Effect of Virtual Reality on managing dental anxiety and vital signs during surgical wisdom tooth extraction: A Randomized Controlled Trial

Abstract

Fear of dental visits is often perceived as an unpleasant experience, leading patients to postpone or cancel appointments until emergencies arise. Virtual reality (VR) intervention has been proposed as a support to overcoming anxiety for dental treatment. This randomized controlled trial evaluated the effectiveness of VR in reducing dental anxiety and stabilizing physiological responses. Thirty-two participants aged 19–51 years with moderate to severe dental anxiety (DAS-R ≥9) were randomly assigned to a VR group or a control group via a basic lottery, i.e., group assignment on arrival at the dentist’s office. The experimental group received VR intervention during treatment, while the control group underwent standard care. Dental Anxiety Scale-Revised (DAS-R) scores and physiological parameters (oxygen saturation, blood pressure, pulse rate) were recorded before and after treatment. Paired-samples t-tests examined within-group changes, while independent-samples t-tests were used to compare groups. Of the 32 participants (59.4% female, 40.6% male), psychological outcomes indicated that VR significantly reduced dental anxiety compared with the control group (p < 0.001). Mean DAS-R scores decreased from 3.38 + 0.71 to 1.69+ 0.47 in the VR group, compared with 3.56 + 0.96 to 2.81 + 0.83 in controls. Clinically, post-treatment, all VR participants reported only mild anxiety, versus 87.5% of controls remaining moderately anxious. Physiological outcomes showed that VR also significantly reduced systolic blood pressure (p = 0.02) but had no significant effect on diastolic pressure, oxygen saturation, or pulse rate. These findings suggest that VR is a cost-effective, non-pharmacological tool for alleviating dental anxiety and enhancing patient comfort during treatment, warranting further investigation of its broader clinical applications through larger, long-term studies.