Effectiveness of Audio and Audio-Visual Distraction Aids for Management of Pain and Anxiety in Children and Adults Undergoing Dental Treatment- A Systematic Review And Meta-Analysis

Abstract

Dentists have a wide variety of techniques available to them such as tell -show-do, relaxation, distraction, systematic desensitisation, modelling, audio analgesia, hypnosis, and behaviour rehearsal. There is no concrete research as systematic review and meta-analysis indicating which explains the most effective distraction technique.

Aim: To summarize effectiveness of audio and audio-visual (AV) distraction aids for management of pain and anxiety in children undergoing dental treatment.

Study design: Literature search: PubMed/MEDLINE, DOAJ, Science Direct from June - July 2020 with randomized control clinical trials conducted on children with audio and AV distraction aids as intervention and those which had anxiety and pain as outcomes were searched. Fifty articles were identified and relevance was determined. 14 studies were included for qualitative synthesis and 05 were eligible for meta-analysis. Cochrane handbook used to assess the risk of bias. The meta analysis conducted using review manager 5.3 software.

Results: Meta-analysis, cumulative mean difference for audio and AV distraction techniques was calculated with main outcomes as pulse rate, O2 level, Vehman's picture and clinical test. These findings showed significant difference favoring the intervention (audio and AV) group when compared with control but indicating more effectiveness of AV distractions.

Conclusion: Different audio-visual aids assist in reducing pain and anxiety in children but using audio distraction aids when audio-visual aids are not available could be acceptable way for distracting and treating children.

Keywords: Anxiety; Audio-visual distraction aids; Venham’s picture test; meta-analysis.