The aim of this study is to assess the effectiveness of audiovisual distraction technique with video eyewear and computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in phobic pediatric patients undergoing pulp therapy of primary molars.
This randomized, crossover clinical study includes 60 children, aged between 4 and 7-year-old (31 boys and 29 girls). Children were randomly distributed equally into two groups as A and B. This study involved two treatment sessions of pulp therapy, 1-week apart. During treatment session I, group A had an audiovisual distraction with video eyewear, whereas group B had audiovisual distraction using projector display only without video eyewear. During treatment session II, group A had undergone pulp therapy without video eyewear distraction, whereas group B had the pulp treatment using video eyewear distraction. Each session involved the pulp therapy of equivalent teeth in the opposite sides of the mouth. At each visit scores on the Modified Child Dental Anxiety Scale (MCDAS) (f) were used to evaluate the level of anxiety before treatment. After the procedure, children were instructed to rate their pain during treatment on the Wong Bakers’ faces pain scale. Changes in pulse oximeter and heart rate were recorded in every 10 min.
From preoperative treatment session I (with video eyewear) to preoperative treatment session II (without video eyewear) for the MCDAS (f), a significant ( P > 0.03) change in the mean anxiety score was observed for group A. Self-reported mean pain score decreases dramatically after treatment sessions’ with video eyewear for both groups.
The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.