Effectiveness of virtual reality in reducing patient anxiety before and after the extraction of third molars under local anaesthesia

a randomised study

Authors

  • Dr. Raphaël Baras Department of Oral and Maxillofacial Surgery, Roger Salengro Hospital, Lille University Hospital, Lille, France
  • Dr. Farah Hajji Department of Maxillofacial Surgery, Jean Bernard Hospital, Valenciennes General Hospital, Valenciennes, France
  • Dr. Lidvine Godaert Department of Supportive Care in Oncology, Valenciennes General Hospital, Valenciennes, France EpiCliV Research Unit, Faculty of Medicine, University of the West Indies, Fort-de-France, Martinique
  • Emeline Cailliau Department of Biostatistics, Lille University Hospital (CHU Lille), Lille, France
  • Dr. Maria Poisson Department of Maxillofacial Surgery, Jean Bernard Hospital, Valenciennes General Hospital, Valenciennes, France

DOI:

https://doi.org/10.61872/sdj-2025-03-04

PMID:

41234063

Keywords:

Virtual reality, Oral surgical procedure, tooth avulsion, Third Molar, Anxiety

Abstract

Anxiety related to dental care remains widespread. It has been demonstrated to be a significant factor in the failure of local anaesthesia. Effectively managing this anxiety is key to ensuring the success of the procedure. VR has recently emerged in the medical field as a new non-pharmacological tool to reduce anxiety in patients undergoing various procedures. The aim of this study is to assess the usefulness of VR in reducing the anxiety experienced by patients during the extraction of wisdom teeth under local anaesthesia. This study was a prospective, single-centre, controlled, open-label study, randomized into two balanced parallel groups. The primary objective was to assess the effectiveness of VR in reducing anxiety during the extraction of three or more than three wisdom teeth under local anaesthesia. The aim was to demonstrate a difference of at least 1.5 points on a 10-point scale between the VR group and the control group. 105 patients were included. 53 in the control group and 52 in the intervention group. Statistically, no significant difference was observed between the intervention group and the control group regarding the mean change in anxiety between the preoperative and postoperative periods ( -1.8 ± 3.5 for the intervention group versus -1.6 ± 4.1 for the control group; P = 0.75). Further studies are needed to determine the effectiveness of VR glasses in reducing anxiety in patients undergoing the extraction of third molars under local anaesthesia.

References

1. Appukuttan D, Subramanian S, Tadepalli A, Damodaran LK. Dental anxiety among adults: an epidemio- logical study in South India. N Am J Med Sci. 2015 Jan;7(1):13-8.

2. Wong MK, Jacobsen PL. Reasons for local anes-thesia failures. J Am Dent Assoc. 1992;123:69–73. doi: 10.14219/jada.archive.1992.0004.

3. Ip HY, Abrishami A, Peng PW, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology. 2009 Sep;111(3):657-77. doi: 10.1097/ALN.0b013e3181aae87a.

4. Wang TF, Wu YT, Tseng CF, Chou C. Associa-tions between dental anxiety and postoperative pain following extraction of horizontally impact-ed wisdom teeth: a prospective observational study. Medicine (Baltimore) 2017;96(47):e8665. doi: 10.1097/MD.0000000000008665.

5. Aravena P.C., Almonacid C., Mancilla M.I. Effect of music at 432 Hz and 440 Hz on dental anxiety and salivary cortisol levels in patients undergoing tooth extraction: A randomized clin-ical trial. J. Appl. Oral Sci. 2020;28:e20190601. doi: 10.1590/1678-7757-2019-0601.

6. Vinayak Smith, et al. The Effectiveness of Vir-tual Reality in Managing Acute Pain and Anxiety for Medical Inpatients: Systematic Review, Journal of Medical Internet Research, Volume 22, Issue 11,2020

7. Yamashita Y., Shimohira D., Aijima R., Mori K., Danjo A. Clinical effect of virtual reality to re-lieve anxiety during impacted mandibular third molar extraction under local anesthesia. J. Oral Maxillofac. Surg. 2020;78:545.e1–545.e6. doi: 10.1016/j.joms.2019.11.016.

8. Ji G, Ne M. Is Virtual Reality Ready for Prime Time in the Medical Space? A Randomized Con-trol Trial of Pediatric Virtual Reality for Acute Procedural Pain Management. Journal of pedi-atric psychology. 2018 Apr 1;43(3):266-275. doi: 10.1093/jpepsy/jsx129.

9. Barros Padilha DX, Veiga NJ, Mello-Moura ACV, Nunes Correia P. Virtual reality and be-haviour management in paediatric dentistry: a systematic review. BMC Oral Health. 2023 Dec 12;23(1):995. doi: 10.1186/s12903-023-03595-7.

10. Algarni YA, Saini RS, Vaddamanu SK et al. The impact of virtual reality simulation on dental education: A systematic review of learning out-comes and student engagement. J Dent Educ. 2024 Nov;88(11):1549-1562. doi: 10.1002/jdd.13619.

11. Ayoub A, Pulijala Y. The application of virtual reality and augmented reality in Oral & Maxil-lofacial Surgery. BMC Oral Health. 2019 Nov 8;19(1):238. doi: 10.1186/s12903-019-0937-8.

12. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biomet-rics. 1986 Mar;42(1):121-30.

13. Liu GF, Lu K, Mogg R, Mallick M, Mehrotra DV. Should baseline be a covariate or dependent variable in analyses of change from baseline in clinical trials? Stat Med. 2009 Sep 10;28(20):2509-30. doi: 10.1002/sim.3639.

14. Vickers AJ. Parametric versus non-parametric statistics in the analysis of randomized trials with non normally distributed data. BMC Med Res Methodol. 2005 Nov 3;5:35. doi: 10.1186/1471-2288-5-35.

15. Mladenovic R, Djordjevic F. Effectiveness of virtual reality as a distraction on anxiety and pain during impacted mandibular third molar surgery under local Anesthesia. J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e15-e20. doi: 10.1016/j.jormas.2021.03.009.

16. Valls-Ontañón A, et al. Effectiveness of virtual reality in relieving anxiety and controlling he-modynamics during oral surgery under local anesthesia: A prospective randomized com-parative study. J Craniomaxillofac Surg. 2024 Mar;52(3):273-278. doi: 10.1016/j.jcms.2024.01.021.

17. Goodship N, Taylor G. Can virtual reality reduce anxiety and pain in dental patients? Evid Based Dent. 2025 Mar;26(1):59-60. doi: 10.1038/s41432-025-01127-6.

18. Das DA, Grimmer KA, Sparnon AL, McRae SE, Thomas BH. The efficacy of playing a virtual re-ality game in modulating pain for children with acute burn injuries: a randomized controlled trial [ISRCTN87413556]. BMC Pediatr. 2005 Mar 3;5(1):1. doi: 10.1186/1471-2431-5-1.

19. Li A, Montaño Z, Chen VJ, Gold JI. Virtual reality and pain management: current trends and fu-ture directions. Pain Manag. 2011 Mar;1(2):147-157. doi: 10.2217/pmt.10.15.

20. Gold, J. et al. Virtual reality in outpatient phle-botomy: Evaluating pediatric pain distraction during blood draw. The Journal of Pain, Volume 6, Issue 3, S57

21. Lu M, et al. Effectiveness of Virtual Reality in the Management of Anxiety and Pain Peri-Treatment for Breast Cancer: A Systematic Re-view and Meta-Analysis. J Nurs Res. 2024 Aug 1;32(4):e343. doi: 10.1097/jnr.0000000000000623.

22. Tian F, Hua M, Zhang W, Li Y, Yang X. Emotion-al arousal in 2D versus 3D virtual reality envi-ronments. PLoS One. 2021 Sep 9;16(9):e0256211. doi: 10.1371/journal.pone.0256211.

Downloads

Published

2025-11-14

How to Cite

Baras, R., Hajji, F., Godaert, L., Cailliau, E., & Poisson, M. (2025). Effectiveness of virtual reality in reducing patient anxiety before and after the extraction of third molars under local anaesthesia: a randomised study. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 135(03), 46-57. https://doi.org/10.61872/sdj-2025-03-04

How to Cite

Baras, R., Hajji, F., Godaert, L., Cailliau, E., & Poisson, M. (2025). Effectiveness of virtual reality in reducing patient anxiety before and after the extraction of third molars under local anaesthesia: a randomised study. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 135(03), 46-57. https://doi.org/10.61872/sdj-2025-03-04