Effect of audio and virtual reality distraction on the dental anxiety of children with mild intellectual disability

• Published in: Special care in dentistry Vol. 44; no. 3; pp. 868 - 877
• Main Authors: Mehrotra, Deepshikha, Shetty, Amarshree A., Rai, Kavita, Kumara
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-05-2024
• Subjects: Anxiety; audio distraction; behavior guidance; Child; Children; Cognitive ability; Cross-Over Studies; Dental Anxiety; Dental caries; Dental restorative materials; dentistry; Female; Humans; Intellectual disabilities; Intellectual Disability; Male; Maxillofacial surgery; Neurodevelopmental disorders; Oxygen saturation; Physiology; Social discrimination learning; special healthcare needs; Statistical analysis; Virtual Reality; anxiety; audio distraction; virtual reality; dentistry; special healthcare needs; behavior guidance; intellectual disability
• ISSN: 0275-1879; 1754-4505
• DOI: 10.1111/scd.12932

Background and Aim
Intellectual disability, is a neurodevelopmental disorder that typically manifests early in childhood and consists of both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. It can be categorized into mild, moderate, severe, and profound based on its severity. Cognitive impairment may be observed predominantly in children with intellectual disabilities. Marked deficits in areas of learning, planning, communication, social participation, and personal independence in children with mild intellectual disabilities make behavior guidance and communication a challenge during dental treatments. The aim was to evaluate and compare the use of two different distraction tools, audio, and virtual reality (VR) on the dental anxiety of children with mild intellectual disability during dental treatment.
Methods
Twenty children diagnosed with mild intellectual disability were equally divided into two groups. A cross‐over study design consisting of two appointments 1 month apart was employed. In the first appointment, audio and VR distractions were provided to participants in Groups 1 and 2, respectively, and the distraction tools provided to the participants were interchanged in the second appointment. A trained observer recorded physiological parameters (pulse rate and oxygen saturation) and observational parameters (Venham's anxiety rating scale) during both appointments at three‐time intervals. Statistical intra‐group and inter‐group comparison analyses were performed using Friedman's and Mann–Whitney U tests.
Results
A decrease in pulse, increase in oxygen saturation levels, and a decrease in Venham's Anxiety Rating Scores (statistically significant p < .05 / highly significant p < .01) was observed on introducing the distraction techniques in Groups 1 and 2 in both appointments. A statistically non‐significant difference (p > .05) in physiological and observational parameters was observed between Groups 1 and 2 in both appointments.
Conclusion
Audio and VR distraction techniques can be employed for behavior guidance in children with mild intellectual disability during restorative dental procedures.