Virtual Reality for Dental Anxiety

Overseen By Sylvie Le May, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: St. Justine's Hospital

Disqualifiers: Epilepsy, Hand paralysis, Eye disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

Duration: 1 day per procedure

88 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether virtual reality (VR) games can reduce fear and anxiety in children undergoing dental work. Participants will either watch a muted cartoon or engage with a VR game during their procedure. The researchers aim to determine if VR is more effective at calming children than a traditional cartoon. Children aged 6 to 17, recommended by their dentist for a dental procedure, may be suitable candidates. They must not have conditions like epilepsy or eye diseases that could complicate VR use. As an unphased trial, this study provides a unique opportunity to explore innovative methods for managing dental anxiety.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. It seems focused on using VR for dental anxiety, so it's unlikely that your medications would be affected, but you should confirm with the trial organizers.

What prior data suggests that this VR technique is safe for children undergoing dental procedures?

Research has shown that virtual reality (VR) is safe for reducing dental anxiety in children. Studies have found that using VR during dental visits can lower fear and pain. One study noted that VR helped calm children needing dental treatments. Another study found that VR glasses significantly reduced pain and anxiety for dental patients, including children.

Most studies report that VR is well-tolerated and does not cause major side effects. Some individuals might feel slight dizziness or discomfort, but these effects are rare and mild. Overall, using VR to distract children during dental visits appears to be a safe and effective method to reduce anxiety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for dental anxiety because it offers a unique distraction technique during dental procedures. Unlike traditional methods like sedation or anti-anxiety medications, VR immerses patients in a virtual environment, helping them focus on something other than the dental work. This approach could reduce anxiety without the side effects associated with medications. By providing an engaging and immersive experience, VR has the potential to transform how patients manage fear in the dentist's chair.

What evidence suggests that Virtual Reality Distraction is effective for reducing dental anxiety in children?

This trial will compare Virtual Reality Distraction with standard treatment during dental procedures. Research has shown that virtual reality (VR) can reduce dental anxiety and fear in children. One study found that VR lowered anxiety during dental procedures for kids. Another study discovered that VR distraction eased fear and pain during dental treatments. Additional research confirmed that VR reduces anxiety in regular dental visits. These studies suggest that VR might be more effective than watching cartoons to calm children during dental appointments. ^{1 4 6 7 8}

Who Is on the Research Team?

Sylvie Le May, PhD

Principal Investigator

St. Justine's Hospital

Are You a Good Fit for This Trial?

This trial is for children who experience dental fear and anxiety when facing dental procedures. To join, they must have a condition related to oral health or have suffered a traumatic dental injury. Children with certain medical conditions that could interfere with the study or those who cannot use VR due to other reasons are not eligible.

Inclusion Criteria

I am between 6 and 17 years old.

Received the dentist's recommendation to participate

I need to have a dental procedure done.

Exclusion Criteria

Any other conditions preventing them from using virtual reality (VR) (e.g., epidermolysis bullosa)

I have weakness or paralysis in my hand.

I have epilepsy.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo dental procedures with either VR immersion or watching a muted cartoon on a wall-mounted TV to assess anxiety reduction

1 day per procedure

1 visit (in-person)

Follow-up

Participants are monitored for satisfaction and physiological parameters immediately after the dental procedure

Immediate post-procedure

1 visit (in-person)

Data Collection and Analysis

Data on anxiety levels, satisfaction, and physiological parameters are collected and analyzed

Ongoing throughout the trial

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Reality Distraction

Trial Overview The trial is testing if using Virtual Reality (VR) games during dental visits can help reduce fear and anxiety in children more effectively than watching cartoons on TV. Kids will wear an eye-tracking VR headset that doesn't require head movement, making it easier for dentists to work.

How Is the Trial Designed?

Group I: Virtual Reality Distraction Experimental Treatment 1 Intervention

Use of virtual reality (VR) during dental procedure.

Group II: Standard Treatment Active Control 1 Intervention

Dental Clinic's standard treatment during dental procedure.

Who Is Running the Clinical Trial?

St. Justine's Hospital

Lead Sponsor

Trials

205

Recruited

87,300+

Published Research Related to This Trial

This randomized controlled trial aims to assess whether virtual reality (VR) can enhance the dental experience for patients undergoing procedures like fillings or extractions, particularly focusing on how it affects their memories of pain and anxiety one week post-treatment.

The study will compare the effectiveness of VR environments—natural versus urban—against standard care, potentially revealing whether VR can help reduce anxiety and improve recollections of dental visits, especially for patients with higher levels of dental anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can virtual nature improve patient experiences and memories of dental treatment? A study protocol for a randomized controlled trial. Tanja-Dijkstra, K., Pahl, S., White, MP., et al.[2022]

This study investigates the efficacy of Virtual Reality Exposure Therapy (VRET) for dental phobia, comparing it to an informational pamphlet control group, with 30 participants aged 18-50 and follow-ups at 1 week, 3 months, and 6 months.

The study aims to measure reductions in dental anxiety and physiological arousal (heart rate) during VRET, potentially establishing VRET as a non-invasive alternative treatment for dental anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial. Raghav, K., Van Wijk, AJ., Abdullah, F., et al.[2022]

Virtual reality (VR) has been shown to effectively reduce pain and anxiety in patients undergoing dental treatments, particularly in children, with a significant effect size of -0.82 for pain reduction based on a meta-analysis of 10 studies.

Despite its effectiveness in pediatric patients, there is a need for more research on the use of VR for adults and its potential as a preparatory tool for dental treatments, as current studies are limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis. López-Valverde, N., Muriel Fernández, J., López-Valverde, A., et al.[2020]

A systematic review of 12 randomized controlled trials involving 818 pediatric patients found that virtual reality (VR) distraction interventions significantly reduced dental anxiety, pain, and heart rate during dental treatments, indicating their effectiveness as a management tool.

Despite the positive results, the evidence for VR's effectiveness in reducing dental anxiety may be weakened by publication bias, highlighting the need for more high-quality studies to confirm these findings and optimize VR delivery in dental settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: A systematic review and meta-analysis. Yan, X., Yan, Y., Cao, M., et al.[2023]

Patients using virtual reality (VR) during dental procedures reported significantly lower levels of anxiety and pain, as indicated by self-evaluation questionnaires.

Physiological data also supported these findings, showing a decrease in anxiety levels, suggesting that VR can effectively distract and reduce discomfort for patients with mild to moderate fear and anxiety during dental treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical use of virtual reality distraction system to reduce anxiety and pain in dental procedures. Wiederhold, MD., Gao, K., Wiederhold, BK.[2022]

A review of 27 studies found that virtual reality (VR) is effective in reducing pain and anxiety during dental and oral surgery procedures, with a significant increase in research on this topic from 2011 to 2021.

Most studies focused on dental procedures, indicating a need for more research in oral and maxillofacial surgery, where VR could potentially enhance patient care by managing anxiety and pain more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Use of Virtual Reality to Reduce Pain and Anxiety in Surgical Procedures of the Oral Cavity: A Scoping Review. Martinez-Bernal, D., Vidovich, C., Keenan, C., et al.[2023]

The use of virtual reality (VR) headsets in oral surgery has shown promise in significantly reducing both pre-operative and post-operative anxiety and pain, based on a review of 6 relevant studies.

While the initial findings are encouraging, indicating that VR can be an effective non-drug technique for managing patient discomfort, further research is necessary to fully confirm its effectiveness in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contribution of virtual reality in oral surgery: A literature review. Falguière, A., LeGruiec, C., Herry, H., et al.[2021]

In a study involving 50 patients undergoing dental extractions, 65% reported that virtual reality (VR) significantly reduced their anxiety levels during the procedure, with 87.5% expressing a desire to use VR again in the future.

The most pronounced benefits of VR were observed in young adults (ages 18-35), males, patients with moderate anxiety, and those undergoing surgical extractions, suggesting that VR could be particularly effective for these groups in dental settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patients' perceptions of the benefits of virtual reality during dental extractions. Ougradar, A., Ahmed, B.[2020]

The study evaluated the effectiveness of virtual reality as a distraction technique during local anesthesia administration in 50 pediatric patients aged 6 to 12, finding that those using virtual reality had higher heart rates during the procedure compared to the control group, indicating increased anxiety levels.

Younger children and females reported higher pain scores regardless of the distraction method, suggesting that these demographics may require additional pain management strategies during dental procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric patients: a randomized clinical trial. Felemban, OM., Alshamrani, RM., Aljeddawi, DH., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4043252/

Clinical Use of Virtual Reality Distraction System to Reduce ... This study examines the efficacy of using VR to control dental pain using both patient reported surveys and physiological measurements to evaluate fear and pain ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05898100

Virtual Reality Distraction for Dental Anxiety (PILOT) The aims of the study are twofold: (1) assess the feasibility and acceptability of VR immersion as a tool to reduce dental fear and anxiety in pediatric ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7495687/

Virtual Reality Relaxation to Decrease Dental Anxiety Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.

4. nature.com nature.com/articles/s41598-023-47764-8

Clinical effects of different virtual reality presentation ... Our results showed that the use of VR during impacted mandibular third molar extraction under local anesthesia effectively alleviated fear and ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0300571223000428

Effectiveness of virtual reality distraction interventions to ... Results showed that VR distraction interventions were effective in reducing the dental anxiety of paediatric patients.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05898100

Virtual Reality Distraction for Dental Anxiety (PILOT) The aims of the study are twofold: (1) assess the feasibility and acceptability of VR immersion as a tool to reduce dental fear and anxiety in pediatric ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10736194/

Virtual reality in managing dental pain and anxiety This study aimed to identify, analyze, and summarize the clinical efficacy of virtual reality (VR) distraction therapy for oral treatment in ...

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0300571225003495

Virtual reality for patients with dental anxiety: A scoping ... 31 studies found that VR glasses significantly reduced pain and anxiety during dental treatment. VR was useful for managing children's behavior during dental ...