62 - Comparing Virtual Reality and Nitrous Oxide in Pediatric Dentistry

Purpose: To compare virtual reality (VR) and nitrous oxide as distraction modalities to alleviate anxiety and dental pain during dental procedures.   

Methods: Sixty-two participants, aged 5 to 12 years, were included in this crossover study.  Participants were randomized during their first visit to receive either nitrous oxide or VR, followed by the alternative option at their subsequent visit. All participants received restorative treatments, such as dental restorations, crowns, and extractions using local anesthesia. The participants were asked to rate their pain with the Wong-Baker Faces scale before and after the procedure. After administration of local anesthesia, the provider gave the participant a FLACC score to rate the child’s reaction during the injection. The provider completed the Houpt Crying and Movement Scale as an assessment of the child’s overall behavior after the procedure was completed.  

Results: There was a statistically significant difference between participant behavior with VR distraction compared to nitrous oxide when measuring the Houpt (P < .001), FLACC (P < .001), and Wong-Baker Faces scores (P = .021). Scores of “definitely p</span>ositive” behaviors were observed more frequently in the nitrous oxide group (70% versus 50%). The VR group exhibited a higher incidence of “negative" behaviors (15% versus 5%).   

Conclusions: Nitrous oxide performed better to reduce dental pain and anxiety than virtual reality. Virtual reality may be a viable non-pharmacologic alternative or adjunct modality to nitrous oxide, but it requires careful case selection.  


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