Evaluating the use of augmented reality in alleviating anxiety and pain in children during intraoral injection administration: a randomized-controlled trial.

Purpose: This study evaluated augmented reality (AR) headsets' effectiveness in reducing anxiety and pain in children (7-9 years) during intraoral injections.

Methods: One hundred eight children were randomized to four groups: Control (cartoons on a mobile device during injection), Group A (cartoons via AR headset during injection), Group B (AR games before being transported to the dental chair), and Group C (AR games before plus cartoons during injection). Anxiety was assessed by Venham's Picture Test (VPT) and heart rate (HR) monitoring; pain was measured with the FLACC Behavioral Pain Assessment Scale and the Wong-Baker FACES Pain Rating Scale.

Results: Post-injection, VPT mean ranks were significantly lower in Groups A (46.59), B (42.83), and C (40.41) compared to the Control group (65.17; P < 0.05). HR monitoring revealed a significant increase during injection in the Control group (107.6 ± 15.7 bpm) and Group A (106.6 ± 13.2 bpm) compared with Groups B (94.7 ± 8.0 bpm) and C (91.4 ± 9.8 bpm; P < 0.05). Severe pain (WBF score ≥ 8) was reported by 18.5% in the Control group versus none in the test groups (P < 0.05). Similarly, FLACC scores indicated the highest discomfort in the Control group, with no severe discomfort observed in Groups A, B, or C (P < 0.05).

Conclusions: AR headsets significantly reduce injection-related anxiety and eliminate severe pain behaviors in children, providing pediatric dental practitioners with a low-cost, easily implemented tool to enhance patient comfort and cooperation. The study was registered at ClinicalTrials.gov (NCT06724341).