Can virtual reality reduce anxiety and pain in dental patients?

Data sourcesA systematic search was conducted across PubMed and Cochrane Library up to April 2024. Study selection The article type was limited to Randomised Controlled Trials, comparing virtual reality (VR) interventions with non-VR methods in dental settings. The selection followed the PRISMA-P guidelines. Using the PICOS framework, studies involving dental patients of any age utilising VR during dental treatments and reporting outcomes on anxiety and pain were included. Data extraction and synthesis Data extraction and quality appraisal were conducted independently by two reviewers using both the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach and the Risk of Bias 2 (ROB-2) tool. Meta-analyses used a random-effects model. Results A total of 263 studies resulted in the inclusion of 27 studies, encompassing several dental treatments. Evidence quality ranged from low to moderate. Meta-analysis of 14 studies, encompassing 957 patients, revealed VR significantly reduced anxiety in children (SMD -1.44, 95% CI -2.24 to -0.63, low quality of evidence). Metal-analysis of five studies (485 patients) revealed VR had no effect on adults' anxiety (SMD -0.35, 95% CI -1.11 to 0.4, low level of certainty). VR significantly reduced pain in both children (11 studies, 791 participants) (SMD -1.11, 95% CI -1.65 to -0.57, moderate level of certainty) and adults (6 studies, 557 participants) (SMD -0.59, 95% CI -1.187 to -0.001, low evidence quality). Heterogeneity was high across studies. Conclusion The study concluded that VR is a promising intervention for reducing anxiety and pain in children during dental procedures, and pain reduction in adults. The authors suggested further research is needed to standardise the VR content and explore its impact across different age groups and dental procedures.