Virtual Reality Distraction vs Nitrous Oxide for Reducing Anxiety and Injection Pain
The purpose of this study was to compare nitrous oxide (N2O) vs virtual reality (VR) as methods for reducing pain and anxiety during a dental injection. The primary objectives were to assess acute changes in stress responses by comparing salivary cortisol levels between the 2 groups and differences in injection pain scores. A total of 132 female subjects serving as their own control received maxillary lateral incisor infiltration injections with the use of either N2O or a VR headset during separate appointments spaced at least 2 weeks apart. Salivary cortisol samples were collected at 6 times throughout each appointment. Pain scores for needle insertion and solution deposition were recorded. Data were analyzed statistically using Wald and paired t tests. N2O significantly lowered salivary cortisol concentrations and subsequent physiologic anxiety as compared with VR (P = .0089). However, no significant differences in needle insertion or solution deposition pain scores were found. Although VR and N2O may be comparable in terms of perceived pain reduction, N2O was a more effective method than VR for physiologic analgesia and anxiolysis.Objective
Methods
Results
Conclusion
Corah Dental Anxiety Scale
Questionnaire and rating scale for Corah Dental Anxiety Scale.
Female Subject Wearing the VR Headset
A clinical picture of the virtual reality (VR) headset.
The Heft-Parker VAS
Values of the Heft-Parker Visual Analogue Scale (VAS). The numbers at the top of the scale were omitted on the patients’ VAS.
Average Cortisol Levels Over Time
Graph illustrates the average cortisol levels for NO and VR over 60 minutes. Overall, nitrous oxide significantly lowered cortisol concentrations and subsequent physiologic anxiety as compared with virtual reality. NO indicates nitrous oxide; VR, virtual reality.
Contributor Notes