Immersive Gaming Intervention Reduces Preoperative Anxiety and Improves Compliance in Children Undergoing...

Preoperative anxiety is prevalent in children undergoing supernumerary tooth extraction and can exacerbate physiological stress responses. Nonpharmacological interventions like immersive gaming interventions (IGI) offer potential anxiolytic benefits, but robust evidence in pediatric dentistry is limited.

In this prospective RCT, 102 children aged 4-12 years scheduled for supernumerary tooth extraction under general anesthesia were randomized to IGI (n = 50) or standard care (n = 52). The IGI group received a multicomponent framework comprising structured therapeutic play, role-reversal simulation, and environmental modification. Anxiety-related emotional distress and somatic symptoms were assessed using the SCARED scale, heart rate (HR), and heart rate variability (LF/HF ratio) at baseline (T0), post-intervention (T1), and preoperatively (T2). Treatment compliance (Frankl scale) and parental satisfaction (100-point questionnaire) were secondary outcomes.

IGI demonstrated substantial reduction in emotional distress across all measures, with large interaction effect sizes (partial eta squared range: 0.14-0.26). At the preoperative stage (T2), SCARED scores in the IGI group were significantly lower than controls (Mean Difference [MD]: 18.5, 95% CI: 16.3-20.7; Cohen's d = 3.42). Heart rate and LF/HF ratio also showed clinically meaningful improvements in the IGI group compared to controls (HR MD: 17.5 bpm, 95% CI: 13.9-21.1; LF/HF MD: 1.33, 95% CI: 1.03-1.63). IGI attenuated anxiety-physiology correlations, including a 65% reduction in the SCARED-LF/HF slope at T2 (unstandardized beta-intervention = 0.029 vs. beta-control = 0.082). The intervention group exhibited superior active cooperation (Risk Difference [RD]: 70.2%, 95% CI: 57.0%-83.4%) and higher "very satisfied" parental ratings (RD: 78.6%, 95% CI: 66.8%-90.4%).

IGI effectively alleviates perioperative emotional distress, decouples psychological-physiological stress responses, and improves cooperation in children undergoing supernumerary tooth extraction. It represents a robust nonpharmacological strategy to enhance the pediatric perioperative experience.

ClinicalTrials.gov identifier: NCT07149727.