Fear Anxiety Clinical Trial
Official title:
Effectiveness of Active and Passive Distraction Techniques on Reducing Fear and Anxiety and Improving Oral Health Knowledge of Children Undergoing Extraction in the Dental Operatory - A Randomized Controlled Trial
The Purpose of this study is to evaluate the effectiveness of active ( video game) and passive (video) distraction techniques on reducing fear and anxiety and improving oral health knowledge of children undergoing extraction in the dental operatory
Dentists are expected to identify and effectively treat childhood dental diseases that are
within the knowledge and skills acquired during their dental education. As every child is
different, safe and effective treatment of oral diseases often requires modifying the child's
behavior. Behavior guidance involves interaction of the dentist and dental team, the patient
and the parent directed towards communication and education. Its goal is to ease fear and
anxiety while promoting an understanding of the need for good oral health.
In 1936, Freud defined Anxiety as an unpleasant affective state or condition, which is
characterized by all that is covered by the word 'nervousness' and it can be prevented by the
avoidance of negative experiences and promotion of positive experiences in children attending
the dental operatory.
In Pediatric dentistry, communicative management and appropriate use of commands have been
used in both cooperative and uncooperative child.Commonly used techniques associated with
this guiding process are tell-show-do, voice control, nonverbal communication, positive
reinforcement and physical restraints. Even though these techniques decrease the perception
of unpleasantness, avert negative behaviours, gain or maintain the patient's attention and
compliance, it is impossible for pediatric dentists to divert their attention from perceiving
pain during invasive dental procedures.
American Academy of Pediatric Dentistry (2008) described distraction as a technique of
diverting the patient's attention from what may be perceived as an unpleasant procedure.
According to McCaul and Malott, one must attend to the pain stimulus in order to perceive it
and also experience the associated distress. Thus distraction might help in reducing the pain
perception. As the individual's attentional capacity is finite, a distracting task that
requires a great deal of the person's attentional resources should leave little attentional
capacity available for processing painful stimuli.
Thus, highly engaging and interactive distraction activities that involve multiple sensory
systems are likely to be more effective than more passive distractors or distracters that
involve only one or two sensory systems. A number of recent distraction interventions for
acute pain in children and adolescents have employed virtual reality (VR) technology in
conjunction with either a passive distraction stimulus, such as a movie (Sullivan, Schneider,
Musselman, Dummett, & Gardiner, 2000), or an interactive distraction activity, such as a
computer game (Dahlquist et al., 2007). However, the actual benefit of VR technology over and
above the benefits of the distracting stimulus that is experienced through the VR equipment
has not been adequately tested in children.
It is observed from the literature review that only few studies were found on virtual reality
distraction and their findings suggest that virtual reality can enhance the effects of
distraction for some children and thus demands further research.
Dental problems in children occur due to their poor oral health knowledge and difficulty of
parents in implementing healthy oral habits for their children at home. Thus in order to
promote oral health knowledge, method of delivering it should be effective. Till date only
one study has focused on educating oral health through video game, thus investigators planned
this study on videogames as videogames has got extreme potential and is a favourite time pass
for children nowadays. The videogame/ video are the interactive tools which would help
educate children in a playful way. Hence this study is planned to compare three behaviour
guiding techniques (active distraction using videogames, passive distraction using video and
verbatim (verbal distraction) in children( participants) for guiding their behavior during
dental procedure in a dental operatory. All these three techniques utilize instructions
related to oral health. In addition to that, investigators have planned to assess whether
these distraction techniques could effectively deliver Oral Health Education to children (
participants).
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