Evaluation of VR and AV Distraction Techniques on Reducing Anxiety Levels of Children during Dental Procedures: Randomized Control Trial

Aim and background: Dental anxiety in children is a common challenge faced by pediatric dentists, often leading to poor cooperation during dental procedures.The present study was conducted to evaluate the effectiveness of virtual reality (VR) and audiovisual (AV) distraction methods in reducing anxiety levels in children undergoing dental treatment.Materials and methods: A total of 42 children, aged 6-10 years, were included in the study.All participants received similar dental treatments and were randomly assigned to either the VR group or the AV group using the sequentially numbered, opaque, sealed envelope (SNOSE) method for allocation concealment.A single examiner conducted all procedures to minimize bias.Anxiety levels were assessed at preoperative and postoperative stages using the Venham clinical anxiety rating scale (VCARS), heart rate (HR), oxygen saturation (SpO₂), and galvanic skin response (GSR).Results: Intergroup comparisons revealed no significant difference in HR before the intervention (p = 0.562); however, postintervention, a significant difference (p = 0.036) was observed, with HR remaining stable in the VR group while increasing in the AV group.Significant intergroup differences in GSR were noted both preintervention (p = 0.025) and postintervention (p = 0.001), with the VR group showing a reduction in mean scores postintervention, while the AV group exhibited elevated scores.No significant changes were observed in SpO₂ levels between the groups pre-(p = 0.099) and postintervention (p = 0.622).Significant differences in VCARS scores postintervention (p = 0.002) indicated a greater reduction in anxiety in the VR group compared to the AV group.Conclusion: Galvanic skin response emerged as a reliable, noninvasive method to assess changes in children's anxiety levels.The use of distraction techniques, particularly VR, was found to be highly effective in reducing anxiety, thereby enhancing patient cooperation and optimizing the efficiency of dental procedures.These results support the integration of GSR monitoring and VR-based interventions into pediatric dental practice to improve patient experience and treatment outcomes.Clinical significance: The study demonstrates that VR distraction is more effective than AV methods in reducing pediatric dental anxiety, as evidenced by lower HR, GSR, and VCARS scores.Integrating VR and GSR monitoring in pediatric dentistry can enhance patient cooperation and improve treatment outcomes.