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      Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children

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          Abstract

          Background

          This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children.

          Methods

          A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7–11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates.

          Results

          Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores.

          Conclusions

          VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

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          Most cited references59

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          Pain in children: comparison of assessment scales.

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            Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy.

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              Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors.

              The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental behaviour management problems (DBMP) in children and adolescents, and their relationships to age, sex, general anxiety, temperament, and general behavioural problems. A broad search of the PubMed database was performed using three combinations of search terms. A large proportion of the identified articles could not be used for the review owing to inadequate endpoints, measures or poor study design. Thirty-two papers of acceptable quality were identified and reviewed. The prevalence of both DFA and DBMP were estimated to 9%, with a decrease in prevalence with age. DFA/DBMP were more frequent in girls. DFA/DBMP were related to general fear and both internalizing and externalizing behavioural problems, although these relationships were not clear-cut. Temperament was related to both DFA and DBMP but with different temperamental characteristics, while general behavioural problems mainly correlated with DBMP. DFA/DBMP are common, and several psychological factors are associated with the development of these problems. In order to better understand these relationships, a number of issues concerning design of research and measurement of DFA/DBMP have to be dealt with.
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                Author and article information

                Journal
                J Dent Anesth Pain Med
                J Dent Anesth Pain Med
                JDAPM
                Journal of Dental Anesthesia and Pain Medicine
                The Korean Dental Society of Anesthsiology
                2383-9309
                2383-9317
                October 2019
                30 October 2019
                : 19
                : 5
                : 277-288
                Affiliations
                [1 ]Department of Paedodontics and Preventive Dentistry, Narayana Dental College, Nellore, India.
                [2 ]Department of Paedodontics and Preventive Dentistry, Priyadarshini Dental College and Hospital, Thiruvallur, India.
                [3 ]Pediatric Dentistry, Preventive Dental Science, College of Dentistry, Majmaah University, Kingdom of Saudi Arabia.
                Author notes
                Corresponding Author: Dr. Sreekanth Kumar Mallineni MDS, FICD, Associate Professor, Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore- 524003, AP, India. Tel: +91-8522900000, drmallineni@ 123456gmail.com ; s.mallineni@ 123456mu.edu.sa
                Author information
                https://orcid.org/0000-0002-8820-941X
                https://orcid.org/0000-0002-5715-4620
                https://orcid.org/0000-0002-9432-2590
                https://orcid.org/0000-0002-1204-5551
                Article
                10.17245/jdapm.2019.19.5.277
                6834716
                31723668
                9219339f-77d1-4035-9578-b08a8c4bbcfd
                Copyright © 2019 Journal of Dental Anesthesia and Pain Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 June 2019
                : 26 August 2019
                : 09 September 2019
                Categories
                Original Article

                counter-stimulation,dental anxiety,distraction,pain perception,virtual reality

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