Virtual Reality Analgesia for Pediatric Dental Patients.

Barbara Atzori,Rosapia Lauro Grotto,Wadee Alhalabi,Andrea Giugni,Massimo Calabrò,Hunter G Hoffman

doi:10.3389/fpsyg.2018.02265

Abstract

Background: Dental procedures often elicit pain and fear in pediatric dental patients.Aim: To evaluate the feasibility and effectiveness of immersive virtual reality as an attention distraction analgesia technique for pain management in children and adolescents undergoing painful dental procedures.Design: Using a within-subjects design, five patients (mean age 13.20 years old, SD 2.39) participated. Patients received tethered immersive interactive virtual reality distraction in an Oculus Rift VR helmet (experimental condition) during one dental procedure (a single dental filling or tooth extraction). On a different visit to the same dentist (e.g., 1 week later), each patient also received a comparable dental procedure during the control condition “treatment as usual” (treatment order randomized). After each procedure, children self-rated their “worst pain,” “pain unpleasantness,” “time spent thinking about pain,” “presence in VR,” “fun,” and “nausea” levels during the dental procedures, using graphic rating scales.Results: Patients reported significantly lower “worst pain” and “pain unpleasantness,” and had significantly more fun during VR, compared to a comparable dental procedure with No VR. Using Oculus Rift VR goggles, patients reported a “strong sense of going inside the computer-generated world,” without side effects. The dentist preferred having the patients in VR.Conclusion: Results of this pilot study provide preliminary evidence of the feasibility of using immersive, interactive VR to distract pediatric dental patients and increase fun of children during dental procedures.

Highlights

Traditional AnalgesiaPain during dental procedures is common, especially during invasive dental treatments such as tooth extractions or dental cavity fillings (Costa et al, 2012)
Experiencing pain and anxiety during dental procedures can result in several negative consequences, such as higher levels of dental fear, Virtual Reality (VR) Analgesia for Pediatric Dental Patients uncooperative behaviors and a general dissatisfaction of the patient with dental care (Guelman, 2005)
Based on the Interruption of Attention Pain Model by Eccleston and Crombez, we predicted that patients focusing their attentional resources on the virtual environment, would experience less pain, including the cognitive, affective and sensory components of pain, and we predicted patients would report having more fun during their dental procedure, on the day they received VR compared to the day they received standard of care with No VR

Summary

Introduction

Traditional AnalgesiaPain during dental procedures is common, especially during invasive dental treatments such as tooth extractions or dental cavity fillings (Costa et al, 2012). Experiencing pain and anxiety during dental procedures can result in several negative consequences, such as higher levels of dental fear, VR Analgesia for Pediatric Dental Patients uncooperative behaviors and a general dissatisfaction of the patient with dental care (Guelman, 2005). Unpleasant early dental/medical experiences can affect patients’ perception of healthcare, can increase pain and suffering during subsequent medical visits, and can reduce preventative healthcare, affecting lifelong health (El-Housseiny et al, 2014). El-Housseiny et al (2014) recently conducted a study on dental fears in children. The children reported the following fears most prominently, ‘fear of usual dental procedures and injections,’ ‘fear of strangers’ (i.e., the dentist), ‘fear of general medical aspects of treatment,’ and ‘fear of health care personnel.’. Dental procedures often elicit pain and fear in pediatric dental patients

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