Effects of Virtual Reality Versus Game Applications on Children’s Dental Fear: A Randomized Clinical Trial

Background: Management of dental anxiety and fear of pediatric dental patients is a major goal in pediatric dentistry to create a positive attitude towards dental procedures and perform a successful treatment. Preoperative positive imagery and distraction during treatment are some of the non-pharmaceutical approaches for reduction of fear and anxiety of pediatric dental patients. This study aimed to compare the efficacy of dental simulation game applications (apps) in smartphones and virtual reality glasses on the management of dental anxiety and fear in 5-8-year-old dental patients. Methods: This randomized clinical trial was conducted on 42 eligible children between 5-8 years in their first dental visit. After prophylaxis and fluoride therapy, patients were randomly assigned to two groups (n=21). Group 1 used Virtual reality glasses during the procedure while group 2 used dental simulation game apps prior to treatment. After completion of dental procedure, dental anxiety and fear of children were recorded in both groups using the Facial Image Scale (FIS) and Modified Child Dental Anxiety Scale (MCDAS); and the results were compared by t-test and Mann-Whitney test (alpha=0.05). Results: The FIS scores were not significantly different between the groups (P=0.068). However, the MCDAS scores showed significantly lower levels of dental anxiety and fear in the VR group compared with the app group (P=0.002). Conclusion: Wearing Virtual reality glasses operating based on the distraction technique during dental procedures was more effective than preoperative use of dental simulation game apps for reduction of dental anxiety and fear of 5-8-year-old children.