Department of Pediatric and Preventive Dentistry, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India.
I.A.S, Zilla panchayat, Dakshina Kannada, Mangalore, Karnataka, India.
Spec Care Dentist. 2024 May-Jun;44(3):868-877. doi: 10.1111/scd.12932. Epub 2023 Oct 17.
Intellectual disability, is a neurodevelopmental disorder that typically manifests early in childhood and consists of both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. It can be categorized into mild, moderate, severe, and profound based on its severity. Cognitive impairment may be observed predominantly in children with intellectual disabilities. Marked deficits in areas of learning, planning, communication, social participation, and personal independence in children with mild intellectual disabilities make behavior guidance and communication a challenge during dental treatments. The aim was to evaluate and compare the use of two different distraction tools, audio, and virtual reality (VR) on the dental anxiety of children with mild intellectual disability during dental treatment.
Twenty children diagnosed with mild intellectual disability were equally divided into two groups. A cross-over study design consisting of two appointments 1 month apart was employed. In the first appointment, audio and VR distractions were provided to participants in Groups 1 and 2, respectively, and the distraction tools provided to the participants were interchanged in the second appointment. A trained observer recorded physiological parameters (pulse rate and oxygen saturation) and observational parameters (Venham's anxiety rating scale) during both appointments at three-time intervals. Statistical intra-group and inter-group comparison analyses were performed using Friedman's and Mann-Whitney U tests.
A decrease in pulse, increase in oxygen saturation levels, and a decrease in Venham's Anxiety Rating Scores (statistically significant p < .05 / highly significant p < .01) was observed on introducing the distraction techniques in Groups 1 and 2 in both appointments. A statistically non-significant difference (p > .05) in physiological and observational parameters was observed between Groups 1 and 2 in both appointments.
Audio and VR distraction techniques can be employed for behavior guidance in children with mild intellectual disability during restorative dental procedures.
智力障碍是一种神经发育障碍，通常在儿童早期表现出来，包括概念、社会和实践领域的智力和适应功能缺陷。根据其严重程度，可分为轻度、中度、重度和极重度。认知障碍可能主要发生在智力障碍儿童中。轻度智力障碍儿童在学习、计划、沟通、社会参与和个人独立方面存在明显缺陷，这使得在牙科治疗过程中行为指导和沟通具有挑战性。目的是评估和比较两种不同的分散注意力工具，音频和虚拟现实 (VR)，在治疗轻度智力障碍儿童的牙科焦虑中的作用。
将 20 名被诊断为轻度智力障碍的儿童平均分为两组。采用交叉研究设计，每个月进行两次预约。在第一次预约中，分别为第 1 组和第 2 组提供音频和 VR 分散注意力，在第二次预约中，为参与者提供的分散注意力工具进行了交换。一名经过培训的观察员在两次预约的三个时间间隔内记录生理参数（脉搏率和血氧饱和度）和观察参数（Venham 焦虑评分量表）。使用 Friedman 和 Mann-Whitney U 检验对内组和组间比较分析进行了统计分析。
在第 1 组和第 2 组的两次预约中，引入分散注意力技术后，脉搏下降，血氧饱和度升高，Venham 焦虑评分量表分数下降（具有统计学意义的 p <.05/高度显著的 p <.01）。在两次预约中，第 1 组和第 2 组之间的生理和观察参数无统计学差异（p >.05）。
在进行修复性牙科手术时，可在轻度智力障碍儿童中使用音频和 VR 分散注意力技术进行行为指导。
