Impact of Virtual Reality Goggles as a Distraction Technique on the Pain Perception and Heart Rate of Pediatric Dental Patients

Authors

  • Hammad Hassan Science of Dental Materials, University College of Medicine and Dentistry, University of Lahore, Pakistan.
  • Syeda Anita Hassan Hamdard College of Medicine and Dentistry, Karachi, Pakistan.
  • Abdul Razzaq Department of Oral Pathology, Avicenna Dental College Lahore, Pakistan.
  • Maheen Edrees de' Montmorency College of Dentistry, Lahore, Pakistan.
  • Zenab Yaasir Science of Dental Materials, Akhter Saeed Medical and Dental College, Lahore, Pakistan.
  • Asma Shakoor Community & Preventive Dentistry Dentistry, CMH Lahore Medical College, NUMS, Pakistan.

DOI:

https://doi.org/10.36570/jduhs.2023.3.1949

Keywords:

Dentists, Pediatric Dentistry, Virtual Reality

Abstract

Objective: To assess the impact of virtual reality (VR) glasses on pain perception and heart rate during inferior
alveolar nerve block in pediatric patients.
Methods: This quasi-experimental investigation was conducted at a dental hospital (University College of
Dentistry), Lahore, Pakistan from June to February 2022. The study included healthy children aged four to twelve
years who needed dental treatment involving an inferior alveolar nerve block. The distraction was done using VR
glasses. Participants were arbitrarily divided into two groups, one with VR and the other without VR. The
patients' behavior was recorded during the nerve block using the face, legs, activity, cry, and consolability
(FLACC) behavioral pain assessment scale. The Pulse rate was monitored before, during, and after the procedure.
Results:Of the total 68 participants, the median age was 8 (7 – 9) years. There were 36 (52.9%) patients in the nonVR group and 32 (47.1%) patients in the VR group. The median FLAACC score was found to be significantly lower in
the VR group as compared to the non-VR group i.e., 1.0 (1.0 - 2.0) vs. 5.0 (4.0 - 5.0) (p-value <0.001) respectively.
Both groups showed significant median differences in face (p-value 0.008), legs (p-value <0.001), activity (p-value
<0.001), crying (p-value <0.001), and consolability (p-value <0.001) scores. During treatment, the heart rate of VR
participants was found to be significantly lower than the non-VR group i.e., 93.0 (90.0 – 96.0) vs. 100.0 (87.7 –
104.0) (p-value 0.044) respectively.
Conclusion: The study revealed that the use of VR goggles as a distraction method demonstrated a significant
reduction in pain perception and heart rate.

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Author Biographies

Syeda Anita Hassan, Hamdard College of Medicine and Dentistry, Karachi, Pakistan.

BDS Graduate

Abdul Razzaq, Department of Oral Pathology, Avicenna Dental College Lahore, Pakistan.

Demonstrator, Department of Oral Pathology

Maheen Edrees, de' Montmorency College of Dentistry, Lahore, Pakistan.

BDS Graduate

Asma Shakoor, Community & Preventive Dentistry Dentistry, CMH Lahore Medical College, NUMS, Pakistan.

Associate Professor, Community Dentistry

References

Chishti F, Hassan HR. Qazi S. Dental anxiety among students of Lahore, Pakistan. Pak J Med Health Sci 2021; 15:2659-61. doi:10.53350/pjmhs211592659

Allani S, Setty JV. Effectiveness of distraction techniques in the management of anxious children in the dental operatory. IOSR J Dent Med Sci 2016; 15:69-73.

doi:10.9790/0853-1510026973

Townsend JA. Protective stabilization in the dental set-ting: a clinical guide. Chapter, Dental Care for Children with Special Needs 2019: 247-67.

doi:10.1007/978-3-030-10483-2_11

Curto Prieto D, Marco B, Tomas JF. P-062: Physical res-traints reduction program. Eur Geriatr Med 2015; 6:S48. doi:10.1016/s1878-7649(15)30165-0

Gs G, George S, Anandaraj S, Sain S, Jose D, Sreenivas A, et al. Comparative evaluation of the efficacy of virtual reality distraction, audio distraction and tell-show-do techniques in reducing the anxiety level of pediatric dental patients: An in vivo study. Int J Clin Pediatr Dent 2021; 14(Suppl 2):S173–8.

doi:10.5005/jp-journals-10005-2106

Nunna M, Dasaraju RK, Kamatham R, Mallineni SK, Nuv-vula S. Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children. J Dent Anesth Pain Med 2019; 19:277–88. doi:10.17245/jdapm.2019.19.5.2777.

Chow H, Hon J, Chua W, Chuan A. Effect of virtual reality therapy in reducing pain and anxiety for cancer-related medical procedures: a systematic narrative review. J Pain Symptom Manage 2021; 61:384-94.

doi:10.1016/j.jpainsymman.2020.08.016

Ali SA, Rais RB. Pakistan's healthcare system: a case of elite capture. South Asia: J S Asian Stud 2021; 44:1206-28. doi:10.1080/00856401.2021.1980840

Sattar MU, Palaniappan S, Lokman A, Shah N, Khalid U, Hasan R. Motivating medical students using virtual reality-based education. Int J Emerg Technol Learn 2020; 15:160. doi:10.3991/ijet.v15i02.11394

Shetty S, Katge F, Koticha P, 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; 12:297–302. doi:10.5005/jp-journals-10005-1640

Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Relia-bility and validity of the face, legs, activity, cry, controllability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care 2010; 19:55-61. doi:10.4037/ajcc2010624

Coxon JD, Hosey MT, Newton JT. The impact of dental anxiety on the oral health of children aged 5 and 8 years: a regression analysis of the child dental health survey 2013. Br Dent J2019; 227:818-22.

doi:10.1038/s41415-019-0853-y

CustOdio NB, Cademartori MG, Azevedo MS, Mendes MA, Schardozim LR, Costa LR, et al. Efficacy of audiovisual distraction using eyeglasses during dental care: a randomized clinical trial. Braz Oral Res 2021; 35:e26. doi:10.1590/1807-3107bor-2021.vol35.0026

Cunningham A, McPolin O, Fallis R, Coyle C, Best P, McKenna G. A systematic review of the use of virtual reality or dental smartphone applications as interventions for the management of pediatric dental anxiety. BMC Oral Health 2021; 21. doi:10.1186/s12903-021-01602-3

LOpez-Valverde N, Muriel-Fernández J, López-Valverde A, Valero Juan LF, Ramírez JM, Flores Fraile J, et al. Use of virtual reality for the management of anxiety and pain in dental treatments: Systematic review and meta-analysis. J Clin Med 2020; 9:1025.

doi:10.3390/jcm9082404

Martinez-Bernal D, Vidovich C, Keenan C, Correll L, Laserna A, Hasselberg M, et al. The use of virtual reality to reduce pain and anxiety in surgical procedures of the oral cavity: A scoping review. J Oral Maxillofac Surg 2023; 81:467–82 doi:10.1016/j.joms.2022.11.011

Eijlers R, Utens EM, Staals LM, de Nijs PF, Berghmans JM, Wijnen RM, et al. Systematic review and meta-analysis of virtual reality in pediatrics: Effects on pain and anxiety: Effects on pain and anxiety. Anesth Analg 2019; 129:1344–53.

doi:10.1213/ANE.0000000000004165

Alshatrat SM, Sabarini JM, Hammouri HM, Al‐Bakri IA, Al‐Omari WM. Effect of immersive virtual reality on pain in different dental procedures in children: A pilot study. Int J Paediatr Dent 2021; 32:264-72. doi:10.1111/ipd.12851

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; 43:97-102. doi:10.17796/1053-4625-43.2.5

Ran L, Zhao N, Fan L, Zhou P, Zhang C, Yu C. Application of virtual reality on non-drug behavioral management of short-term dental procedure in children. Trials 2021; 22:562. doi:10.1186/s13063-021-05540-x

Du Q, Ma X, Wang S, Zhou S, Luo C, Tian K, et al. A digital intervention using virtual reality helmets to reduce dental anxiety of children under local anesthesia and primary teeth extraction: A randomized clinical trial. Brain Behav 2022; 12:e2600. doi.org/10.1002/brb3.2600

Mahmoud Y, Dowidar K, ElHabashy L, Deghady A. Effect of virtual reality glasses distraction on the anxiety of preschool children during pulpotomy treatment: Randomized controlled clinical trial. Alex Dent J 2022; 47:212. doi:10.21608/adjalexu.2021.70615.1178

Yan X, Yan Y, Cao M. Effectiveness of virtual reality distraction interventions to reduce dental anxiety in pediatric patients: A systematic review and meta-analysis. J Dent 2023; 132:104455. doi:10.1016/j.jdent.2023.104455

Adel Zakhary S, Eid, Wassef N. Audio-visual distraction effect on heart rate in children during dental treatment, a randomized clinical trial. Egypt Dent J 2020; 66:27-34. doi:10.21608/edj.2020.77496

Felemban OM, Alshamrani RM, Aljeddawi DH, Bagher SM. Effect of virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric patients: a randomized clinical trial. BMC Oral Health 2021; 21:321. doi:10.1186/s12903-021-01678-x

What are the risks of virtual reality and augmented reality, and what good practices does ANSES recommend? Anses - Agence nationale de securite sanitaire de l'alimentation, de l'environnement et du travail. [Internet].2021. Available from https://www.anses.fr/en/content/what-are-risks-virtual-reality-and-augmented-reality-and-what-good-practices-does-anses

Bailey B, Bryant L, Hemsley B. Virtual reality and augmented reality for children, adolescents, and adults with communication disability and neurodevelo-pmental disorders: a systematic review. Rev J Autism Dev Disord 2022; 9:160-83. doi:10.1007/s40489-020-00230-x

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Published

2023-11-22

How to Cite

Hammad Hassan, Syeda Anita Hassan, Razzaq, A., Edrees, M., Yaasir, Z., & Shakoor, A. (2023). Impact of Virtual Reality Goggles as a Distraction Technique on the Pain Perception and Heart Rate of Pediatric Dental Patients. Journal of the Dow University of Health Sciences (JDUHS), 17(3). https://doi.org/10.36570/jduhs.2023.3.1949

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Original Articles