Dental anxiety is defined as an excessive and persistent fear of dental stimuli and treatments. As the child approaches the dental chair, he or she may experience an increase in the objective, detectable through the signs such as blood pressure and heart rate.

This problem is widespread in approximately 6-20% of the pediatric population, often linked to incorrect perceptions and expectations on the part of the young patient.

To deal with the anxious picture, the subject can draw on internal resources, but, in this sense, it is advisable that the dentist also put in place interceptive measures. Among these, one of the most documented ones is the maneuvering of distraction, with particular reference to those based on the use of audiovisual media.

Television sets, video games, 3D viewers, although recently introduced into clinical practice, have already been successfully documented in the dental field and the execution of several other maneuvers, starting from magnetic resonance imaging to intramuscular injections. Moreover, authors have pointed out that the method does not interfere with communication between dentist and patient.

In fact, not all studies agree in detecting actual benefits in terms of behavior or reduction of the painful symptom.

To provide a comprehensive view of the issue, the Zhang group has recently published (Oral Diseases, March 2018) a systematic review of the literature.

The survey involved the databases – PubMed, EMBASE, and Cochrane Central Register of Controlled Trials, with the last being updated at the end of October 2017. Starting from a pool of 36 studies (once a total of 70 duplicates obtained from the first research had been removed), 9 full-text studies were taken to qualitative evaluation, which considered the physiological signs of anxiety, including the heart rate and oxygen saturation, as mentioned earlier. These, present in 6 of the 9 studies, constitute a direct measure of the degree of psychological arousal in the patient, suffering from dental anxiety, and, in this study, they were the subject of quantitative evaluation (meta-analysis). Of the two, a statistically significant lower mean value of heart rate was found in a total sample of 352 patients treated with the aid of audiovisual support. On the contrary, no statistical significance was found for the oxygen saturation data.

Most studies use self-report and behavior rating scales, defining audiovisual distractions as an effective measure in reducing anxiety and promoting patient collaboration.

The authors conclude by recommending the use of this approach in pediatric patients with dental anxiety.

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