Comparing Brief Relaxation Period to Virtual Reality Period in Reducing Dental Anxiety Prior to Root Canal Treatment: A Randomized Control Trial

Abstract

Introduction: Anxiety is a debilitating and difficult sensation many people face on a daily basis. Up to 20% of American adults experience dental anxiety2. Dental anxiety can present both psychologically and physiologically as a barrier to starting, completing and/or finishing dental treatment.2,4 Catastrophizing the procedure, which is common practice in anxious patients, will alter and increase the perception of pain66. Approaching and understanding dental anxiety has shown to produce more positive treatment outcomes and overall increased patient satisfaction2, 4, 6. Non-pharmacological approaches to reducing dental anxiety can be a quick, non-invasive, method to put patients at ease and can save chair time for both practitioner and patient, as well as a more pleasant experience for the patient. Objectives: The goal of this study is to investigate non-pharmacologic approaches to reducing dental anxiety prior to non-surgical root canal treatment. This will be done by comparing an Auditory Alone Brief Relaxation period (ABR) to a Relaxation Virtual Reality period (RVR). Materials and Methods: 60 subjects who need non-surgical root canal treatment was randomly allocated into 2 groups. One group received earphones to listen to a guided brief relaxation recording, focusing on breathing and a body scan. The other group received virtual reality goggles and choose a scene of their liking to experience. State Trait Anxiety Indicator (STAI), Visual Analog Scale (VAS), and vitals were measured to objectively determine baseline anxiety score followed by the same metrics after brief relaxation or virtual reality experience. A student will perform root canal treatment, and VAS and vitals were again be recorded at the end of the appointment. Results: Both RVR and ABR showed a statistically significant decrease in anxiety in STAI-S (p value <.001 for both), STAI-T (p value 0.025 ABR; <.001 RVR). VAS scores also significantly reduced from T1 to T2 to T3 time frame. Discussion: Our study investigated and compared two different interventions in reducing anxiety prior to endodontic therapy. The results showed that both ABR and RVR reduced anxiety prior to endodontic therapy and had an effect even after the endodontic therapy was completed. Additionally, when comparing the time points T1, T2, and T3, heart rate decreased throughout the procedure and more importantly, after the intervention (ABR or RVR) was delivered. Both anxiety scales, STAI and VAS showed a statistical significant decrease in anxiety throughout the appointment. Conclusion: Non-pharmacological techniques like guided meditation and virtual reality are a valid and unique approach to reducing anxiety prior to endodontic therapy. Both ABR and RVR interventions reduced the feelings of anxiety throughout the entire endodontic appointment. This study displays the ease of incorporating both interventions to reduce anxiety in an economical and noninvasive fashion.