Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

Abstract

Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the e ectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. Methods: MEDLINE, CENTRAL, PubMed, EMBASE,Wiley Library andWeb of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations. Results: 31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies (n = 4), anxiety levels in three (n = 3) and anxiety and pain together in seven (n = 7). Our meta-analysis was based on ten studies (n = 10). The e ect of VR was studied mainly in the pediatric population (for pain SMD = 0.82). In the adult population, only two studies (not significant) were considered. Conclusions: The findings of the meta-analysis show that VR is an e ective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.