Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial

Abstract

Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre™) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment.

Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham's clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken.

Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p = 0.029), and the scores decreased significantly during treatment in the AV-group (p = 0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p = 0.02), but not in the AV-group.

Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment.

Keywords: Children; anxiety; behaviour; dental fear; restorative treatment.

Figure 1.

Illustration of the AV distraction eyeglass goggle Merlin i-theatre™ in a clinical setting.

Figure 2.

The proportions of clinical anxiety and cooperative behaviour (MVARS) with either audiovisual distraction (AV-group; A) or no distraction (CTR-group; B). *Significant decrease in clinical anxiety throughout the restorative procedure in visit 3.

Figure 3.

The proportions of self-reported measures of anxiety (FIS), ranging from ‘very happy’ (1) to ‘very unhappy’ (5), before and after each visit with either audiovisual distraction (AV-group; A) or no distraction (CTR-group; B).