Q U I N T E S S E N C E I N T E R N AT I O N A L
Audiovisual video eyeglass distraction during dental treatment in children Diana Ram, DMD1/Joseph Shapira, DMD2/Gideon Holan, DMD3/ Florella Magora, MD4/Sarale Cohen, PhD5/Esti Davidovich, DMD, MSc6
Objective: To investigate the effect of audiovisual distraction (AVD) with video eyeglasses on the behavior of children undergoing dental restorative treatment and the satisfaction with this treatment as reported by children, parents, dental students, and experienced pediatric dentists. Method and Materials: During restorative dental treatment, 61 children wore wireless audiovisual eyeglasses with earphones, and 59 received dental treatment under nitrous oxide sedation. A Frankl behavior rating score was assigned to each child. After each treatment, a Houpt behavior rating score was recorded by an independent observer. A visual analogue scale (VAS) score was obtained from children who wore AVD eyeglasses, their parents, and the clinician. Results: General behavior during the AVD sessions, as rated by the Houpt scales, was excellent (rating 6) for 70% of the children, very good (rating 5) for 19%, good (rating 4) for 6%, and fair, poor, or aborted for only 5%. VAS scores showed 85% of the children, including those with poor Frankl ratings, to be satisfied with the AVD eyeglasses. Satisfaction of parents and clinicians was also high. Conclusion: Audiovisual eyeglasses offer an effective distraction tool for the alleviation of the unpleasantness and distress that arises during dental restorative procedures. (Quintessence Int 2010;41:673–679)
Key words: audiovisual distraction, behavior management, pediatric dentistry, video eyeglasses
The distress and unpleasantness associated with dental treatment in healthy children has been extensively researched. Negative attitudes toward dental care often result from discomfort with the invasiveness of treatment
1
Senior Clinical Lecturer, Department of Pediatric Dentistry, The
Hebrew University—Hadassah School of Dental Medicine, Jerusalem, Israel. 2
Professor, Chairman of the Department of Pediatric Dentistry,
The Hebrew University—Hadassah School of Dental Medicine, Jerusalem, Israel. 3
Clinical Professor, Department of Pediatric Dentistry, The Hebrew University—Hadassah School of Dental Medicine,
Jerusalem, Israel. 4
Professor Emeritus, Department of Anesthesiology and Critical
Care, Hadassah Medical Center, Jerusalem, Israel. 5
Visiting Professor, Department of Anesthesiology and Critical
Care, Hadassah Medical Center, Jerusalem, Israel. 6
Clinical Lecturer, Department of Pediatric Dentistry, The
Hebrew University—Hadassah School of Dental Medicine, Jerusalem, Israel. Correspondence: Dr Diana Ram, Department of Pediatric Dentistry, The Hebrew University Hadassah School of Dental Medicine, P.O. Box 12272, Jerusalem, Israel. Email: dianar@ ekmd.huji.ac.il
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despite efficacious pain relief with local anesthetics. A plethora of studies have assessed causes of fear and anxiety and have offered effective interventional modalities to prevent, reverse, or reduce the incidence of discomfort. Klingberg and Broberg1 recently reviewed the prevalence and multidimensional aspects of psychologic factors relating to dental behavior management in children. Numerous pharmacologic and nonpharmacologic techniques have been proposed for achieving nondisruptive behavior during the multiple visits necessary for nearly all pediatric dental restorative procedures. Behavioral management support is common, utilizing such means as tranquilizing verbal approaches, tell-show-do, physical contact by light touching and stroking, and relaxation exercises.2–5 Parental reassurance and brief intermittent opportunities allowing for release from the invasive treatment have been shown to reinforce children’s cooperative behavior.6,7 Although helpful, these methods are not always fully effective, especially for highly
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