Overview
The purpose of this prospective, randomized, single-blind clinical study is to evaluate and compare the effectiveness of distraction using virtual reality (VR) glasses and deep-pressure stimulation using weighted blankets on dental anxiety, cooperation, and pain perception in school-aged children. The study focuses on children aged 5-9 years with high dental anxiety (CFSS-DS score ≥39) who require dental procedures involving local anesthesia, such as Class II restorations, pulpotomy, or extractions. Participants will be randomly assigned to four groups: a control group receiving standard behavior guidance, a VR group, a weighted blanket group, and a combined group using both VR and weighted blankets. The study aims to determine the effects of these non-pharmacological, non-invasive, sensory-based interventions on children's clinical experience and physiological parameters.
Description
This clinical trial is designed as a four-arm, randomized controlled study to compare sensory-based behavior guidance techniques in pediatric dentistry.
Study Arms:
Group 1 (Control): Treatment with basic behavior guidance techniques.
Group 2 (VR): Treatment using virtual reality (VR) glasses as a distraction tool.
Group 3 (WB): Treatment using a 3-kg weighted blanket for deep-pressure stimulation.
Group 4 (Combined): Simultaneous use of VR glasses and a weighted blanket.
- Methodology
Children aged 5-9 years who meet the inclusion criteria will be evaluated at multiple time points: pre-treatment, during local anesthesia, and post-treatment.
Outcome Measures:
Dental Anxiety: Assessed using the Facial Image Scale (FIS) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS).
Cooperation: Evaluated using the Frankl Behavior Rating Scale and the FLACC (Face, Legs, Activity, Cry, Consolability) scale.
Pain Perception: Measured using the Wong-Baker FACES Pain Rating Scale.
Physiological Parameters: Heart rate and oxygen saturation will be monitored throughout the procedure.
Acceptability: Subjective feedback from children and parents will be collected via post-treatment surveys to assess the feasibility of and satisfaction with the interventions.
Inclusion is restricted to systemically healthy children (ASA I-II) whose body weight (15-30 kg) is compatible with the 3-kg weighted blanket to ensure safety and appropriate therapeutic pressure.
Eligibility
Inclusion Criteria:
- Children aged between 5 and 9 years.
- Children with a total score of 39 or higher on the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS).
- Requirement for dental treatment necessitating local anesthesia, such as Class II restorations, pulpotomy, pulpectomy, or extractions.
- Systemically healthy children classified as ASA I or ASA II.
- Voluntary participation of both the child and the parent, with written informed consent obtained from the parent.
- Body weight between 15 and 30 kg, ensuring that the 3-kg weighted blanket corresponds to 10-20% of the child's body weight.
Exclusion Criteria:
- Children with a CFSS-DS score of 38 or lower.
- Presence of intellectual or developmental disabilities.
- Presence of visual or hearing impairments.
- Presence of neurodevelopmental or neurological disorders, such as epilepsy.
- Acute or chronic respiratory diseases.
- Neuromuscular or orthopedic conditions that may pose a risk during the use of the weighted blanket.
- History of dizziness, nausea, or vertigo associated with virtual reality use.
- Refusal of the specific interventions, namely VR glasses or the weighted blanket, by the child or the parent.
