Comparison of active versus passive audiovisual distraction tools on children's behaviour, anxiety and pain in paediatric dentistry: a randomised crossover clinical trial.

Aim: To determine the effect of active distraction when playing PlayStation® video games, compared to passive distraction when watching a cartoon with audiovisual eyeglasses, on parental perception of patients' anxiety, and children's anxiety, pain, behaviour and heart rate during restorative procedures in paediatric dentistry.

Materials And Methods: Study design: Randomised crossover clinical trial. There were 34 patients in the cartoon film group (passive distraction) and 34 in the Playstation® video game group (active distraction), aged 6-8 years, who required a minimum of 2 visits for restorative treatment. Rimax® iVision 5.0 eyeglasses were used in both groups. Parental perception of patients' anxiety (Modified Corah Dental Anxiety Scale), and children's anxiety (Venham Picture Test), pain (Wong-Baker Faces Scale), behaviour (Frankl Scale) and heart rate were evaluated at each of the treatment visits. Preference for and satisfaction with the audiovisual product were also assessed.

Results: There were significant differences in self-reported pain between control (P=0.016) and experimental (P=0.013) visits in both groups, with lower values in the Playstation® video game group. No significant differences were found (P>0.05) in the other variables evaluated with the use of active distraction. A significant increase in heart rate was recorded at each treatment visit (P=0.0001) when the anaesthetic was injected. All the patients wanted to continue watching or playing their chosen cartoon or Playstation® video game during subsequent visits.

Conclusion: The use of PlayStation® video games for active audiovisual distraction, compared with passive distraction with a cartoon, improved self-reported pain but did not reduce parents' perception of patients' anxiety, pain, global behaviour, or heart rate. Both distraction methods were accepted by paediatric patients.