Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Efficacy of kaleidoscope, virtual reality, and video games to alleviate dental anxiety during local anesthesia in children: a randomized clinical trial

  • Karthik Anchala (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital) ;
  • Voppathotty Tirumala (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital) ;
  • Kanamarlapudi Venkata Saikiran (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital) ;
  • Niharika Reddy Elicherla (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital) ;
  • Shaik Rahul (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital) ;
  • Sivakumar Nuvvula (Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital)
  • Received : 2024.04.16
  • Accepted : 2024.05.21
  • Published : 2024.06.01
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Abstract

Background: Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. Methods: Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests. Results: In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. Conclusion: Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.

Keywords

References

  1. Al Homoud RA, Alshellatie AK, Alzumaie AS, Al-Bayati SA. Behavior and anxiety levels in pediatric patient: The behavioral changes and anxiety of pediatric patient in dental clinic. Clin Exp Dent Res 2023; 9: 1223-31.  https://doi.org/10.1002/cre2.795
  2. Asaad RS, Abdulbagi RA, AlHawsawi AM, Hawsawi HM, Abusaif AM. Dental fear and anxiety among children in Jeddah, Saudi Arabia. Curr Sci Int 2019; 8: 75-82. 
  3. Radhakrishna S, Srinivasan I, Setty JV, D R MK, Melwani A, Hegde KM. Comparison of three behavior modification techniques for management of anxious children aged 4-8 years. J Dent Anesth Pain Med 2019; 19: 29-36.  https://doi.org/10.17245/jdapm.2019.19.1.29
  4. Bagher SM, Felemban OM, Alandijani AA, Tashkandi MM, Bhadila GY, Bagher AM. The effect of virtual reality distraction on anxiety level during dental treatment among anxious pediatric patients: a randomized clinical trial. J Clin Pediatr Dent 2023; 47: 63-71. 
  5. Flores AM, Gomez MR, Gonzalez GI, Delgadillo RH, Enriquez SN, Cepeda MA, et al. Distraction techniques in children with dental fear and anxiety. Int J Appl Sci 2022; 8: 513-6.  https://doi.org/10.22271/oral.2022.v8.i1h.1469
  6. Merdad L, El-Housseiny AA. Do children's previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)? BMC Oral Health 2017; 17: 47. 
  7. 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. 
  8. Shekhar S, Suprabha BS, Shenoy R, Rao A, Rao A. Effect of active and passive distraction techniques while administering local anaesthesia on the dental anxiety, behaviour and pain levels of children: a randomised controlled trial. Eur Arch Paediatr Dent 2022; 23: 417-27.  https://doi.org/10.1007/s40368-022-00698-7
  9. American Academy of Pediatric Dentistry. Behaviour guidance for the pediatric dental patient. Reference Manual of Pediatric Dentistry. Chicago, Ill: Pediatr Dent 2019: 266-79. 
  10. Al- Khotani A, Bello LA, Christidis N. Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial. Acta Odontol Scand 2016; 74: 494-501.  https://doi.org/10.1080/00016357.2016.1206211
  11. Hegde KM, R N, Srinivasan I, D R MK, Melwani A, Radhakrishna S. Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: a crossover split-mouth study. J Dent Anesth Pain Med 2019; 19: 143-9.  https://doi.org/10.17245/jdapm.2019.19.3.143
  12. Nuvvula S, Alahari S, Kamatham R, Challa RR. Effect of audiovisual distraction with 3D video glasses on dental anxiety of children experiencing administration of local analgesia: a randomised clinical trial. Eur Arch Paediatr Dent 2015; 16: 43-50.  https://doi.org/10.1007/s40368-014-0145-9
  13. Nunna M, Dasaraju RK, Kamatham R, Mallineni SK, Nuvvula 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.  https://doi.org/10.17245/jdapm.2019.19.5.277
  14. Bulut M, Kucuk Alemdar D, Bulut A, Salci G. The effect of music therapy, hand massage, and kaleidoscope usage on postoperative nausea and vomiting, pain, fear, and stress in children: a randomized controlled trial. J Perianesth Nurs 2020; 35: 649-57.  https://doi.org/10.1016/j.jopan.2020.03.013
  15. Koc Ozkan T, Polat F. The effect of virtual reality and kaleidoscope on pain and anxiety levels during venipuncture in children. J Perianesth Nurs 2020; 35: 206-11.  https://doi.org/10.1016/j.jopan.2019.08.010
  16. Pande P, Rana V, Srivastava N, Kaushik N. Effectiveness of different behavior guidance techniques in managing children with negative behavior in a dental setting: a randomized control study. J Indian Soc Pedod Prev Dent 2020; 38: 259-65.  https://doi.org/10.4103/JISPPD.JISPPD_342_20
  17. Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? J Dent Child 1962; 29: 150-63. 
  18. Shetty RM, Khandelwal M, Rath S. RMS Pictorial Scale (RMS-PS): an innovative scale for the assessment of child's dental anxiety. J Indian Soc of Pedod Prev Dent 2015; 33: 48-52.  https://doi.org/10.4103/0970-4388.149006
  19. Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs 1988; 14: 9-17. 
  20. Azab MM. Influence of different personal protective equipment on children's anxiety in dental office: a randomized controlled trial. BMC Oral Health 2022; 22: 421. 
  21. 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. 
  22. Remi RV, Anantharaj A, Praveen P, Prathibha RS, Sudhir R. Advances in pediatric dentistry: new approaches to pain control and anxiety reduction in children - a narrative review. J Dent Anesth Pain Med 2023; 23: 303-15.  https://doi.org/10.17245/jdapm.2023.23.6.303
  23. Varshitha K, Uloopi KS, Vinay C, RojaRamya KS, Chaitanya P, Ahalya P. Effectiveness of distraction with virtual reality eyewear in managing 6-11-year-old children with hearing impairment during dental treatment: a randomized controlled trial. Int J Clin Pediatr Dent 2023; 16: 820-3.  https://doi.org/10.5005/jp-journals-10005-2588
  24. Leyda-Menendez AM, Vidigal EA, Abanto J, Ribelles-Llop M. Efficacy of two behavioural management techniques during inferior alveolar nerve block administration in pre-school children: a randomised clinical trial. Eur Arch Paediatr Dent 2023; 24: 85-93.  https://doi.org/10.1007/s40368-022-00758-y
  25. Dahlander A, Soares F, Grindefjord M, Dahllof G. Factors associated with dental fear and anxiety in children aged 7 to 9 years. Dent J 2019; 7: 68. 
  26. Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent 2016; 8: 35-50.  https://doi.org/10.2147/CCIDE.S63626
  27. Kreibig SD. Autonomic nervous system activity in emotion: a review. Biol Psychol 2010; 84: 394-421.  https://doi.org/10.1016/j.biopsycho.2010.03.010
  28. Caffery Mc, Pasero C. Pain: Clinical manual. 2nd ed. St.Louis, MO: Mosby Publishers.1999, pp 399-427. 
  29. Koepp MJ, Gunn RN, Lawrence AD, Cunningham VJ, Dagher A, Jones T, Brooks DJ, et al. Evidence for striatal dopamine release during a video game. Nature 1998; 393: 266-8.  https://doi.org/10.1038/30498
  30. Attar RH, Baghdadi ZD. Comparative efficacy of active and passive distraction during restorative treatment in children using an iPad versus audio-visual eyeglasses: a randomised controlled trial. Eur Arch Paediatr Dent 2015; 16: 1-8.  https://doi.org/10.1007/s40368-014-0136-x
  31. Buldur B, Candan M. Does virtual reality affect children's dental anxiety, pain, and behaviour? A randomised, placebo-controlled, cross-over trial. Pesquisa Brasileira em Odontopediatria e Clinica Integrada 2020; 21: e0082. 
  32. Al-Khotani A, Bello LA, Christidis N. Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial. Acta Odontol Scand 2016; 74: 494-501.  https://doi.org/10.1080/00016357.2016.1206211
  33. Torres-Rojas K, Chumpitaz-Cerrate V, Chavez-Rimache L, Nunez-Diaz D, Perez-Jimenez V. Comparison of the anesthetic effect of alkalized lidocaine versus non-alkalized lidocaine administered at a slow rate in mandibular primary molars. J Dent Res Dent Clin Dent Prospects 2023; 17: 47-53.  https://doi.org/10.34172/joddd.2023.37014
  34. Shindova M, Belcheva A. Pain assessment methods among pediatric patients in medical and dental research. Med Biol Stud Clin Stud Soc Med Health Care 2016; 6: 16-23. 
  35. Gold JI, Mahrer NE. Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. J Pediatr Psychol 2018; 43: 266-75.  https://doi.org/10.1093/jpepsy/jsx129
  36. Atzori B, Lauro Grotto R, Giugni A, Calabro M, Alhalabi W, Hoffman HG. Virtual reality analgesia for pediatric dental patients. Front Psychol 2018; 9: 2265.