Effects of Virtual Reality Distraction and Nitrous Oxide Inhalation Sedation during Invasive Dental Procedures: A Comparative Evaluation Based on Dental Anxiety

Introduction: Effective paediatric dental care depends on strong communication and behaviour management. Dental anxiety, affecting 3%–43% of children, poses a major challenge. Modern techniques, both pharmacological and non-pharmacological, aim to ease anxiety. Virtual reality distraction, using immersive 3D environments, has emerged as a popular method to reduce fear and improve experiences. Materials and Methods: The study included 24 children, each attending three dental visits. During the first visit, oral examinations were conducted, behaviour guidance was provided and the dental setup was introduced. Eligible participants were randomly assigned to Group A (NOIS) or Group B (VR distraction), with 12 children in each group. Anxiety and behaviour were assessed during the second visit, where a Class I restoration was performed on a carious tooth (ICDAS score ≤2). At the third visit, the invasive procedure involving LA administration was carried out, and anxiety and behaviour were recorded. Results: Statistical analysis revealed that during the third visit, children in the VR group exhibited significantly higher pulse rates and Venham’s Clinical Cooperation Scale (VCCS) scores compared to the NOIS group during LA administration. Conclusion: NOIS proved significantly more effective than VR distraction in reducing pain and anxiety and ensuring patient cooperation during LA administration.