The effects of virtual reality and external cooling and vibration (Buzzy®) on dental anxiety and pain during inferior alveolar nerve block in children: a randomized clinical trial

Background: To compare the effectiveness of virtual reality (VR) and external cooling and vibration distraction techniques on dental anxiety and pain in children during inferior alveolar nerve block (IANB). Methods: In this randomized controlled parallel arm trial, 120 children aged 6 to 12 years requiring IANB were included and randomly assigned into one of three groups: Group I: VR eyeglasses, Group II: Buzzy® device and Group III: Control (conventional behavior management technique). Dental anxiety levels were measured by the heart rate (HR) and oxygen saturation level (SpO2) before, during, and after the IANB procedure. Pain perception was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale, Wong Baker Faces Scale (WBS) and Visual Analog Scale (VAS). Results: A significant increase in HR was observed in all groups during the IANB procedure (p < 0.05). Group II (Buzzy® device) showed the lowest FLACC scores, followed by Group I (VR eyeglasses) and Group III (Control), with statistically significant differences among groups (p < 0.05). However, no significant differences were found between the groups in terms of WBS and VAS scores (p > 0.05). Conclusions: Although neither VR eyeglasses nor the Buzzy® device significantly reduced physiological indicators of dental anxiety during IANB, both techniques were effective in lowering pain levels compared to conventional behavior management techniques. Clinical Trial Registration: The study protocol was retrospectively registered at www.clinicaltrials.gov (ID: NCT06788301).

Dental anxiety; Distraction; Local anesthesia; Pain; Pediatric dentistry

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