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Effectiveness of Audio and Audio-Visual Distraction on Dental Anxiety of Children and Adolescents with Intellectual
Shreya Tiwari1, Aruna Sharma1, Eswari Ramassamy1
1Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Puducherry, India.
Objective:
This systematic review and meta-analysis aimed to assess the effectiveness of audio and audio-visual (AV) distraction techniques on dental anxiety in children and adolescents with intellectual disability (ID).
Methods:
A thorough search was conducted up to December 2025 following the PRISMA 2020 guidelines by two independent researchers in seven databases, supplemented by hand search and grey literature search. Data extraction was performed using predetermined criteria. Risk of bias of selected studies was assessed using Cochrane collaboration's risk of bias tool for randomized trials (RoB2) and risk of bias in non-randomized studies of interventions, version 2 (ROBINS-I V2). Meta analysis of included studies was performed using pooled odds ratio and its corresponding 95% confidence intervals.
Results:
Out of 1622 total studies identified, twelve studies were included. Nine studies were included in the meta-analysis. Audio-visual distraction generally showed improvements in children's behavior and physiological responses. Statistically significant values were observed in electrodermal activity and Venham's behavior rating scale.
Conclusion:
Audio-visual distraction may help to reduce dental anxiety in children with intellectual disability. However, there is inconsistent evidence, and further well-designed studies need to be conducted to establish their effectiveness more clearly.
