International Journal of Clinical Pediatric Dentistry

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VOLUME 18 , ISSUE 1 ( January, 2025 ) > List of Articles

ORIGINAL RESEARCH

Comparison of Effectiveness of Virtual Reality and Clown Dentists as Anxiety Management Tools among 3–13-year-old Children for Dental Procedures: A Randomized Controlled Trial

Sfurty Prakash, Neha Sheoran, Bhavna G Saraf, Vrinda Sharma, Wajiha Khan, Manish Shaw

Keywords : Behavior management, Dental anxiety, Hospital clown, Virtual reality

Citation Information : Prakash S, Sheoran N, Saraf BG, Sharma V, Khan W, Shaw M. Comparison of Effectiveness of Virtual Reality and Clown Dentists as Anxiety Management Tools among 3–13-year-old Children for Dental Procedures: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2025; 18 (1):105-113.

DOI: 10.5005/jp-journals-10005-2972

License: CC BY-NC 4.0

Published Online: 14-02-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Background: The procedural pain in dentistry has undesirable effect on child's psychology and future dental visits; therefore, means to decrease these is absolutely essential. Aim: To assess the effectiveness and comparison of virtual reality (VR) and clown dentists as anxiety management tools. Design: This prospective three-arm randomized controlled trial included children aged 3–13 years. They were divided randomly into three groups, a control group (group I) in whom no anxiety management was given and two test groups in whom intervention by VR (group II) or clown dentists/hospital clown (group III) was imparted. Heart rate and anxiety scores were measured by Chota Bheem–Chutki (CBC) pain scale before and after procedure. Results: Data was analyzed for 159 children. The mean anxiety pretreatment in group I was 2.09, in group II it was 3.03, and in group III it was 3.15. Posttreatment, the anxiety level spiked in group I to 3.20, whereas it dipped in group II and III, the mean level being 1.81 and 1.84, respectively, the difference being statistically significant. Conclusion: The anxiety and hemodynamic parameter were lower in both intervention groups (VR and dental clown) than those of the control group.


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  1. Grisolia BM, Dos Santos APP, Dhyppolito IM, et al. Prevalence of dental anxiety in children and adolescents globally: a systematic review and metanalysis. Int J Paediatr Dent 2021;31(2):168–183. DOI: 10.1111/ipd.12712
  2. Chhabra N, Chhabra A, Walia G. Prevalence of dental anxiety and fear among five to ten year old children: a behaviour based cross sectional study. Minerva Stomatol 2012;61(3):83–89. PMID: 22402299.
  3. Sadana G, Grover R, Mehra M, et al. A novel Chhota Bheem–Chutki scale for dental anxiety determination in children. J Int Soc Prev Community Dent 2016;6:200–205. DOI: 10.4103/2231-0762.183108
  4. Alshatrat SM, Sabarini JM, Hammouri HM, et al. Effect of immersive virtual reality on pain in different dental procedures in children: a pilot study. Int J Paediatr Dent 2022;32(2):264–272. DOI: 10.1111/ipd.12851
  5. Sridharan K, Sivaramakrishnan G. Therapeutic clowns in pediatrics: a systematic review and meta-analysis of randomized controlled trials. Eur J Pediatr 2016;175:1353–1360. DOI: 10.1007/s00431-016-2764-0
  6. Wolyniez I, Rimon A, Scolnik D, et al. The effect of a medical clown on pain during intravenous access in the pediatric emergency department: a randomized prospective pilot study. Clin Pediatr (Phila) 2013;52:1168–1172. DOI: 10.1177/0009922813502257
  7. Agostini F, Monti F, Neri E, et al. Parental anxiety and stress before pediatric anesthesia: a pilot study on the effectiveness of preoperative clown intervention. J Health Psychol 2014;19(5):587–601. DOI: 10.1177/1359105313475900
  8. Lopes-Junior LC, Silveira DSC, Olson K, et al. Clown intervention on psychological stress and fatigue in pediatric patients with cancer undergoing chemotherapy. Cancer Nurs 2020;43(4):290–299. DOI: 10.1097/NCC.0000000000000690
  9. Allani S, Setty JV. Effectiveness of distraction techniques in the management of anxious children in the dental operatory. IOSR J Dent Med Sci 2016;15(10):69–73. DOI: 10.9790/0853-1510026973
  10. Chaudhary S, Showkat I, Sinha A. Comparative evaluation of the effectiveness of active and passive distraction aids in the management of anxious pediatric dental patients. Chron Dent Res 2019;8(2):2–6. DOI: 10.36106/ijsr
  11. Koticha P, Katge F, Shetty S, et al. 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. DOI: 10.5005/jp-journals-10005-1640
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