A systematic review of the use of virtual reality or dental smartphone applications as interventions for management of paediatric dental anxiety

Andrea Cunningham, Orlagh McPolin, Richard Fallis, Catherine Coyle, Paul Best, Gerald McKenna, Andrea Cunningham, Orlagh McPolin, Richard Fallis, Catherine Coyle, Paul Best, Gerald McKenna

Abstract

Background: Virtual reality (VR) has been used successfully in medicine both as a distraction tool during procedures, and as an acclimatisation tool to prepare for a procedure or experience. It has not yet become widely used in dentistry, but could theoretically have a role in exposure-based acclimatisation for dental experiences.

Methods: To examine the use of VR or bespoke dental smartphone applications pre- or perioperatively in dentistry, to decrease anxiety in a paediatric population attending for dental examination or treatment, compared with children/adolescents who receive no intervention, or more conventional behavioural management techniques. Searches were made of eight electronic databases: the Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE(PubMed), EMBASE, PsycINFO, CINAHL, Scopus and Web of Science. Further searches reference cross-checks were performed to identify studies that were not discovered online.

Results: Systematic reviews and randomised control trials have demonstrated the successful use of VR to both distract patients perioperatively during medical procedures, and also preoperatively to prepare them for these interventions. However, to date, VR has only been applied to dentistry in a very limited number of studies. Three studies using virtual reality in a dental setting demonstrated decreased pain and anxiety compared with no intervention. All three of these studies were carried out in the perioperative period. A fourth study used a bespoke dental app and imagery to prepare patients with Autism Spectrum Disorder (ASD) for dental treatment, finding statistically significant decreases in both the number of appointments and number of attempts required to carry out a procedure.

Conclusion: VR is a promising tool which to date has been under-utilised in dentistry. High quality, clinical studies are required to assess the use of preoperative VR and smartphone applications to prepare patients for dental examination and procedures under local or general anaesthetic.

Keywords: Anxiolysis; Autism spectrum disorder; Behavioural management; Paediatric dentistry; Pain control; Prevention; Virtual reality.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

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Fig. 1
PRISMA search strategy

References

    1. Bryson S. Virtual reality in scientific visualization. Commun ACM. 1996;39(5):62–71. doi: 10.1145/229459.229467.
    1. Evans C, Moonesinghe R. Virtual reality in pediatric anesthesia: a toy or a tool. Pediatr Anaesth. 2020;30:386–387. doi: 10.1111/pan.13842.
    1. Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17:391–406. doi: 10.1111/j.1365-263X.2007.00872.x.
    1. Ravaghi V, Hill K, Ryan R, Dennes M. Children’s Dental Health Survey 2013 Country specific report: Northern Ireland. Available at: . Last accessed 03/07/2020.
    1. Sury M, Palmer J, Cook T, Pandit J. The state of UK anaesthesia: a survey of National Health Service activity on 2013. Br J Anaesth. 2014;113:575584. doi: 10.1093/bja/aeu292.
    1. Kain Z, Mayes L, O'connor T, Cicchetti D. Preoperative anxiety in children. Arch Paediatr Adolesc Med. 1996;150:1238–1245. doi: 10.1001/archpedi.1996.02170370016002.
    1. Fortier M, Del Rosario A, Kain Z. Perioperative anxiety in children. Pediatric Anesthesia. 2010;20:318–322. doi: 10.1111/j.1460-9592.2010.03263.x.
    1. NHS Digital. Hospital Admitted Patient Care Activity 2018-19. Available at: . Last accessed 03/07/2020
    1. MacCormac C, Kinirons M. Reasons for referral of children to a general anaesthetic service in Northern Ireland. Int J Paediatr Dent. 1998;8(3):191–196. doi: 10.1046/j.1365-263x.1998.00086.x.
    1. British Dental Association. Children’s oral health in Northern Ireland 2018. Available at: . Last accessed 03/07/2020.
    1. Gherman A, Achimas-Cadariu P, Sucala M. A systematic analysis of mobile apps that prepare patients for medical procedures. J Evid Based Psychother. 2016;16(1):85.
    1. Plowman L, Stephen C, McPake J. Growing up with technology: young children learning in a digital world. London: Routledge; 2012.
    1. Botella C, Fernandez-Alvarez J, Guillen V, Garcia-Palacios A, Banos R. Recent progress in virtual reality exposure therapy for phobias: a systematic review. Curr Psychiatry Rep. 2017;19(7):42. doi: 10.1007/s11920-017-0788-4.
    1. Gujjar K, van Wijk A, Kumar R, de Jongh A. Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: a randomized controlled trial. J Anxiety Disord. 2019;62:100–108. doi: 10.1016/j.janxdis.2018.12.001.
    1. Ryu JH, Park SJ, Park JW, Kim JW, Yoo HJ, Kim TW, Hong JS, Han SH. Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia. Br J Surg. 2017;104(12):1628–1633. doi: 10.1002/bjs.10684.
    1. Kim J, Chiesa N, Raazi M, Wright KD. A systematic review of technology-based preoperative preparation interventions for child and parent anxiety. Can J Anesth. 2019;66(8):966–986. doi: 10.1007/s12630-019-01387-8.
    1. Böhnlein J, Altegoer L, Kriskin N, Roesmann K, Redlich R, Dannlowski U, Leehr E. Factors influencing the success of exposure therapy for specifiic phobia: a systematic review. Neurosci Biobehav Rev. 2020;108:796–820. doi: 10.1016/j.neubiorev.2019.12.009.
    1. Benito K, Walther M. Therapeutic process during exposure: habituation model. J Obsess Compuls Relat Disorders. 2015;6:147–157. doi: 10.1016/j.jocrd.2015.01.006.
    1. Rizzo A, Schultheis M, Kerns K, Mateer C. Analysis of assets for virtual reality applications in neuropsychology. Neuropsychol Rehabil. 2004;14:207–239. doi: 10.1080/09602010343000183.
    1. Powers M, Emmelkamp P. Virtual reality exposure therapy for anxiety disorders: a meta-analysis. J Anxiety Disord. 2008;22:561–569. doi: 10.1016/j.janxdis.2007.04.006.
    1. Kim G, Biocca F. Immersion in virtual reality can increase exercise motivation and physical performance. In: International conference on virtual, augmented and mixed reality 2018; 94–102.
    1. Slater M. Immersion and the illusion of presence in virtual reality. Br J Psychol. 2018;109:431. doi: 10.1111/bjop.12305.
    1. Campbell C, Hosey MT, McHugh S. Facilitating coping behavior in children prior to dental general anesthesia: a randomized controlled trial. Paediatr Anaesth. 2005;15:831–838. doi: 10.1111/j.1460-9592.2004.01565.x.
    1. Kerimoglu B, Neuman A, Paul J, Stefanov DG, Twersky R. Anesthesia induction using video glasses as a distraction tool for the management of preoperative anxiety in children. Anesth Analg. 2013;117:1373–1379. doi: 10.1213/ANE.0b013e3182a8c18f.
    1. Wismeijer AA, Vingerhoets AJ. The use of virtual reality and audiovisual eyeglass systems as adjunct analgesic techniques: a review of the literature. Ann Behav Med. 2005;30(3):268–278. doi: 10.1207/s15324796abm3003_11.
    1. Hoffman HG, García-Palacios A, Patterson DR. The effectiveness of virtual reality for dental pain control: a case study. Cyberpsychol Behav. 2001;4:527–535. doi: 10.1089/109493101750527088.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–341. doi: 10.1016/j.ijsu.2010.02.007.
    1. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, Emberson JR. RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj. 2019;366:14898.
    1. Humphris G, Morrison T, Lindsay S. The modified dental anxiety scale: validation and United Kingdom norms. Commun Dent Health. 1995;12:143–150.
    1. Wong DL, Baker CM. Smiling face as anchor for pain intensity scales. Pain. 2001;89(2):295–297. doi: 10.1016/S0304-3959(00)00375-4.
    1. Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293–297.
    1. Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale–Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93(2):173–183. doi: 10.1016/S0304-3959(01)00314-1.
    1. Al-Halabi MN, Bshara N, AlNerabieah Z. Effectiveness of audio visual distraction using virtual reality eyeglasses versus tablet device in child behavioral management during inferior alveolar nerve block. Anaesth Pain Intensive Care 2018;22:55–61.
    1. Aminabadi NA, Erfanparast L, Sohrabi A, Oskouei SG, Naghili A. The impact of virtual reality distraction on pain and anxiety during dental treatment in 4–6 year-old children: a randomized controlled clinical trial. J Dental Res Dental Clin Dental Prospects. 2012;6(4):117.
    1. Panda A. Effect of virtual reality distraction on pain perception during dental treatment in children. Int J Oral Care Res. 2017;5(4):278–281. doi: 10.5005/jp-journals-10051-0115.
    1. Zink AG, Molina EC, Diniz MB, Santos MT, Guaré RO. Communication application for use during the first dental visit for children and adolescents with autism spectrum disorders. Pediatr Dent. 2018;40(1):18–22.
    1. Barreiros D, de Oliveira DSB, de Queiroz AM, da Silva RAB, de Paula-Silva FWG, Küchler EC. Audiovisual distraction methods for anxiety in children during dental treatment: a systematic review and meta-analysis. J Indian Soc Pedod Prev Dent. 2018;36(1):2–8. doi: 10.4103/JISPPD.JISPPD_188_16.
    1. Schuemie MJ, van der Straaten P, Krijn M, van der Mast CAPG. Research on presence in virtual reality: a survey. Cyberpsychol Behav. 2001;4(2):183–201. doi: 10.1089/109493101300117884.
    1. Morgan AG, Rodd HD, Porritt JM, Baker SR, Creswell C, Newton T, Williams C, Marshman Z. Children's experiences of dental anxiety. Int J Pediatr Dent. 2017;27(2):87–97. doi: 10.1111/ipd.12238.
    1. Autism Speaks. ATN/AIR-P Tool Kit for Dental Professionals. Available upon request from .

Source: PubMed

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