Med (Lausanne) 2023; 10:1186823. [PMID: 37181379 PMCID: PMC10169594 DOI: 10.3389/fmed.2023.1186823] [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: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Procedural sedation and analgesia are now considered standard care for managing pain and anxiety in pediatric dental patients undergoing diagnostic and therapeutic procedures outside of the operating room. Anxiolysis, which combines both pharmacologic and non-pharmacologic approaches, plays a significant role in procedural sedation. Non-pharmacologic interventions such as Behavior Management Technology can help reduce preprocedural agitation, ease the transition to sedation, reduce the required amount of medication for effective sedation, and decrease the occurrence of adverse events. As the introduction of novel sedative regimen and methods in pediatric dentistry, the potential role of mainstay sedatives administered by new routes, for new indications, and with new delivery techniques, should be considered. The purpose of this paper is to examine and discuss the current state of sedation techniques in pediatric dentistry.
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Affiliation(s)
- Feng Gao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Laboratory of Oral Diseases and Biomediacal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yujia Wu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Laboratory of Oral Diseases and Biomediacal Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Hitching R, Hoffman HG, Garcia-Palacios A, Adamson MM, Madrigal E, Alhalabi W, Alhudali A, Sampaio M, Peterson B, Fontenot MR, Mason KP. The Emerging Role of Virtual Reality as an Adjunct to Procedural Sedation and Anesthesia: A Narrative Review. J Clin Med 2023; 12:843. [PMID: 36769490 PMCID: PMC9917582 DOI: 10.3390/jcm12030843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 01/24/2023] Open
Abstract
Over the past 20 years, there has been a significant reduction in the incidence of adverse events associated with sedation outside of the operating room. Non-pharmacologic techniques are increasingly being used as peri-operative adjuncts to facilitate and promote anxiolysis, analgesia and sedation, and to reduce adverse events. This narrative review will briefly explore the emerging role of immersive reality in the peri-procedural care of surgical patients. Immersive virtual reality (VR) is intended to distract patients with the illusion of "being present" inside the computer-generated world, drawing attention away from their anxiety, pain, and discomfort. VR has been described for a variety of procedures that include colonoscopies, venipuncture, dental procedures, and burn wound care. As VR technology develops and the production costs decrease, the role and application of VR in clinical practice will expand. It is important for medical professionals to understand that VR is now available for prime-time use and to be aware of the growing body in the literature that supports VR.
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Affiliation(s)
- Rita Hitching
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Hunter G. Hoffman
- Department of Mechanical Engineering HPL, University of Washington, Seattle, WA 98195, USA
- Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Azucena Garcia-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, 12071 Castellon de la Plana, Spain
| | - Maheen M. Adamson
- WRIISC-WOMEN and Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Esmeralda Madrigal
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Wadee Alhalabi
- Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Immersive Virtual Reality Research Group, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Computer Science, School of Engineering, Computing and Informatics, Dar Al-Hekma University, Jeddah 21589, Saudi Arabia
| | - Ahad Alhudali
- Immersive Virtual Reality Research Group, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mariana Sampaio
- Department of Psychology, University of Coimbra, 3000-115 Coimbra, Portugal
- Department of Social Work, Catholic University of Portugal, 1649-023 Lisbon, Portugal
| | | | - Miles R. Fontenot
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, USA
| | - Keira P. Mason
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children’s Hospital, Boston, MA 02115, USA
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Zhang YY, Vimala R, Chui PL, Hilmi IN. Effect of visual distraction on pain in adults undergoing colonoscopy: a meta-analysis. Surg Endosc 2022; 37:2633-2643. [PMID: 36369410 DOI: 10.1007/s00464-022-09724-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Pain is a contributing factor to the low compliance rate for performing a colonoscopy on screening for colorectal cancer. PURPOSE This meta-analysis aimed to evaluate the effect of visual distraction on adults undergoing colonoscopy. METHODS We searched PubMed, EMBASE, Web of Science, and Cochrane Library Database from their inception to February 2022. Randomized controlled trials comparing visual distraction with non-visual distraction were considered for inclusion. The fixed-effects and random-effects models were used to pool the data from individual studies and the Cochrane risk of bias assessment tool was used to determine the methodology quality. RESULTS This meta-analysis included four studies (N = 301) for pain level and total procedure time, three studies (N = 181) for satisfaction score, three studies (N = 196) for anxiety level, and four studie (N = 402) for willingness to repeat the procedure. The pooled analysis shown that significantly lower pain levels (SMD, - 0.25; 95% CI - 0.47 to - 0.02; P = 0.03), higher satisfaction score with the procedure (SMD, 0.63; 95% CI, 0.33 to 0.93; P < 0.0001), and higher willingness to repeat the procedure (OR, 2.66; 95% CI 1.70 to 4.17; P < 0.0001) in the visual distraction group than those in the non-visual distraction group, with no significant differences in total procedure time (SMD,- 0.07; 95% CI - 0.30 to 0.15; P = 0.53) or anxiety level (SMD,- 0.27; 95% CI - 0.55 to 0.01; P = 0.06). CONCLUSIONS Visual distraction improved the patient's pain, satisfaction, and willingness to repeat the procedure. Thus, visual stimulation is an effective way to reduce pain during colonoscopy and should be recommended.
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Gizani S, Seremidi K, Katsouli K, Markouli A, Kloukos D. Basic behavioral management techniques in paediatric dentistry: A systematic review and meta-analysis. J Dent 2022; 126:104303. [PMID: 36152953 DOI: 10.1016/j.jdent.2022.104303] [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: 06/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To systematically retrieve and assess studies regarding the effectiveness of basic behavioral management techniques (BMTs) in paediatric patients. DATA SOURCES Electronic and hand searches were conducted to locate Randomized Controlled Trials (RCTs) reporting on objective and subjective evaluation of anxiety and behavior of children up to 12 years of age. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool (RoB 2.0 Tool), were performed independently and in duplicate for all included studies. Mean differences and standard deviations were used to summarize the data from each study and meta-analyses were conducted with studies of limited heterogeneity. STUDY SELECTION A total of 708 papers were identified and screened, 122 retrieved for full text appraisal and 62 finally included. Results suggested that all basic BMTs have acceptable effectiveness on paediatric patients' anxiety, fear and behavior during dental treatment. Meta-analysis showed a statistically significant difference in favor of distraction for subjective anxiety using facial scale (Mean diff.: 2.78; 95% CI: -3.08, -0.53; p=0.005) and Modified Child Dental Anxiety Scale (Mean diff.: 12.76; 95% CI: -6.09, -4.47; p=0.001) and a non-significant difference for heart rate (Mean diff.: 1.70; 95% CI: -6.54, 0.46; p=0.09). Music significantly reduced heart rate when compared to a control comparator, underlining the superiority of the BMT (Mean diff.: 2.71; 95% CI: -3.70, -0.59; p=0.007). CONCLUSIONS Limited evidence about efficacy of one technique over another raises important issues on the topic for future research regarding the management of the child patient in the dental setting of the 21st century. CLINICAL SIGNIFICANCE Behavioral management comprises a challenge for clinicians, who need to be familiar with a range of techniques to meet patients' needs at individual level and be flexible in their implementation. Appropriate technique should incorporate patients' personality and parents' active involvement, within the contents of the changes in modern societies.
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Affiliation(s)
- Sotiria Gizani
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece.
| | - Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Konstantina Katsouli
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Antigoni Markouli
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, Athens Greece
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Singh R, Gupta N, Gambhir N. Comparative Evaluation of Reduction in Pain Perception Using 5% Topical LA vs Freezed Cone as a Preparatory Agent for Intraoral Injection in Children and Effect of VRD as Distraction Technique. Int J Clin Pediatr Dent 2022; 15:558-563. [PMID: 36865722 PMCID: PMC9973116 DOI: 10.5005/jp-journals-10005-2453] [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: 02/05/2023] Open
Abstract
Aim To compare freezed cone and 5% lignocaine as a numbing agent before intraoral injection and evaluate the effect of virtual reality distraction (VRD) as a distraction technique in reducing pain perception in children. Study design Around 60 children of 6-11 years old undergoing treatment for the extraction or any pulp therapy of primary tooth were selected. Freezed cone and 5% lidocaine were used to decrease the pain during local anesthesia (LA). VRD was used as a distraction method and to analyze the pain perception, Wong-Baker Faces Pain Rating Scale was used. Materials and methods Each child was randomly assigned to receive ice as a topical anesthetic or lignocaine 5% as a topical anesthetic agent. The pain perception was evaluated after the injection of 2% lignocaine hydrochloride (HCL). The primary researcher evaluated the pain during injection using the sound, eye, motor (SEM) scale. The pain experienced during injection was evaluated using Wong-Baker Faces Pain Rating Scale. Results In the freezed cone group with the VRD technique, maximum responded to the less pain score. On the contrary, many responded to higher pain scores in the freezed cone group without the VRD technique. Conclusion It was concluded that the VRD technique can be used for distraction and the frozen ice cone can be an alternative method to reduce the pain perception during LA. How to cite this article Singh R, Gupta N, Gambhir N. Comparative Evaluation of Reduction in Pain Perception Using 5% Topical LA vs Freezed Cone as a Preparatory Agent for Intraoral Injection in Children and Effect of VRD as Distraction Technique. Int J Clin Pediatr Dent 2022;15(5):558-563.
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Affiliation(s)
- Rashi Singh
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Natasha Gambhir
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
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Kohli N, Hugar SM, Soneta SP, Saxena N, Kadam KS, Gokhale N. Psychological behavior management techniques to alleviate dental fear and anxiety in 4-14-year-old children in pediatric dentistry: A systematic review and meta-analysis. Dent Res J (Isfahan) 2022; 19:47. [PMID: 35915712 PMCID: PMC9338387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/05/2021] [Accepted: 01/19/2022] [Indexed: 10/26/2022] Open
Abstract
Child's uncooperative behavior can impede the efficient delivery of dental care. Therefore, in spite of exceeding availability of behavior management techniques there is a need to search for a psychological behavior management technique that effectively reduces fear and anxiety during dental treatment and instill a change in child's attitude toward the treatment and is also acceptable by the parents. The aim of our systematic review is to determine the efficacy of various psychological behavior management techniques in managing a child's behavior in pediatric dentistry by assessing the fear and anxiety levels, ease of use by the clinician, application in various operative procedures, and parental acceptance. A systematic search was conducted by two reviewers in databases PubMed, Google Scholar, Scopus, Web of Science, and Cochrane for the studies published from January 1, 2011, to December 31, 2020. Studies included were clinical studies which evaluated the efficacy of various psychological behavior management techniques by evaluating the fear and anxiety levels and the changes in behavior during dental treatment in children aged between 4 and 14 years. The studies selected were then assessed for quality with the help of predetermined criteria which categorized the studies into high, medium, and low. Through search strategy, 7147 articles were yielded. After screening through titles and abstracts, 60 nonduplicated articles were selected which were further screened for full text. At the end, 15 articles were included in systematic review and 3 articles for meta-analysis. It was concluded that all the psychological behavior management techniques aided in reduction of fear and anxiety. In noninvasive procedures, conventional psychological behavior management techniques can be effective but in invasive procedures other newer psychological behavior management techniques showed better results. The aspect of parental acceptance regarding various techniques was not discussed in any of the included studies.
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Affiliation(s)
- Neha Kohli
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Shivayogi M. Hugar
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India,Address for correspondence: Dr. Shivayogi M. Hugar, Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India. E-mail:
| | - Sanjana P. Soneta
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Nivedita Saxena
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Krishna S. Kadam
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Niraj Gokhale
- Department of Pediatric and Preventive Dentistry, KAHER'S KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
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Addab S, Hamdy R, Thorstad K, May S, Tsimicalis A. Use of virtual reality in managing paediatric procedural pain and anxiety: An integrative literature review. J Clin Nurs 2022; 31:3032-3059. [DOI: 10.1111/jocn.16217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/23/2021] [Accepted: 12/16/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Sofia Addab
- Experimental Surgery Faculty of Medicine McGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Reggie Hamdy
- Experimental Surgery Faculty of Medicine McGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Kelly Thorstad
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Sylvie May
- CHU Ste‐Justine Montreal Quebec Canada
- Faculty of Nursing Université de Montréal Montreal Quebec Canada
| | - Argerie Tsimicalis
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
- Ingram School of Nursing McGill University Montreal Quebec Canada
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Jahanimoghadam F, Shojaeepoor R, Aftabi R, Shahravan A, Horri A, Jookar S. Impact of Laughter Therapy on Anxiety and Pain in Pediatric Dentistry: A Double-Blinded Randomized, Controlled Clinical Trial. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Affiliation(s)
| | - Raziyeh Shojaeepoor
- Kerman University of Medical Sciences, Iran; Kerman University of Medical Sciences, Iran
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Al-Jaloud MM, Al-Osaidi KS, Al-Anzi SS, Al-Jalban HA, Al-Shahrani FM, Al-Omari SD, Al-Shahrani AS, Al-Enezi MM, almusjan SA, Al-Faridi SA. Effect of Various Distraction Techniques on Pain and Anxiety of Pediatric Dental Patients: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/vtftdjbaws] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Silva MVD, Bussadori SK, Santos EM, Rezende KM. Behaviour Management of the Contemporary Child in Paediatric Dentistry: An Overview of the Research. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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