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The aim of this study is to evaluate the effectiveness of two different audiovisual distraction techniques (Audio Video eyeglasses "VR BOX"/ Tablet) in the management of anxious pediatric patients during inferior alveolar nerve block
Group A (Control group): IAN will be administrated with basic behavior guidance techniques and without using any type of distraction aids.
Group B: IAN will be administrated with using AV eyeglasses "VR BOX" and wireless headphone.
Group C: IAN will be administrated with using tablet device and wireless headphone
All of the children who experienced an inferior alveolar block with/without distraction will be assessed by using a combination of measures: Wong-Baker FACES (self-report), pulse rate (physiological) and behavior (using FLACC behavior rating scale "external evaluator
This study will evaluate the effectiveness of two types of distraction aids that contain video using (tablet device or VR BOX eyeglasses) and audio distraction using wireless headphone. pain and anxiety will be evaluated during inferior alveolar nerve block using three behavioral scales, Wong-Baker FACES (self-report), pulse rate (physiological) and behavior (using FLACC behavior rating scale "external evaluator".
The first measure of heart pulse rate will be recorded directly when the patient seated comfortably on the dental chair, after anesthesia, the second heart pulse rate will be taken and the child patients will ask to choose a face that describe their status from one of the Wong Baker faces scale.
For each child patient, all of the body responses will be recorded during the whole procedure and then will be evaluated by an external assessor to determine the children behavioral score according to FLACC scale.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VR Box | Experimental | Inferior alveolar nerve block will be performed with the aid of VR box as a means of distracting patients' attention. |
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| Tablet device | Experimental | Inferior alveolar nerve block will be performed with the aid of a tablet device as a means of distracting patients' attention. |
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| Anesthesia | Active Comparator | Inferior alveolar nerve block will be performed in the normal manner without any specific intervention to distract patients' attention. Classic anesthesia will be applied. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VR Box | Procedure | Distraction will be made during the injection of the drug using this method. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain levels | using self-reported Wong-Baker FACES pain scale with 0 indicating 'no pain' and five indicating 'worst pain'. | five minutes following the inferior alveolar nerve block injection. |
| Anxiety levels | This will be evaluated using the Face-Legs-Activity-Cry-Consolability (FLACC) scale employing an external evaluator in which all of the body responses will be recorded once the needle penetrate the oral tissue. (0 low anxiety and pain level - 10 high anxiety and pain level) | Within the first minute of injecting the needle into the oral mucosa (oral tissues). |
| Change in physiological pulse rate | using Finger Pulse Oximeter | (1) five minutes after the patient is seated comfortably on the dental chair, (2) five minutes following the injection of the anesthetic drug |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mohammed Nour Al-Halabi, DDS | MSc student in Pedodontics, University of Damascus Dental School, Damascus, Syria | Principal Investigator |
| Zuhair AlNerabieah, DDS | MSc student in Pedodontics, University of Damascus Dental School, Syria | Principal Investigator |
| Nada Bshara, MD MSc Phd | Associate Professor of Pedodontics, University of Damascus Dental School, Syria | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Peadodontics, University of Damascus Dental School | Damascus | DM20AM18 | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16951038 | Background | Madhok M, Teele M. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics. 2006 Sep;118(3):1321; author reply 1321-2. doi: 10.1542/peds.2006-1351. No abstract available. | |
| 18853287 | Background | Wang ZX, Sun LH, Chen AP. The efficacy of non-pharmacological methods of pain management in school-age children receiving venepuncture in a paediatric department: a randomized controlled trial of audiovisual distraction and routine psychological intervention. Swiss Med Wkly. 2008 Oct 4;138(39-40):579-84. doi: 10.4414/smw.2008.12224. |
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| ID | Term |
|---|---|
| D000758 | Anesthesia |
| ID | Term |
|---|---|
| D000760 | Anesthesia and Analgesia |
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| Tablet Device | Procedure | Distraction will be made during the injection of the drug using this method |
|
| Anesthesia | Drug | Anesthesia will be obtained by injecting the drug into the oral mucosa before performing the dental treatment. |
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| 24970519 | Background | Al-Namankany A, Petrie A, Ashley P. Video modelling and reducing anxiety related to dental injections - a randomised clinical trial. Br Dent J. 2014 Jun;216(12):675-9. doi: 10.1038/sj.bdj.2014.497. |
| 22583875 | Background | El-Sharkawi HF, El-Housseiny AA, Aly AM. Effectiveness of new distraction technique on pain associated with injection of local anesthesia for children. Pediatr Dent. 2012 Mar-Apr;34(2):e35-8. |
| 23211912 | Background | Hoge MA, Howard MR, Wallace DP, Allen KD. Use of video eyewear to manage distress in children during restorative dental treatment. Pediatr Dent. 2012 Sep-Oct;34(5):378-82. |
| 26929683 | Background | Fakhruddin KS, Hisham EB, Gorduysus MO. Effectiveness of audiovisual distraction eyewear and computerized delivery of anesthesia during pulp therapy of primary molars in phobic child patients. Eur J Dent. 2015 Oct-Dec;9(4):470-475. doi: 10.4103/1305-7456.172637. |