Effectiveness of Audiovisual Distraction During Dental Treatment Under Nitrous Oxide/Oxygen Conscious Sedation in Paediatric Patients: A Randomized Crossover Clinical Trial

Background/Objectives: Dental anxiety represents a major challenge in paediatric dentistry and is a frequent cause of non-cooperative behaviour during dental treatment. Nitrous oxide/oxygen inhalation conscious sedation is widely used to reduce anxiety in children, while audiovisual distraction is a non-pharmacological behavioural technique aimed at diverting attention from stressful stimuli. Evidence regarding the combined effect of these two approaches during dental treatment is still limited. Methods: This randomized crossover clinical trial included 25 paediatric patients aged 4–7 years with dental anxiety and previous failed attempts at conventional dental treatment. Each child underwent two dental treatment sessions under nitrous oxide/oxygen conscious sedation, one with and one without audiovisual distraction. Anxiety and behaviour were assessed using the Modified Venham Scale and the Facial Image Scale (FIS). Vital parameters were recorded before, during, and after sedation. Results: A significant reduction in heart rate over time was observed in both groups (p < 0.05). In children aged 4–5 years, the combined audiovisual distraction and conscious sedation approach was associated with significantly lower heart rate values compared to conscious sedation alone (p < 0.05). No significant differences were found between the two approaches for behavioural scores assessed by the Venham and FIS scales. Conclusions: Although behavioural scores did not differ significantly, audiovisual distraction contributed to greater physiological stability, particularly in terms of heart rate control. This no-pharmacological approach may complement the pharmacological effects of nitrous oxide sedation by enhancing the overall sense of relaxation and comfort during dental care.