Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (5): 529-536.doi: 10.7518/gjkq.2022065

• Original Articles • Previous Articles     Next Articles

Intervention effect of virtual reality technology on dental fear in the treatment of deep caries in children

Ren Hai-xia1,2(),Liu Yingfeng2,Liang Huimin1,Li Jiayong2,Wen Chunqin2,Wang Chunmei1()   

  1. 1.College of Nursing, Tianjin Medical University, Tianjin 300070, China
    2.Dept. of Stomatology, Tianjin Rehabilitation Center, Tianjin 300191, China
  • Received:2021-11-01 Revised:2022-02-17 Online:2022-09-01 Published:2022-09-16
  • Contact: Chunmei Wang E-mail:rhxgood2008@126.com;cmwang8543@126.com

RichHTML

17

PDF (PC)

284

Abstract:

Objective This study aims to evaluate the effectiveness of the virtual reality (VR) technology in reducing pain perception and anxiety level in children with dental fear (DF) during the treatment of deep caries and analyze the effect of VR technology in relieving DF. Methods Children aged 5-8 years who need pulpotomy for deep caries were selected as research object. A total of 160 children were screened out by the children’s fear survey schedule-dental subscale (CFSS-DS), of which 120 and 40 cases were mild (CFSS-DS score=16-30) and moderate (CFSS-DS score=31-45) DF. Children with mild and moderate DF were randomly divided into four groups: mild DF VR (group 1, 60 cases), mild DF Tell-Show-Do (TSD; group 2, 60 cases), moderate DF VR (group 3, 20 cases), and moderate DF TSD (group 4, 20 ca-ses) groups. Groups 1 and 3 were intervened by wearing VR glasses (VR group), whereas groups 2 and 4 were intervened by TSD behavior guidance (TSD group). The effects of two intervention measures on alleviating children’s DF were evaluated using psychological evaluation (i.e., CFSS-DS), cooperative behavior evaluation, physiological response (heart rate), pain degree, and treatment compliance evaluation. VR glasses’ applicability assessment scale was used to analyze its applicability. Results All 160 children completed treatment. No significant difference in the CFSS-DS score and heart rate before treatment was observed between VR and TSD groups (P>0.05). The CFSS-DS score differences before and after treatment, heart rate du-ring treatment (in group 3), pain grade, and treatment compliance of TSD and VR groups were statistically significant (P<0.05). However, no significant difference was observed in heart rate during treatment between groups 1 and 2 (P>0.05). The ratio of the heart rate difference (before and during treatment) to baseline was also not statistically significant (P>0.05). The intragroup comparison and heart rates during treatment were higher than those before treatment in four groups (P<0.01). Significant differences in CFSS-DS score differences before and after treatment were observed in groups 1, 3, and 4 (P<0.05) but not in group 2 (P>0.05). Children had high evaluation on the applicability of VR glasses. Conclusion The VR technology was superior to TSD guidance in reducing the anxiety and pain degree of children with DF, but no significant difference was observed in reducing the physiological response (heart rate) of children compared with TSD guidance. Children were satisfied with the application of VR glasses.

Key words: virtual reality technology, Tell-Show-Do behavior guidance, children, dental fear, pain

CLC Number: 

  • R 78

TrendMD: 

Tab　1

General information of children"

测量项目轻度CDF中度CDF
试验组（n=60）对照组（n=60）P值试验组（n=20）对照组（n=20）P值
年龄/岁6.12±0.136.20±0.130.4435.98±0.216.35±0.250.265
性别/例男34370.0719110.655
女2623119
治疗前CFSS-DS评分22.93±0.5822.70±0.670.79337.90±0.7936.70±1.160.399

Tab　2

Score of CFSS-DS scale before and after treatment"

组别治疗前治疗后治疗前后差值P1 值a
轻度畏惧VR22.93±0.5819.77±0.563.17±0.490.000**
轻度畏惧TSD22.70±0.6721.33±0.761.37±0.750.073
中度畏惧VR37.90±0.7925.60±1.3412.30±0.940.000**
中度畏惧TSD36.70±1.1633.15±1.213.55±1.100.004**
P2值b0.7900.1000.047*
P3值c0.4000.000**0.000**

Tab　3

Venham clinical anxiety and cooperative beha-vior rating evaluation"

组别等级秩平均值P值
012345
轻度畏惧VR30164100058.680.540a
轻度畏惧TSD27158100062.32
中度畏惧VR104240016.400.020*b
中度畏惧TSD46050524.60

Tab　4

Heart rates before and during treatment"

组别心率

Q值

[（治疗中－治疗前）/治疗前]

P1 值a
治疗前治疗中
轻度畏惧VR97.07±1.56109.43±1.690.13±0.010.000**
轻度畏惧TSD96.72±1.78107.52±2.400.11±0.010.000**
中度畏惧VR97.50±4.23110.90±4.460.14±0.020.000**
中度畏惧TSD108.05±4.53126.55±4.870.18±0.040.000**
P2值b0.8830.5000.250
P3值c0.0970.023*0.395

Tab　5

Evaluation of pain grade during local injection"

组别等级秩平均值P值
012345
轻度畏惧VR3814260054.570.039*a
轻度畏惧TSD2622624066.43
中度畏惧VR144200017.100.041*b
中度畏惧TSD87030223.90

Tab 6

Evaluation of treatment compliance"

组别等级依从例数依从率/%P值
好较好差
轻度畏惧VR564060100.000.000**a
轻度畏惧TSD183485286.67
中度畏惧VR182020100.000.000**b
中度畏惧TSD21351575.00

Tab　7

Evaluation of VR glasses applicability"

测量指标级别例数构成比/%
眼镜舒适性十分舒适7695.0
舒适22.5
比较舒适22.5
比较不舒适00.0
不舒适00.0
疲劳感完全不疲劳80100.0
有点疲劳00.0
特别疲劳00.0
十分疲劳00.0
游戏吸引程度/分>57897.5
≤522.5
意愿性愿意7695.0
无所谓22.5
不愿意22.5
1 王春丽, 李华, 李秀娥. 牙科焦虑症的研究现状及进展[J]. 中华现代护理杂志, 2020, 26(22): 2965-2970.
Wang CL, Li H, Li XE. Research status and pro-gress of dental anxiety[J]. Chin J Modern Nurs, 2020, 26(22): 2965-2970.
2 王一珠. 音乐疗法在牙科畏惧症儿童治疗中的临床应用评价[D]. 北京: 中国人民解放军医学院, 2017.
Wang YZ. Evaluation of the clinical application of music therapy in the treatment of children with dental fear[D]. Beijing: Chinese PLA Medical College, 2017.
3 葛立宏. 儿童口腔医学[M]. 北京: 人民卫生出版社, 2020: 266.
Ge LH. Pediatric dentistry[M]. Beijing: People’s Medical Publishing House, 2020: 266.
4 崔庆赢, 陈思宇, 付帅, 等. 口腔颌面外科门诊拔牙患者牙科焦虑症调查分析[J]. 华西口腔医学杂志, 2018, 36(3): 314-318.
Cui QY, Chen SY, Fu S, et al. Survey and analysis of tooth extraction anxiety of dental patients[J]. West China J Stomatol, 2018, 36(3): 314-318.
5 许永华. 儿童口腔门诊牙科畏惧症的相关影响因素探讨及日间全麻下干预研究[D]. 郑州: 郑州大学, 2019.
Xu YH. To study the related influencing factors of children’s dental fear in outpatient and the treament under dental general anesthesia[D]. Zhengzhou:Zhengzhou University, 2019.
6 Aziz M, Jat SA, Qazi FU, et al. Audiovisual distraction: a pricking pain reduction modality among ladies receiving intraoral injections[J]. J Coll Physicians Surg Pak, 2020, 30(1): 4-8.
7 Rao DG, Havale R, Nagaraj M, et al. Assessment of efficacy of virtual reality distraction in reducing pain perception and anxiety in children aged 6-10 years: a behavioral interventional study[J]. Int J Clin Pediatr Dent, 2019, 12(6): 510-513.
8 Hoffman HG, Patterson DR, Rodriguez RA, et al. Virtual reality analgesia for children with large severe burn wounds during burn wound debridement[J]. Front Virtual Real, 2020, 1: 602299.
9 Guideline on behavior guidance for the pediatric dental patient[J]. Pediatr Dent, 2016, 38(6): 185-198.
10 López-Valverde N, Muriel-Fernández J, López-Valverde A, et al. Use of virtual reality for the management of anxiety and pain in dental treatments: systematic review and meta-analysis[J]. J Clin Med, 2020, 9(10): 3086.
11 田宋青梦. 认知行为疗法对减轻学龄前儿童牙科焦虑症的有效性研究[D]. 太原: 山西医科大学, 2020.
Tian SQM. Effectiveness of cognitive behavioral therapy in reducing dental anxiety in preschool children[D]. Taiyuan: Shanxi Medical University, 2020.
12 Rajeswari SR, Chandrasekhar R, Vinay C, et al. Effectiveness of cognitive behavioral play therapy and audiovisual distraction for management of preoperative anxiety in children[J]. Int J Clin Pediatr Dent, 2019, 12(5): 419-422.
13 卢佳璇, 余东升, 林家成, 等. 改良中文版儿童牙科畏惧调查表的信度和效度考评[J]. 中华口腔医学研究杂志(电子版), 2011, 5(3): 288-294.
Lu JX, Yu DS, Lin JC, et al. Reliability and validation of the Chinese version of modified children’s fear survey schedule-dental subscale[J]. Chin J Stomatol Res (Electron Ed), 2011, 5(3): 288-294.
14 Serino S, Repetto C. New trends in episodic memory assessment: immersive 360° ecological videos[J]. Front Psychol, 2018, 9: 1878.
15 Ozdemir S, Parlakyıldız Gokce A, Unver T. Simulation of three intraoral radiographic techniques in pediatric dental patients: subjective comfort assessment using the VAS and Wong-Baker faces pain rai-ting scale[J]. BMC Oral Health, 2020, 20(1): 33.
16 王春燕. 行为管理技术在学龄前患龋儿童牙科焦虑症中的应用研究[D]. 济南: 山东大学, 2019.
Wang CY. Application study on the role of behavior management in dentalanxiety among preschool children with tooth decay[D]. Jinan: Shandong University, 2019.
17 熊晓菊, 毛靖. 虚拟现实技术在儿童乳牙拔除术中的应用[J]. 护理学杂志, 2012, 27(12): 47-49.
Xiong XJ, Mao J. Application of virtual reality to children receiving removal of baby teeth[J]. J Nurs Sci, 2012, 27(12): 47-49.
18 Nuvvula S, Alahari S, Kamatham R, et al. Effect of audiovisual distraction with 3D video glasses on dental anxiety of children experiencing administration of local analgesia: a randomised clinical trial[J]. Eur Arch Paediatr Dent, 2015, 16(1): 43-50.
19 Arane K, Behboudi A, Goldman RD. Virtual reality for pain and anxiety management in children[J]. Can Fam Physician, 2017, 63(12): 932-934.
20 Eijlers R, Utens E, Staals LM, et al. Systematic review and meta-analysis of virtual reality in pedia-trics: effects on pain and anxiety[J]. Anesth Analg, 2019, 129(5): 1344-1353.
[1] Han Chong,He Dongning,Yu Feiyan,Wu Dongchao. Research progress on the mechanism and treatment of pain after oral implants [J]. Int J Stomatol, 2024, 51(1): 99-106.
[2] Wu Li’an. Application of partial crown reattachment in complicated crown-root fractures of permanent anterior teeth in children [J]. Int J Stomatol, 2023, 50(6): 623-631.
[3] Liao Honglin,Fang Zhonghan,Zhang Yanyan,Liu Fei,Shen Jiefei.. Diagnosis and treatment of post-traumatic trigeminal neuropathic pain after dental implantation [J]. Int J Stomatol, 2023, 50(6): 729-738.
[4] Pei Ling,Zeng Ni,Yang Chao,Wang Yan,He Miao,Luo Qiang,Shi Bing. Analgesic effects of local anesthesia after cleft lip and palate repair [J]. Int J Stomatol, 2022, 49(6): 657-662.
[5] He Hong.. Clinical diagnosis and strategies for early orthodontic treatment of Class Ⅲ malocclusion with tonsillar hypertrophy in children [J]. Int J Stomatol, 2022, 49(3): 249-254.
[6] Yang Hong,Jin Yu,Lai Wenli. Randomized cross-control trial of placebo in the regulation of orthodontic tooth movement pain [J]. Int J Stomatol, 2020, 47(4): 424-430.
[7] Yu Lintong,Song Guangtai. Application of erbium laser in pediatric dentistry [J]. Int J Stomatol, 2020, 47(3): 351-355.
[8] Meijie Wang,Xin Tan,Yuwei Zhao,Haiyang Yu. Influences of immediat implant or traditional implant on postoperative pain [J]. Int J Stomatol, 2019, 46(3): 292-296.
[9] Dan Liu,Bochun Mao,Ruyan Luo,Ke Cui,Bing Shi,Caixia Gong. Family resilience for families of children with cleft lip and palate and discussion on its influencing factors [J]. Int J Stomatol, 2019, 46(3): 297-301.
[10] Weilin Pan,Yubin Cao,Chang Liu,Jiyuan Liu,Chunjie Li,Jian Pan,Chengge Hua. Flap design associated pain after the extraction of mandibular third molars: a systematic review and Meta-analysis [J]. Inter J Stomatol, 2019, 46(2): 142-148.
[11] Ding Jie, Song Guangtai.. Clinical application of minimally invasive techniques in the management of children’s dental caries [J]. Inter J Stomatol, 2018, 45(4): 473-479.
[12] You Wenzhe, Xia Bin.. Oral health promotion and maintenance of mental/intellectual disabled children [J]. Inter J Stomatol, 2018, 45(4): 492-496.
[13] Liu Xiaohua, Wang Enbo. Application progress on cone beam computed tomography imaging localization in extraction of embedded supernumerary teeth in children [J]. Inter J Stomatol, 2018, 45(3): 295-300.
[14] Cai Donglin, Lu Rui. Research progress on the etiology of recurrent aphthous ulcer in children [J]. Inter J Stomatol, 2018, 45(2): 145-149.
[15] Chen Jing, Huang Xiaofeng.. Development of laser applications in orthodontics [J]. Inter J Stomatol, 2017, 44(6): 712-716.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[7] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 458 -460 .
[8] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 452 -454 .
[9] . [J]. Inter J Stomatol, 2008, 35(S1): .
[10] . [J]. Inter J Stomatol, 2008, 35(S1): .