(PO68) Pain Scores and Cortisol Levels When Using Virtual Reality Distraction in Patients With Symptomatic Irreversible Pulpitis

Abstract: Anxiety and pain related to dental treatment pose a barrier to delivering effective care to patients. In some circumstances, the dental provider may employ adjunctive solutions to ameliorate patient pain and anxiety. While many choices are currently available, none are considered the “gold standard.” Virtual reality (VR) is a recently developed technology that could potentially provide benefits not currently achieved by other adjuncts. While studies exist examining its effects in a dental setting, none have been conducted on adult patients in an endodontic setting. The purpose of this study was to use VR to evaluate its effects on pain, anxiety, and satisfaction in an adult population undergoing endodontic treatment. A total of 93 patients with a diagnosis of symptomatic irreversible pulpitis were enrolled. Patients were randomly assigned to the experimental VR group or control (protective eyewear) and received endodontic treatment. Pain, anxiety, and salivary cortisol measurements were recorded throughout the procedure. Patients also recorded their satisfaction and desire to use VR in future visits. Data were analyzed statistically with a variety of tests. VR’s effects on anxiety, pain, and anesthetic success were not statistically significant. Patients who experienced anesthetic failure had higher preoperative and intraoperative cortisol levels. Salivary cortisol increased during local anesthesia and decreased throughout the remainder of the procedure; these findings were independent of VR use. VR failed to demonstrate any significant effect on patient pain, anxiety, or anesthetic success. While patients expressed a preference for using VR in the future (89%), satisfaction among patients was similar.