None listed
Conditions
Brief summary
Dental phobia is a common phobia which involves a fear of visiting dentist and receiving dental treatment. It makes people avoid dentist as a result of which anxious patients do not receive important dental treatment. Virtual reality exposure therapy (VRET) is a novel treatment commonly used to treat patients with anxiety disorders.The intervention involves using virtual reality head mounted device and appropriate software to immerse an anxious patient in a virtual scenario which mimics their fear stimuli. The virtual exposure is repeated several times, till the patient becomes used to the fear provoking stimuli and it no longer triggers anxiety. The aim of this study is to evaluate the safety and efficacy of virtual reality exposure therapy using a multiple baseline study design. The hypothesis of this study is that there will be no drop outs, adverse events or symptom exacerbation in both the study groups. Also VRET would reduce dental anxiety scores, decrease avoidance of dental treatment, reduced average heart rate during therapy and improved dental attendance. Two interventions were tested on 10 participants (5 each): Virtual reality exposure therapy (VRET) and informational pamphlet (Control). In VRET group, Participants were exposed to five different scenarios, during which their levels of distress were measured every 35 seconds. Each scenario was repeated until it reduces the participant distress.The heart rate was continuously monitored during VRET. Those in the control group were given an information pamphlet, which includes information about dental anxiety and what to expect from a visit to the dentist while undergoing a dental procedure. Dental anxiety measures were taken repeatedly during a 14-week study period and at six-month follow-up using questionnaires. Also, the presence or absence of dental phobia was evaluated at 6 months.
Interventions
Participants in this group were exposed to five different virtual reality (VR) scenarios sequentially in a pre-determined hierarchy using a head mounted device (HMD) and a heart rate wrist band.
1) Sitting passively on the dental chair (no tools).
2) Inspection of the oral cavity using mouth mirror.
3) Introduction of an injection.
4) Introduction of drill without sound
5) Introduction of drill with sound
VRET was conducted utilizing two networked computers of which the VR-simulator compute
Participants in this group were exposed to five different virtual reality (VR) scenarios sequentially in a pre-determined hierarchy using a head mounted device (HMD) and a heart rate wrist band. 1) Sitting passively on the dental chair (no tools). 2) Inspection of the oral cavity using mouth mirror. 3) Introduction of an injection. 4) Introduction of drill without sound 5) Introduction of drill with sound VRET was conducted utilizing two networked computers of which the VR-simulator computer (Dell XPS-8700 desktop with 4th Generation Intel Core i7-4790 processor (8M Cache, up to 4.0 GHz) and ASUS NVIDIA GEFORCE GTX 750 TI OC 2GB GDDR5 graphic card) rendered the virtual environment and the other User interface-computer allowed the researcher to control and individualize the VR stimuli presented to the patient. An Oculus development kit 2 HMD (Head Mounted Display) with a resolution of 960X1080 per eye was used to immerse the participants in the VR dental environment. A Mio-link wrist band was used to record the HR of the VRET participants in real-time during therapy. The entire VR treatment was administered in a single session. During the exposure session the level of discomfort/distress is assessed using Subjective Units of Distress (SUD) scale every 35 seconds for each scenario. The exposure with each VR scenario was repeated until a SUD score of less than or equal to 2 is obtained before proceeding to the next scenario. Also, the heart rate is monitored continuously during the exposure to determine the physiological response during virtual reality exposure therapy (VRET). Further, the VR experience is evaluated during and following VRET.
Sponsors
ACTA Amsterdam
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Avoidance of dental treatment for more than 12 months, MDAS score more than or equal to 15, age between 18 to 60 yr, in need of a dental filling or extraction or both with a planned maximum treatment length of 30 minutes per appointment and satisfying “Phobia Checklist” criteria of dental phobia.
Exclusion criteria
-Hearing or visual impairment such as stereoscopy blindness or nystagmus. - Known mental disorders such as psychosis, post-traumatic stress disorder, developmental or intellectual disability and cognitive impairment. - Known balance disorders such as vertigo and cybersickness - Patients with previous history of epileptic seizures. - Any history of cardiac problems - Patients who are undergoing, or have undergone, any cognitive behavioral therapy (CBT)-based intervention for dental phobia. - Language impediment (cannot understand English). - Patients wearing glasses of greater than plus 3.5 power.
Outcome results
None listed