Comparison of effectiveness of three distraction techniques to allay dental anxiety during inferior alveolar nerve block in children: A randomized controlled clinical trial

BACKGROUND: Among the numerous methods used to control anxiety, distraction is the most popular method for controlling behavior during dental procedures in children. The present study aimed to use a fidget spinner, kaleidoscope, and virtual reality as distraction techniques individually and observe the effects on the anxiety levels of children subjected to inferior alveolar nerve block (IANB). METHODS: In this parallel-group randomized clinical trial, 102 children aged 6–9 years requiring IANB for various dental treatments were screened and 60 children who met the inclusion criteria were enrolled and randomly assigned into four groups of 15 each; Group 1 fidget spinner (FS), Group 2 kaleidoscope, Group 3 virtual reality (VR) and Group 4 no distraction (Control). The child's self-reported anxiety levels using Venham's picture test (VPT); the pulse oximeter was used to measure physiological signs of oxygen saturation and pulse rate at three intervals i.e. before, during, and after the IANB procedure. The collected data were statistically analyzed with SPSS 21 software. Paired t-test and One way ANOVA were used to compare the VPT, oxygen saturation, and pulse rate values. FINDINGS: Groups 1, 2, and 3 showed significantly lower mean VPT scores compared to Group 4. Groups 1 & 3 showed lower mean pulse rates and Group 2 showed comparable mean pulse rates to Group 4 respectively during the IANB procedure. Oxygen saturation levels remained non-significant between all the Groups (p > 0.05). INTERPRETATION: Fidget spinner, kaleidoscope, and virtual reality seem to be effective distraction methods and can be recommended as effective approaches to help alleviate children's dental anxiety during IANB procedures.