Does Virtual Reality Reduce Dental Treatment Stress in Patients With Dental Anxiety? A Comparison With Nitrous Oxide...

This study aimed to compare the effects of virtual reality (VR) and nitrous oxide (N₂O) sedation on anxiety and stress in patients with dental anxiety.

Eight patients with dental anxiety (five women; mean age, 41 years) with scores ≥ 19 on the Japanese version of the Modified Dental Anxiety Scale underwent three interventions: VR (natural landscapes and ambient music), N₂O (30% N₂O/70% oxygen), and no intervention (control). Autonomic nervous activity, including low frequency (LF), high frequency (HF), and the LF/HF ratio, was measured. VR significantly reduced LF and LF/HF levels compared to those of the control (p < 0.05), suggesting lower sympathetic nervous system activity, whereas N₂O had no effect (p = 0.88, 0.46, respectively). VR and N₂O increased HF levels compared to those of the control (p < 0.05), reflecting enhanced parasympathetic activity. Subjective anxiety was lower for VR and N₂O interventions (p < 0.05). VR immersion ratings indicated that most participants experienced moderate-to-high immersion levels.

VR is an effective, noninvasive option for managing dental anxiety, suggesting greater reductions in sympathetic-related markers than those of control and, in some analyses, N₂O, in this small crossover sample. Its accessibility and lack of pharmacological side effects support its integration into patient-centered care, particularly for mild-to-moderate dental anxiety.