Effect of Virtual Reality Distraction Method on the Level of Salivary Cortisol in Children With Autism Spectrum Disorder During Dental Treatment.

To examine the effect of using Virtual Reality distraction on salivary cortisol levels in children with Autism Spectrum Disorders (ASD) during routine dental treatments. A randomized cross-over study was designed and children with a known diagnosis of ASD, between 8 and 15 years of age, requiring routine, non-invasive dental treatments, were recruited. They were divided into 2 groups (group 1 and group 2) and scheduled for dental treatments using conventional behavior management and/or VR distraction techniques in their first and second dental visit, accordingly. Wong-Baker Faces pain rating scale, Venham's picture test and Frankl's behavior rating scale were administered at the end of each visit to assess subjective parameters of pain, anxiety, and behavior. Salivary cortisol levels were estimated in all children at 3 intervals (baseline, pre-treatment, and post-treatment). 19 children completed the study protocol (group 1 = 10, group 2 = 9) and statistically significant changes were observed in subjective ratings of pain (between groups) and dental anxiety and behavior (between dental visits), in favor of when VR distraction was used. Statistically significant differences were noted in the physiologic stress of the children between dental visits at pre-treatment (in group 2), post-treatment (in both groups), and between the 2 groups at post-treatment (in visit 2), all in favor of VR distraction being used. VR distraction may be recommended as an effective behaviour management technique for children with ASD. CTRI/2018/05/013982 "Retrospectively Registered".