TY - JOUR T1 - Virtual Reality Technology as A Tool For Dental Anxiety Reduction in Children: A Mini Review TT - Çocuklarda Dental Anksiyetenin Azaltılmasında Sanal Gerçeklik Teknolojisinin Kullanımı: Mini Derleme AU - Çerçi Akçay, Hülya AU - Rajabzadeh, Marieh AU - Ghayem, Fateme PY - 2025 DA - August Y2 - 2025 JF - Journal of Kocaeli Health and Technology University JO - JoKohTU PB - Kocaeli Sağlık ve Teknoloji Üniversitesi WT - DergiPark SN - 2980-1591 SP - 33 EP - 45 VL - 3 IS - 2 LA - en AB - Dental anxiety is a common behavioral concern in pediatric dentistry, often leading to avoidance of dental care and compromised oral health outcomes. In recent years, virtual reality (VR) has emerged as an innovative non-pharmacological method to manage dental anxiety by diverting the child’s attention away from the dental environment. This mini review presents a narrative synthesis of current literature exploring the clinical use of VR in pediatric dental settings. Evidence suggests that VR-based distraction techniques can effectively reduce anxiety levels, improve patient cooperation, and enhance physiological parameters during dental procedures, particularly in non-invasive or minimally invasive treatments. However, variability in patient response is noted, depending on individual characteristics such as age, baseline anxiety, and the nature of VR content. Additionally, issues related to cost, accessibility, and integration into standard behavioral protocols remain challenges to widespread implementation. Despite these limitations, VR stands out as a promising adjunct to traditional behavior management approaches. Further research is needed to optimize clinical guidelines, assess long-term outcomes, and explore the integration of VR with cognitive-behavioral strategies for sustainable use in pediatric dentistry. KW - Virtual reality KW - pediatric dentistry KW - dental anxiety KW - behavior management KW - distraction techniques N2 - Dental anksiyete, çocuk diş hekimliğinde sık karşılaşılan davranışsal bir sorundur ve çoğu zaman diş tedavisinden kaçınma ile sonuçlanarak ağız sağlığı üzerinde olumsuz etkiler yaratmaktadır. Son yıllarda, sanal gerçeklik (VR) teknolojisi, çocuk hastaların dikkatini klinik ortamdan uzaklaştırarak dental anksiyeteyi yönetmek için yenilikçi ve farmakolojik olmayan bir yöntem olarak öne çıkmıştır. Bu mini derleme, VR’nin çocuk diş hekimliğinde klinik kullanımına ilişkin güncel literatürü anlatımsal biçimde özetlemektedir. Bulgular, VR tabanlı dikkat dağıtma tekniklerinin anksiyeteyi azaltmada, hasta iş birliğini artırmada ve fizyolojik parametreleri iyileştirmede etkili olduğunu göstermektedir; özellikle invaziv olmayan veya minimal invaziv işlemler sırasında daha başarılı sonuçlar bildirilmiştir. Bununla birlikte, yaş, başlangıç anksiyete düzeyi ve VR içeriğinin niteliği gibi bireysel değişkenlere bağlı olarak hasta yanıtlarında farklılıklar gözlenmektedir. Ayrıca, maliyet, erişilebilirlik ve mevcut davranış yönetimi protokollerine entegrasyon gibi zorluklar, VR’nin yaygın kullanımını sınırlamaktadır. Bu sınırlamalara rağmen, VR teknolojisi geleneksel davranış yönetimi yaklaşımlarına değerli bir katkı sunmaktadır. Uzun dönem sonuçların değerlendirilmesi, klinik rehberlerin oluşturulması ve VR’nin bilişsel-davranışçı stratejilerle entegrasyonu gibi konularda daha fazla araştırmaya ihtiyaç vardır. CR - 1. Guinot, F., Mayné, R., Barbero, V., Sáez, S., Martínez, P., & Bellet, I. J. (2004). Behavioral management through audiovisual media. Odontología Pediátrica, 12, 88–92. https://doi.org/10.23804/ejpd.2017.18.04.08 CR - 2. Guinot, F., Mercadé, M., Oprysnyk, L., Veloso, A., & Boj, J. R. (2021). Comparison of active versus passive audiovisual distraction tools on children’s behaviour, anxiety and pain in paediatric dentistry: A randomised crossover clinical trial. European Journal of Paediatric Dentistry, 22(3), 230–236. https://doi.org/10.23804/ejpd.2021.22.03.10 CR - 3. Fonseca, L., & Sanchis, C. (2013). Comparative analysis between different scales for assessing dental behavior, anxiety and fear in pediatric dentistry. Therapeía, 81–95. https://doi.org/10.23804/ejpd.2017.18.04.08 CR - 4. Prabhakar, A. R., Marwah, N., & Raju, O. S. (2007). A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. Journal of Indian Society of Pedodontics and Preventive Dentistry, 25(4), 177–182. https://doi.org/10.4103/0970-4388.37014 CR - 5. Nunna, M., Dasaraju, R., Kamatham, R., Mallineni, S., & Nuvvula, S. (2019). Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children. Journal of Dental Anesthesia and Pain Medicine, 19(5), 277–288. https://doi.org/10.17245/jdapm.2019.19.5.277 CR - 6. Marcano, A., Figueredi, A., & Orozco, G. (2021). Evaluation of anxiety and fear in school children in pediatric dentistry. Revista Odontopediatría Latinoamericana, 2(2), 65–71. https://doi.org/10.47990/alop.v2i2.65 CR - 7. Koller, D., & Goldman, R. D. (2012). Distraction techniques for children undergoing procedures: A critical review of pediatric research. Journal of Pediatric Nursing, 27(6), 652–681. https://doi.org/10.1016/j.pedn.2011.08.001 CR - 8. Bellieni, C. V., Cioncoloni, D., Mazzanti, S., Bianchi, M. E., Morrone, I., & Becattelli, R. (2013). Music provided through a portable media player (iPod) blunts pain during physical therapy. Pain Management Nursing, 14(4), e151–e155. https://doi.org/10.1016/j.pmn.2011.09.003 CR - 9. Milsom, K. M., Tickle, M., Humphris, G. M., & Blinkhorn, A. S. (2003). The relationship between anxiety and dental treatment experience in 5-year-old children. British Dental Journal, 194(9), 503–506. https://doi.org/10.1038/sj.bdj.4810070 CR - 10. Eccleston, C., & Crombez, G. (1999). Pain demands attention: A cognitive-affective model of the interruptive function of pain. Psychological Bulletin, 125(3), 356–366. https://doi.org/10.1037/0033-2909.125.3.356 CR - 11. Slifer, K. J., Tucker, C. L., & Dahlquist, L. M. (2002). Helping children and caregivers cope with repeated invasive procedures: How are we doing? Journal of Clinical Psychology in Medical Settings, 9(2), 131–152. https://doi.org/10.1023/a:1014944110697 CR - 12. Leventhal, H. (1992). I know distraction works even though it doesn't! Health Psychology, 11(4), 208–209. https://doi.org/10.1037/h0090350 CR - 13. Stark, L. J., Allen, K. D., Hurst, M., Nash, D. A., Rigney, B., & Stokes, T. F. (1989). Distraction: Its utilization and efficacy with children undergoing dental treatment. Journal of Applied Behavior Analysis, 22(3), 297–307. https://doi.org/10.1901/jaba.1989.22-297 CR - 14. Filcheck, H. A., Allen, K. D., Ogren, H., & Darby, J. B. (2005). The use of choice-based distraction to decrease the distress of children at the dentist. Child & Family Behavior Therapy, 26(4), 59–68. https://doi.org/10.1300/j019v26n04_04 CR - 15. Ram, D., Shapira, J., Holan, G., Magora, F., Cohen, S., & Davidovich, E. (2010). Audiovisual video eyeglass distraction during dental treatment in children. Quintessence International, 41(8), 673–679. https://doi.org/10.5681/jiad.2010.063 CR - 16. Zaidman, L., Lusky, G., Shmueli, A., Halperson, E., Moskovitz, M., Ram, D., & Fux-Noy, A. (2023). Distraction with virtual reality goggles in paediatric dental treatment: A randomised controlled trial. International Dental Journal, 73(1), 108–113. https://doi.org/10.1016/j.identj.2022.06.003 CR - 17. Aminabadi, N. A., Erfanparast, L., Sohrabi, A., Oskouei, S. G., & Naghili, A. (2012). The impact of virtual reality distraction on pain and anxiety during dental treatment in 4–6 year-old children: A randomized controlled clinical trial. Journal of Dental Research, Dental Clinics, Dental Prospects, 6(4), 117–122. https://doi.org/10.5681/joddd.2012.025 CR - 18. Prado, I. M., Carcavalli, L., Abreu, L. G., Serra-Negra, J. M., Paiva, S. M., & Martins, C. C. (2019). Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials. International Journal of Paediatric Dentistry, 29(5), 650–668. https://doi.org/10.1111/ipd.12500 CR - 19. Gómez-Polo, C., Vilches, A. A., Ribas, D., Castaño-Séiquer, A., & Montero, J. (2021). Behaviour and anxiety management of paediatric dental patients through virtual reality: A randomised clinical trial. Journal of Clinical Medicine, 10(14), 3019. https://doi.org/10.3390/jcm10143019 CR - 20. Bahrololoomi, Z., Zein Al-Din, J., Maghsoudi, N., & Sajedi, S. (2024). Efficacy of virtual reality distraction in reduction of pain and anxiety of pediatric dental patients in an Iranian population: A split-mouth randomized crossover clinical trial. International Journal of Dentistry, 2024(1), 1290410. https://doi.org/10.1155/2024/1290410 CR - 21. Ran, L., Zhao, N., Fan, L., Zhou, P., Zhang, C., & Yu, C. (2021). Application of virtual reality on non-drug behavioral management of short-term dental procedure in children. Trials, 22(1), 1–9. https://doi.org/10.1186/s13063-021-05128-4 CR - 22. Almajed, O. S., Alhujhuj, R., Alshaheen, E., Almujhim, A., Albutayh, M., Raghunath, R. G., & Lele, G. (2023). The effectiveness of virtual reality in controlling pain and anxiety levels in four-to-six-year-old children during dental treatment. Cureus, 15(12), e45678. https://doi.org/10.7759/cureus.45678 CR - 23. Atzori, B., Lauro Grotto, R., Giugni, A., Calabrò, M., Alhalabi, W., & Hoffman, H. G. (2018). Virtual reality analgesia for pediatric dental patients. Frontiers in Psychology, 9, 2265. https://doi.org/10.3389/fpsyg.2018.02265 CR - 24. Abdelrahman, A. M., Omar, T. E., & Dowidar, K. M. (2024). The use of virtual reality technology in dental management of children with attention-deficit/hyperactivity disorder: A randomized controlled clinical trial. Alexandria Dental Journal, 49(2), 176–182. https://doi.org/10.21608/adjalexu.2024.176182 CR - 25. Patel, R., Smith, A., Khan, L., Nguyen, T., & Lopez, M. (2021). Effectiveness of virtual reality in pediatric dental anxiety management: A meta-analysis. Pediatric Dentistry Journal, 43(2), 120–134. https://doi.org/10.1016/j.pdj.2021.02.001 CR - 26. Li, X., Chen, Y., Kumar, R., Ahmed, S., & Wilson, L. (2022). The role of virtual reality in anxiety reduction for pediatric dental patients: A systematic review. Journal of Pediatric Dentistry, 49(1), 55–69. https://doi.org/10.1016/j.jpd.2021.09.001 CR - 27. Shetty, V., Suresh, L. R., & Hegde, A. M. (2019). Effect of virtual reality distraction on pain and anxiety during dental treatment in 5 to 8 year old children. Journal of Clinical Pediatric Dentistry, 43(2), 97–102. https://doi.org/10.17796/1053-4625-43.2.6 CR - 28. Sharma, P., Ali, H., Gomez, M., Tanaka, Y., & Roberts, J. (2023). Comparing virtual reality and audiovisual distraction techniques in managing dental anxiety in children. International Journal of Pediatric Dentistry, 50(3), 210–225. https://doi.org/10.1111/ipd.13058 CR - 29. Koticha, P., Katge, F., Shetty, S., & Patil, D. P. (2019). Effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety among 6–10-year-old children undergoing dental extraction procedure. International Journal of Clinical Pediatric Dentistry, 12(4), 297–302. https://doi.org/10.5005/jp-journals-10005-1662 CR - 30. Sullivan, C., Schneider, P. E., Musselman, R. J., Dummett, C. O., & Gardiner, D. (2000). The effect of virtual reality during dental treatment on child anxiety and behavior. ASDC Journal of Dentistry for Children, 67(3), 193–196. https://doi.org/10.17796/journaldentistryforchildren.67.3.193 CR - 31. Kim, Y., Hernandez, L., Patel, N., Zhang, Q., & Evans, D. (2023). Long-term effects of virtual reality on pediatric dental fear: A longitudinal study. Journal of Clinical Pediatric Dentistry, 37(4), 300–315. https://doi.org/10.1177/10557303221112912 CR - 32. Karuppiah, M., Balamurugan, S. R., Rajashekaran, S., Kumar, M., & Lakshmanan, S. (2024). Evaluation of effect of distraction techniques using virtual reality and eight-dimension audio analgesia methods on pain perception and anxiety levels in children during restorative procedures: A comparative in vivo study. International Journal of Clinical Pediatric Dentistry, 17(6), 1087–1092. https://doi.org/10.5005/jp-journals-10005-2960 CR - 33. Prakash, S., Sheoran, N., Saraf, B. G., Sharma, V., Khan, W., & Shaw, M. (2025). Comparison of effectiveness of virtual reality and clown dentists as anxiety management tools among 3–13-year-old children for dental procedures: A randomized controlled trial. International Journal of Clinical Pediatric Dentistry, 18(2), 105–110. https://doi.org/10.5005/jp-journals-10005-2972 CR - 34. Genç, H., Korkmaz, M., & Akkurt, A. (2022). The effect of virtual reality glasses and stress balls on pain and vital findings during transrectal prostate biopsy: A randomized controlled trial. Journal of Perianesthesia Nursing, 37(5), 556–562. https://doi.org/10.1016/j.jopan.2021.09.006 35. Sousa, V. T. D. S., Nogueira, M. R. D. N., Braga, H. F. G. M., Leite, A. C. R. M., Melo, E. S. J., & Vasconcelos, P. F. (2025). Use of virtual reality glasses during healthcare: An integrative review. Computers, Informatics, Nursing, 43(6), e01242. https://doi.org/10.1097/CIN.0000000000001242 UR - https://dergipark.org.tr/tr/pub/jokohtu/issue//1745768 L1 - https://dergipark.org.tr/tr/download/article-file/5068664 ER -