Effect of audiovisual distraction with 3D video glasses on dental anxiety of children experiencing administration of local analgesia: a randomised clinical trial

Abstract

Aim

To determine the effect of three-dimensional (3D) audiovisual (AV) distraction in reducing dental anxiety of children.

Study design

A randomised clinical trial with a parallel design carried out on 90 children (49 boys and 41 girls) aged between 7 and 10 years (mean age of 8.4 years) to ascertain the comparative efficacy of audio (music) and AV (3D video glasses) distraction in reducing the dental anxiety of children during local analgesia (LA) administration.

Methods

Ninety children were randomly divided into three groups; control (basic behaviour guidance techniques without distraction), audio (basic techniques plus music) and AV (basic techniques plus 3D AV) distraction groups. All the children experienced LA administration with/without distraction and the anxiety was assessed using a combination of measures: MCDAS(f) (self-report), pulse rate (physiological), behaviour (using Wright’s modification of Frankl behaviour rating scale and Houpt scale) and preferences of children.

Results

All 90 children completed the study. A highly significant reduction in the anxiety of audiovisual group as reported by the MCDAS(f) values (p < 0.001) and Houpt scale (p = 0.003); whereas pulse rate showed statistically significant increase (p < 0.001) in all the three groups irrespective of distraction. The child preferences also affirmed the usage of 3D video glasses.

Conclusions

LA administration with music or 3D video glasses distraction had an added advantage in a majority of children with 3D video glasses being superior to music. High levels of satisfaction from children who experienced treatment with 3D video glasses were also observed.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. Aitken JC, Wilson S, Coury D, Moursi M. The effect of music distraction on pain, anxiety and behavior in pediatric dental patients. Pediatr Dent. 2002;24:114–8.

    PubMed  Google Scholar 

  2. Alwin NP, Murray JJ, Britton PG. An assessment of dental anxiety in children. Br Dent J. 1991;17:201–7.

    Article  Google Scholar 

  3. American Academy of Pediatric Dentistry Reference Manual. Guideline on behavior guidance for the pediatric dental patient 2012/13;34: 170-82 downloaded on 19-10-12 from http://www.aapd.org/media/Policies_Guidelines/Gbehaveguide.pdf.

  4. Bagdadi ZD. Evaluation of audio analgesia for restorative care in children treated using electronic dental anesthesia. J Clin Pediatr Dent. 2000;25:9–12.

    Google Scholar 

  5. Bentsen B, Wenzel A, Svensson P. Comparison of the effect of video glasses and nitrous oxide analgesia on the perceived intensity of pain and unpleasantness evoked by dental scaling. Eur J Pain. 2003;7:49–53.

    PubMed  Article  Google Scholar 

  6. Berggren N, Derakshan N. Attentional control deficits in trait anxiety: Why you see them and why you don’t. Biol Psychol. 2013;92:440–6.

    PubMed  Article  Google Scholar 

  7. Dahlquist LM, McKenna KD, Jones KK, et al. Active and passive distraction using a head-mounted display helmet: effects on cold pressor pain in children. Health Psychol. 2007;26:794–801.

    PubMed  Article  Google Scholar 

  8. Diercke K, Ollinger I, Bermejo JI, et al. Dental fear in children and adolescents: a comparison of forms of anxiety management practised by general and paediatric dentists. Int J Paediatr Dent. 2012;22:60–7.

    PubMed  Article  Google Scholar 

  9. El-Sharkawi HFA, El-Housseiny AA, Aly AM. Effectiveness of new distraction technique on pain associated with injection of local anesthesia for children. Pediatr Dent. 2012;34:142–5.

    Google Scholar 

  10. Florella M, Sarale C, Ram RD. Audiovisual iatrosedation with video eyeglasses distraction method in pediatric dentistry: case history. J Int Dent Med Res. 2010;3:133–6.

    Google Scholar 

  11. Gawronska-Skorkowska J, Zienkiewicz J, Majkowicz M. Music therapy before and during oral surgeries as a positive relaxing influence on the young patients. Annales Academiae Medicae Gedanensis. 2002;32:161–72 (In Polish).

    Google Scholar 

  12. Hoge MA, Howard MR, Wallace DP, Allen KD. Use of video eyewear to manage distress in children during restorative dental treatment. Pediatr Dent. 2012;34:378–82.

    PubMed  Google Scholar 

  13. Howard KE, Freeman R. Reliability and validity of a faces version of the modified child dental anxiety scale. Int J Paediatr Dent. 2007;17:281–8.

    PubMed  Article  Google Scholar 

  14. Klieber C, McCarthy AM. Evaluating instruments for a study on children’s responses to a painful procedure when parents are distraction coaches. J Pediatr Nurs. 2006;21:99–107.

    Article  Google Scholar 

  15. Lambert SA. Distraction, imagery, and hypnosis: Techniques for management of children’s pain. J Child Fam Nurs. 1999;2:5–15.

    PubMed  Google Scholar 

  16. Liau FL, Kok SH, Lee JJ, et al. Cardiovascular influence of dental anxiety during local anesthesia for tooth extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:16–26.

    PubMed  Article  Google Scholar 

  17. Manepalli S, Nuvvula S, Kamatham R, Nirmala S. Comparative efficacy of a self report scale and physiological measures in dental anxiety of children. J Investig Clin Dent. 2013. doi:10.1111/jicd.12046 [Epub ahead of print].

  18. Marwah N, Prabhakar AR, Raju OS. Music distraction- its efficacy in management of anxious pediatric dental patients. J Indian Soc Pedod Prev Dent. 2005;23:168–70.

    PubMed  Article  Google Scholar 

  19. Mason S, Johnson MH, Wooley C. A comparison of distractors for controlling distress in young children during medical procedures. J Clin Psychol Med. 1999;6:239–48.

    Article  Google Scholar 

  20. Mc Donald RE, Avery DR, Dean JA, Jones JE. Local anesthesia and pain control for the child and adolescent. In: Mc Donald and Avery’s Dentistry for the Child and Adolescent. Dean JA, Avery DR, Mc Donald RE, editors. 9th edition (Restricted South Asia) 2011, Reed Elsevier India Pvt. Ltd: p. 242–243.

  21. McGrath PA, deVeber LL, Hearn MJ. Multidimensional pain assessment in children. In: Fields H, Dubner R, Cervero F, editors. Proceedings of the Fourth world congress on pain. New York, NY: Raven Press; Advances in pain research and therapy 1985;9:387–393.

  22. Meyer FU. Haemodynamic changes under emotional stress following a minor surgical procedure under local anaesthesia. Int J Oral Maxillofac Surg. 1987;16:688–94.

    PubMed  Article  Google Scholar 

  23. Myers DR, Kramer WS, Sullivan RE. A study of the heart action of the child dental patient. ASDC J Dent Child. 1972;39:99–106.

    PubMed  Google Scholar 

  24. Nilsson S, Finnstrom B, Kokinsky E, Enskar K. The use of virtual reality for needle-related procedural pain and distress in children and adolescents in a paediatric oncology unit. Eur J Oncol Nurs. 2009;13:102–9.

    PubMed  Article  Google Scholar 

  25. Patel A, Schieble T, Davidson M, et al. Distraction with a hand-held video game reduces pediatric preoperative anxiety. Paediatr Anaesth. 2006;16:1019–27.

    PubMed  Article  Google Scholar 

  26. Peretz B, Gluck GM. Assessing an active distracting technique for local anaesthetic injection in pediatric dental patients: Repeated deep breathing and blowing out air. J Clin Pediatr Dent. 1999;24:5–8.

    PubMed  Google Scholar 

  27. Prabhakar AR, Marwah N, Raju OS. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. J Indian Soc Pedod Prev Dent. 2007;25:177–82.

    PubMed  Article  Google Scholar 

  28. Ram D, Shapira J, Holan G, et al. Audiovisual video eyeglass distraction during dental treatment in children. Quintessence Int. 2010;41:673–9.

    PubMed  Google Scholar 

  29. Robson W. WARNING: 3D video hazardous to your health. (2010). Downloaded from URL: http://www.audioholics.com/editorials/warning-3d-video-hazardous-to-your-health.

  30. Rodolfa ER, Kraft W, Reilley RR. Etiology and treatment of dental anxiety and phobia. Am J Clin Hypn. 1990;33:22–8.

    PubMed  Article  Google Scholar 

  31. Rosenberg HM, Katcher AH. Heart rate and physical activity of children during dental treatment. J Dent Res. 1976;55:648–51.

    PubMed  Article  Google Scholar 

  32. Simpson WJ, Ruzicka RL, Thomas NR. Physiologic responses of children to initial dental experience. ASDC J Dent Child. 1974;41:465–70.

    PubMed  Google Scholar 

  33. Taggart P, Hedworth-Whitty R, Carruthers M, Gordon PD. Observations on electrocardiogram and plasma catecholamines during dental procedures: the forgotten vagus. Br Med J. 1976;2:787–9.

    PubMed Central  PubMed  Article  Google Scholar 

  34. Weinstein P, Getz T, Ratener P, Domoto P. Dentists’ responses to fear- and non fear-related behaviors in children. J Am Dent Assoc. 1982;104:38–40.

    PubMed  Google Scholar 

  35. Weydert JA, Shapiro DE, Acra SA, et al. Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC Pediatr. 2006;6:29. doi:10.1186/1471-2431-6-29.

    PubMed Central  PubMed  Article  Google Scholar 

  36. West GA, Reid KH, Bastawi AE. Clinical Science: Autonomic responses to dental procedures in pedodontic patients during a standard restoration session. J Dent Res. 1983;62:728–32.

    PubMed  Article  Google Scholar 

  37. Wright GZ, Stigers JI. Nonpharmacologic management of children’s behaviors. In: Mc Donald and Avery’s Dentistry for the child and adolescent. Dean JA, Avery DR, Mc Donald RE, editors. 9th edition (Restricted South Asia) 2011, Reed Elsevier India Pvt. Ltd: p. 31.

  38. Yelderman M, New W Jr. Evaluation of pulse oximetry. Anesthesiology. 1983;59:349–52.

    PubMed  Article  Google Scholar 

  39. Zhang G, Hou R, Zhou H, et al. Improved sedation for dental extraction using video eyewear in conjunction with nitrous oxide: a randomized, controlled, cross-over clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2012;113:188–92.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to R. Kamatham.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nuvvula, S., Alahari, S., Kamatham, R. et al. 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 16, 43–50 (2015). https://doi.org/10.1007/s40368-014-0145-9

Download citation

Keywords

  • Distraction
  • Behaviour guidance
  • Children’s dental anxiety