Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study

Karin Tanja-Dijkstra,David R Moles,Sabine Pahl,Mathew P White,Malcolm Bruce,Jackie Andrade,Cheng Qian,Jon May,Mel Slater

doi:10.1371/journal.pone.0091276

Abstract

Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events.

Highlights

Patient pain and anxiety are undesirable side-effects of many medical procedures and can affect the patient’s willingness to undergo treatment [1], [2]
Our research extends previous virtual reality (VR) studies by showing that VR distraction in a simulated dental context affected memories a week later
Participants higher in dental anxiety showed a greater reduction in memory vividness than lower dental-anxiety participants. This is an important extension because it helps us understand the cognitive processes by which VR distraction can work

Summary

Introduction

Patient pain and anxiety are undesirable side-effects of many medical procedures and can affect the patient’s willingness to undergo treatment [1], [2]. Medical (e.g. analgesic) interventions to reduce pain during treatments are frequently used but can be expensive and may have their own side-effects. Simple, noninvasive alternatives, such as ‘‘distraction therapy’’ are desirable. A recent systematic review of eleven studies looked at the effectiveness of virtual reality distraction on pain reduction [8]. They concluded that more sophisticated VR techniques, capable of completely immersing the individual were associated with greater pain relief. According to Gold and colleagues [9] VR provides a powerful means of modifying affect, because of its immersive nature

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