Effects of Virtual Reality Versus Game Applications on Children’s Dental Fear: A Randomized Clinical Trial

Document Type : original article

Authors

1 Department of Paediatric Dentistry, School of dentistry, Tehran University of Medical Sciences, Tehran, Iran.

2 School of dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran.

3 Researcher, Dental research center, Dentistry research institute, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Management of dental anxiety and fear of pediatric dental patients is a major goal in pediatric dentistry to create a positive attitude towards dental procedures and perform a successful treatment. Preoperative positive imagery and distraction during treatment are some of the non-pharmaceutical approaches for reduction of fear and anxiety of pediatric dental patients. This study aimed to compare the efficacy of dental simulation game applications (apps) in smartphones and virtual reality glasses on the management of dental anxiety and fear in 5-8-year-old dental patients.
Methods: This randomized clinical trial was conducted on 42 eligible children between 5-8 years in their first dental visit. After prophylaxis and fluoride therapy, patients were randomly assigned to two groups (n=21). Group 1 used Virtual reality glasses during the procedure while group 2 used dental simulation game apps prior to treatment. After completion of dental procedure, dental anxiety and fear of children were recorded in both groups using the Facial Image Scale (FIS) and Modified Child Dental Anxiety Scale (MCDAS); and the results were compared by t-test and Mann-Whitney test (alpha=0.05).
Results: The FIS scores were not significantly different between the groups (P=0.068). However, the MCDAS scores showed significantly lower levels of dental anxiety and fear in the VR group compared with the app group (P=0.002).
Conclusion: Wearing Virtual reality glasses operating based on the distraction technique during dental procedures was more effective than preoperative use of dental simulation game apps for reduction of dental anxiety and fear of 5-8-year-old children.

Keywords

References

  1. Stigers JI. Nonpharmacologic management of children's behavior. In: Dean JA, Jones JE, Sanders BJ, Walke Vinson LA, Yepes JF. Dentistry for the child and adolescent. 11 ed, Elsevier, Inc. 2022: 340- 55.
  2. Boyce WT. The lifelong effects of early childhood adversity and toxic stress. Pediatr Dent 2014; 36 92): 102-8.
  3. Brahm CO, Lundgren J, Carlsson SG, Nilsson P, Corbeil J, Hägglin C. Dentists' views on fearful patients. Problems and promises. Swed Dent J. 2012; 36(2):79-89.
  4. Behavior Guidance for the Pediatric Dental Patient. Pediatr Dent. 2018 Oct 15; 40(6):254-67.
  5. Paryab M, Arab Z. The effect of Filmed modeling on the anxious and cooperative behavior of 4-6 years old children during dental treatment: A randomized clinical trial study. Dent Res J (Isfahan). 2014; 11(4):502-7.
  6. Sinha M, Christopher NC, Fenn R, Reeves L. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics. 2006; 117(4):1162-8.
  7. Buldur B. Behavior Management in Pediatric Dentistry: An Overview and Interpretation. Pesqui bras odontopediatria clín integr. 2019; 19(1):46-9.
  8. 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(3):268-78.
  9. Griffiths. Video games: The good news. Education and Health. 1997; 15:10-2.
  10. Panchal J, Panda A, Trivedi K, Chari D, Shah R, Parmar B. Comparative evaluation of the effectiveness of two innovative methods in the management of anxiety in a dental office: a randomized controlled trial. J Dent Anesth Pain Med 2022; 22(4):295-304.
  11. Kevadia MV, Sandhyarani B, Patil AT, Gunda SA. Comparative Evaluation of Effectiveness of Tell-Play-Do, Film Modeling and Use of Smartphone Dental Application in the Management of Child Behavior. Int J Clin Pediatr Dent. 2020; 13(6):682-7.
  12. Elicherla SR, Bandi S, Nuvvula S, Challa RS, Saikiran KV, Priyanka VJ. Comparative evaluation of the effectiveness of a mobile app (Little Lovely Dentist) and the tell-show-do technique in the management of dental anxiety and fear: a randomized controlled trial. J Dent Anesth Pain Med. 2019; 19(6):369-78.
  13. Shetty V, Suresh LR, Hegde AM. Effect of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 5 to 8 Year Old Children. J Clin Pediatr Dent. 2019; 43(2):97-102.
  14. Niharika P, Reddy NV, Srujana P, Srikanth K, Daneswari V, Geetha KS. Effects of distraction using virtual reality technology on pain perception and anxiety levels in children during pulp therapy of primary molars. J Indian Soc PedodPrev Dent. 2018; 36(4):364-9.
  15. Meshki R, Basir L, Alidadi F, Behbudi A, Rakhshan V. Effects of Pretreatment Exposure to Dental Practice Using a Smartphone Dental Simulation Game on Children's Pain and Anxiety: A Preliminary Double-Blind Randomized Clinical Trial. J Dent (Tehran). 2018; 15(4):250-8.
  16. Ghadimi S, Estaki Z,Rahbar P, Shamshiri AR. Effect of Visual Distraction on Children’s Anxiety During Dental Treatment: A Crossover Randomized Clinical Trial. Eur Arch Paediatr Dent. 2018; 19(4):239-44.
  17. Panda A. Effect of Virtual Reality Distraction on Pain Perception during Dental Treatment in Children. International Journal of Oral Care & Research. 2017; 5:278-81.
  18. Patil V, Vaid K, Gokhale N, Shah P, Mundada M, Hugar S. Evaluation of effectiveness of dental apps in management of child behavior: A pilot study. International Journal of Pedodontic Rehabilitation. 2017; 2(1):14-8.
  19. Harsh A Shah NSK, Sadanand Kulkarni and Shikha Choubey. Evaluation of dental anxiety and hemodynamic changes (Sympatho-Adrenal Response) during various dental procedures using smartphone applications v/s traditional behavior management techniques in pediatric patients. International Journal of Applied Research. 2017; 3(5):429-33.
  20. Sullivan C, Schneider PE, Musselman RJ, Dummett CO Jr, Gardiner D. The effect of virtual reality during dental treatment on child anxiety and behavior. ASDC J Dent Child. 2000 May-Jun; 67(3):193-6, 160-1
  21. Lee JH, Jung HK, Lee GG, Kim HY, Park SG, Woo SC. Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients. Korean J Anesthesiol. 2013; 65(6):508-18.
  22. Aminabadi NA, Erfanparast L, Sohrabi A, Oskouei SG, Naghili A. 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(4):117-24.
  23. Patel A, Schieble T, Davidson M, Tran MC, Schoenberg C, Delphin E, et al. Distraction with a hand-held video game reduces pediatric preoperative anxiety. PaediatrAnaesth. 2006; 16(10):1019-27.
  24. Shahrbanian S, Ma X, Aghaei N, N K-B, Simmonds M. Use of virtual reality (immersive vs. non immersive) for pain management in children and adults: A systematic review of evidence from randomized controlled trials. European Journal of Experimental Biology. 2012; 2: 1408-22.
  25. Kaur R, Jindal R, Dua R, Mahajan S, Sethi K, Garg S. Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients. J Indian Soc PedodPrev Dent. 2015; 33(3):192-203.
  26. Prabhakar AR, Marwah N, Raju OS. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. J Indian Soc PedodPrev Dent. 2007; 25(4):177-82.
  27. Frankle S N. Should the Parent Remain with the Child in the Dental Operatory. J Dent Child. 1962; 29:150-63.
  28. Javadinejad Sh, Soheilipour F, Jaderi P, Nasr N. Reliability and Validity of the RMS Pictorial Scale in Comparison with Facial Image Scale and Venham Picture Test for Assessment of Child Anxiety. J Isfahan Dent Sch 2018; 14(2):207-14
  29. Javadinejad S, Farajzadegan Z, Sherkat S, Shokri Mozhdehi M. Reliability and Validity of the Modified Retranslated Persian Version of Child Dental Anxiety Scale in Comparison with Corah’s Dental Anxiety Scale and Venham Picture Test. J Res Dent Sci 2014; 11 (2):112-5.
  30. Afshar H, Baradaran Nakhjavani Y, Mahmoudi-Gharaei J, Paryab M, Zadhoosh S. The Effect of Parental Presence on the 5 year-Old Children's Anxiety and Cooperative Behavior in the First and Second Dental Visit. Iran J Pediatr. 2011 Jun; 21(2):193-200.
  31. Corkey B, Freeman R. Predictors of dental anxiety in six-year-old children: findings from a pilot study. ASDC J Dent Child. 1994; 61(4):267-71.
  32. Holst A, Crossner CG. Direct ratings of acceptance of dental treatment in Swedish children. Community Dent Oral Epidemiol. 1987; 15(5):258-63.
  33. Klingberg G, Berggren U, Carlsson SG, Noren JG. Child dental fear: cause-related factors and clinical effects. Eur J Oral Sci. 1995; 103(6):405-12.
  34. Paryab M, Hosseinbor M. Dental anxiety and behavioral problems: a study of prevalence and related factors among a group of Iranian children aged 6-12. J Indian Soc Pedod Prev Dent. 2013 Apr-Jun; 31(2):82-6.
  35. Howitt JW, Stricker G. Sequential changes in response to dental procedures. J Dent Res. 1970; 49(5):1074-7.

 

Journal of Pediatric Perspectives
Volume 10, Issue 12
December 2022
Pages 17068-17076

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