Effectiveness of audiovisual distraction eyewear and computerized delivery of anesthesia during pulp therapy of primary molars in phobic child patients

Kausar Sadia Fakhruddin, El Batawi Hisham, Mehmet Omer Gorduysus, Kausar Sadia Fakhruddin, El Batawi Hisham, Mehmet Omer Gorduysus

Abstract

Objectives: The aim of this study is to assess the effectiveness of audiovisual distraction technique with video eyewear and computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in phobic pediatric patients undergoing pulp therapy of primary molars.

Materials and methods: This randomized, crossover clinical study includes 60 children, aged between 4 and 7-year-old (31 boys and 29 girls). Children were randomly distributed equally into two groups as A and B. This study involved two treatment sessions of pulp therapy, 1-week apart. During treatment session I, group A had an audiovisual distraction with video eyewear, whereas group B had audiovisual distraction using projector display only without video eyewear. During treatment session II, group A had undergone pulp therapy without video eyewear distraction, whereas group B had the pulp treatment using video eyewear distraction. Each session involved the pulp therapy of equivalent teeth in the opposite sides of the mouth. At each visit scores on the Modified Child Dental Anxiety Scale (MCDAS) (f) were used to evaluate the level of anxiety before treatment. After the procedure, children were instructed to rate their pain during treatment on the Wong Bakers' faces pain scale. Changes in pulse oximeter and heart rate were recorded in every 10 min.

Results: From preoperative treatment session I (with video eyewear) to preoperative treatment session II (without video eyewear) for the MCDAS (f), a significant (P > 0.03) change in the mean anxiety score was observed for group A. Self-reported mean pain score decreases dramatically after treatment sessions' with video eyewear for both groups.

Conclusion: The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children.

Keywords: Audiovisual distraction eyewear; dental anxiety; pulp therapy.

Figures

Figure 1
Figure 1
Patient flow through the research study

References

    1. Arntz A, van Eck M, Heijmans M. Predictions of dental pain: The fear of any expected evil, is worse than the evil itself. Behav Res Ther. 1990;28:29–41.
    1. Ince B, Ercan E, Dalli M, Dulgergil CT, Zorba YO, Colak H. Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent. 2009;3:273–9.
    1. Pinkham JR, Casamassimo PS, McTigue DJ, Fields HW, Jr, Nowak AJ. 4th ed. Philadelphia, Pa: Elsevier Saunders; 2005. Infancy Through Adolescence, Pediatric Dentistry.
    1. Allen KD, Stanley RT, McPherson K. Evaluation of behavior management technology dissemination in pediatric dentistry. Pediatr Dent. 1990;12:79–82.
    1. Mahesh R, Prasad V, Menon PA. A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation. Eur J Dent. 2013;7:225–8.
    1. 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.
    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;30:268–78.
    1. Sinha M, Christopher NC, Fenn R, Reeves L. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics. 2006;117:1162–8.
    1. Dahlquist LM, Weiss KE, Clendaniel LD, Law EF, Ackerman CS, McKenna KD. Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. J Pediatr Psychol. 2009;34:574–84.
    1. Sullivan C, Schneider PE, Musselman RJ, Dummett CO, Jr, Gardiner D. The effect of virtual reality during dental treatment on child anxiety and behavior. ASDC J Dent Child. 2000;67:193.
    1. Allen KD, Kotil D, Larzelere RE, Hutfless S, Beiraghi S. Comparison of a computerized anesthesia device with a traditional syringe in preschool children. Pediatr Dent. 2002;24:315–20.
    1. Gibson RS, Allen K, Hutfless S, Beiraghi S. The wand vs. traditional injection: A comparison of pain related behaviors. Pediatr Dent. 2000;22:458–62.
    1. 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.
    1. Hockenberry MJ, Wilson D, Winkelstein ML. 7th ed. St. Louis: Mosby/Elsevier; 2005. Wong's Essentials of Pediatric Nursing; p. 1259.
    1. Badalaty MM, Houpt MI, Koenigsberg SR, Maxwell KC, DesJardins PJ. A comparison of chloral hydrate and diazepam sedation in young children. Pediatr Dent. 1990;12:33–7.
    1. Currie WR, Biery KA, Campbell RL, Mourino AP. Narcotic sedation: An evaluation of cardiopulmonary parameters and behavior modification in pediatric dental patients. J Pedod. 1988;12:230–49.
    1. Doring KR. Evaluation of an alphaprodine-hydroxyzine combination as a sedative agent in the treatment of the pediatric dental patient. J Am Dent Assoc. 1985;111:567–76.
    1. Houpt MI, Weiss NJ, Koenigsberg SR, Desjardins PJ. Comparison of chloral hydrate with and without promethazine in the sedation of young children. Pediatr Dent. 1985;7:41–6.
    1. American Academy of Pediatric Dentistry. Elective use of minimal, moderate and deep sedation and general anesthesia in pediatric dental patients. Pediatric Dent. 2004;24:90–8.
    1. Bellieni CV, Cordelli DM, Raffaelli M, Ricci B, Morgese G, Buonocore G. Analgesic effect of watching TV during venipuncture. Arch Dis Child. 2006;91:1015–7.
    1. Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA., 3rd Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. 2000;85:305–9.
    1. Cassidy KL, Reid GJ, McGrath PJ, Finley GA, Smith DJ, Morley C, et al. Watch needle, watch TV: Audiovisual distraction in preschool immunization. Pain Med. 2002;3:108–18.
    1. Sparks L. Taking the “ouch” out of injections for children. Using distraction to decrease pain. MCN Am J Matern Child Nurs. 2001;26:72–8.
    1. Dowling JS. Humor: A coping strategy for pediatric patients. Pediatr Nurs. 2002;28:123–31.
    1. O’Donnell JJ, Maurice SC, Beattie TF. Emergency analgesia in the paediatric population. Part III non-pharmacological measures of pain relief and anxiolysis. Emerg Med J. 2002;19:195–7.
    1. Rusy LM, Weisman SJ. Complementary therapies for acute pediatric pain management. Pediatr Clin North Am. 2000;47:589–99.
    1. Berggren U, Meynert G. Dental fear and avoidance: Causes, symptoms, and consequences. J Am Dent Assoc. 1984;109:247–51.
    1. Jones CM, Heidmann J, Gerrish AC. Children's ratings of dental injection and treatment pain, and the influence of the time taken to administer the injection. Int J Paediatr Dent. 1995;5:81–5.
    1. Hochman M, Chiarello D, Hochman CB, Lopatkin R, Pergola S. Computerized local anesthetic delivery vs. traditional syringe technique. Subjective pain response. N Y State Dent J. 1997;63:24–9.
    1. Schleder JR, Reader A, Beck M, Meyers WJ. The periodontal ligament injection: A comparison of 2% lidocaine, 3% mepivacaine, and 1:100,000 epinephrine to 2% lidocaine with 1:100,000 epinephrine in human mandibular premolars. J Endod. 1988;14:397–404.
    1. Oztas N, Ulusu T, Bodur H, Dogan C. The wand in pulp therapy: An alternative to inferior alveolar nerve block. Quintessence Int. 2005;36:559–64.
    1. Malamed SF. 4th ed. St. Louis, MO: CV Mosby Co; 2003. Sedation: A Guide to Patient Management; p. 337.
    1. Ran D, Peretz B. Assessing the pain reaction of children receiving periodontal ligament anesthesia using a computerized device (Wand) J Clin Pediatr Dent. 2003;27:247–50.
    1. Ashkenazi M, Blumer S, Eli I. Effectiveness of computerized delivery of intrasulcular anesthetic in primary molars. J Am Dent Assoc. 2005;136:1418–25.
    1. Nakai Y, Milgrom P, Mancl L, Coldwell SE, Domoto PK, Ramsay DS. Effectiveness of local anesthesia in pediatric dental practice. J Am Dent Assoc. 2000;131:1699–705.
    1. Oulis CJ, Vadiakas GP, Vasilopoulou A. The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children. Pediatr Dent. 1996;18:301–5.
    1. Sharaf AA. Evaluation of mandibular infiltration versus block anesthesia in pediatric dentistry. ASDC J Dent Child. 1997;64:276–81.
    1. Ralph E, McDonland RE, Avery DR. Local anesthesia for the child and adolescent. In: McDonland RE, Avery DR, editors. Dentistry for the Child and Adolescent. 7th ed. St. Louis, MO: CV Mosby Co; 1985. pp. 288–90.
    1. Wright GZ, Starkey PE, Gardiner DE. St. Louis, MO: CV Mosby Co; 1983. Managing Children's Behavior in the Dental Office; pp. 132–3.

Source: PubMed

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