Citation Information :
Koticha P, Katge F, Shetty S, Patil DP. Effectiveness of Virtual Reality Eyeglasses as a Distraction Aid to Reduce Anxiety among 6–10-year-old Children Undergoing Dental Extraction Procedure. Int J Clin Pediatr Dent 2019; 12 (4):297-302.
Introduction: Distraction is commonly used nonpharmacologic pain management technique by pedodontists to manage pain and anxiety. There are some new techniques which uses audiovideo stimulation and distract the patient by exposing him or her to three-dimensional videos. These techniques are referred to as virtual reality audiovisual systems. The aim is to evaluate the effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety of children undergoing extraction procedure.
Objective: The aim of this study is to evaluate the effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety of children undergoing dental extraction procedure.
Materials and methods: Thirty children of age 6–10 years (n = 60) with bilateral carious primary molars indicated for extraction were randomly selected and divided into two groups of 30 each. The first one was group I (VR group) (n = 30) and group II (control group) (n = 30). Anxiety was measured by using Venham\'s picture test, pulse rate and oxygen saturation. Anxiety level between group I and group II was assessed using paired “t” test.
Results: The mean pulse rate values after extraction procedure in group I were 107.833 ± 1.356 and group II were 108.4 ± 0.927 respectively. The pulse rate values in intergroup comparison were found statistically significant p = 0.03.
Conclusion: The virtual reality used as a distraction technique improves the physiologic parameters of children aged 6–10 years but does not reduce the patient\'s self-reported anxiety according to Venham\'s picture test used.
Bankole OO, Aderinokun GA, et al. Maternal and child's anxiety—effect on child's behaviour at dental appointments and treatments. Afr J Med Med Sci 2002;31:349–352.
Folayan MO, Fatusi A. Effect of psychological management techniques on specific item score change during the management of dental fear in children. J Clin Pediatr Dent 2005;29:335–340. DOI: 10.17796/jcpd.29.4.d431t7024u4037u6.
Asl Aminabadi N, Erfanparast L, et al. The impact of virtual reality distraction on pain and anxiety during dental treatment in 4–6 year-old children: a randomized controlled clinical trial. J Dent Res Dent Clin Dent Prospects 2012;6:117–124. DOI: 10.5681/joddd.2012.025.
Richmond BJ, Sato T. Enhancement of inferior temporal neurons during visual discrimination. J Neurophysiol 1987;58:1292–1306. DOI: 10.1152/jn.1918.104.22.1682.
Kleiber C, Harper DC. Effects of distraction on children's pain and distress during medical procedures: a meta-analysis. Nurs Res 1999 Jan-Feb;48(1):44–49. DOI: 10.1097/00006199-199901000-00007.
Sullivan C, Schneider PE, et al. The effect of virtual reality during dental treatment on child anxiety and behavior. ASDC J Dent Child 2000;67:193.
Wismeijer AA, Vingerhoets AJ. The use of virtual reality and audiovisual eyeglass systems as adjunct analgesic techniques: A review of the literature. Ann Behav Med 2005;30:268–278. DOI: 10.1207/s15324796abm3003_11.
Sinha M, Christopher NC, et al. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics 2006;117:1162–1168. DOI: 10.1542/peds.2005-1100.
Prabhakar AR, Marwah N, et al. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. J Indian Soc Pedod Prev Dent 2007;25:177–182. DOI: 10.4103/0970-4388.37014.
Dahlquist LM, Weiss KE, et al. Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. J Pediatr Psychol 2009;34:574–584. DOI: 10.1093/jpepsy/jsn023.
Armfield JM, Spencer AJ, et al. Dental fear in Australia: who's afraid of the dentist? Aust Dent J 2006;51:78–85. DOI: 10.1111/j.1834-7819.2006.tb00405.x.
Abdelmoniem SA, Mahmoud SA. Comparative evaluation of passive, active, and passive-active distraction techniques on pain perception during local anesthesia administration in children. J Adv Res 2016;7(3):551–556. DOI: 10.1016/j.jare.2015.10.001.
Wiederhold MD, Wiederhold BK. Virtual reality and interactive simulation for pain distraction. Pain Medicine 2007;8(3):S182–S188. DOI: 10.1111/j.1526-4637.2007.00381.x.
Wiederhold MD, Gao K, et al. Clinical use of virtual reality distraction system to reduce anxiety and pain in dental procedures. Cyberpsychol Behav Soc Netw 2014;17(6):359–365. DOI: 10.1089/cyber. 2014.0203.
El-Sharkawi HF, El-Housseiny AA, et al. Effectiveness of new distraction technique on pain associated with injection of local anesthesia for children. Pediatr Dent 2012;34(2):35–38.
Hoge MA, Howard MR, et al. Use of video eyewear to manage distress in children during restorative dental treatment. Pediatr Dent 2012;34(5):378–382.
Venham LL, Gaulin-Kremer E, et al. Interval rating scales for children's dental anxiety and uncooperative behavior. Paediatr Dent 1980;2(3):195–202.
Navit S, Johri N, et al. Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients. J Clin Diagn Res 2015;9(12):ZC05–ZC09. DOI: 10.7860/JCDR/2015/15564.6910.
Pinkham JR. Behavior management of children in the dental office. Dent Clin North Am 2000;44(3):471–486.
Al-Khotani A, Bello LA, et al. Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial. Acta Odontol Scand 2016;74(6):494–501. DOI: 10.1080/00016357.2016.1206211.
Pozos-Guillén A, Chavarría-Bolaños D, et al. Split-mouth design in Paediatric Dentistry clinical trials. Eur J Paediatr Dent 2017 Mar;18(1):61–65. DOI: 10.23804/ejpd.2017.18.01.13.
Slifer KJ, Tucker CL, et al. Helping children and caregivers cope with repeated invasive procedures: how are we doing? J Clin Psychol 2002;9(2):131–152.
Kreibig SD. Autonomic nervous system activity in emotions: a review. Biol Psychol 2010;84(3):394–421. DOI: 10.1016/j.biopsycho. 2010.03.010.
Mccarthy F. A clinical study of blood pressure responses to epinephrine-containing local anesthetic solutions. J Dent Res 1957; 36(1):132–141. DOI: 10.1177/00220345570360010901.
Hoffman H, Garcia-Palacios A, et al. The effectiveness of virtual reality for dental pain control. Cyberpsychol Behav 2001;4(4):527–535. DOI: 10.1089/109493101750527088.
Nilson S, Finnstrom B, et al. The use of virtual reality for needle related procedural pain and distress in children and adolescents in a pediatric oncology unit. Eur J Oncol Nurs 2009;13(2):102–109. DOI: 10.1016/j.ejon.2009.01.003.
Sharar SR, Carrougher GJ, et al. Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies. Arc Phys Med Rehabil 2007;88(12):S43–S49. DOI: 10.1016/j.apmr.2007.09.004.
Hoffman HG, Patterson DR, et al. Effectiveness of virtual reality-based pain control with multiple treatments. Clin J Pain 2001;17(3):229–235. DOI: 10.1097/00002508-200109000-00007.
Kaur B, Sarin J, et al. Effectiveness of cartoon distraction on pain perception and distress in children during intravenous injection. IOSR Journal of Nursing and Health Science 2014;3(3):8–15. DOI: 10.9790/1959-03320815.
Rayen R, Muthu MS, et al. Evaluation of physiological and behavioral measures in relation to dental anxiety during sequential dental visits in children. Indian J Dent Res 2006;17(1):27–34. DOI: 10.4103/0970-9290.29895.
Guinot Jimeno F, Mercadé Bellido M, et al. Effect of audiovisual distraction on children's behavior anxiety and pain in the dental setting. Eur J Paediatr Dent 2014;15(3):297–302.
Baghdadi ZD. Evaluation of audio analgesia for restorative care in children treated using electronic Dental anesthesia. J Clin Pediatr Dent 2000;25(1):9–12.