Trial Outcomes & Findings for Augmented Reality Distraction for Reducing Pain in Pediatric Dental Procedures (NCT NCT06954883)

NCT ID: NCT06954883

Last Updated: 2026-01-06

Results Overview

Pain was assessed immediately after local anesthesia injection using the Wong-Baker FACES Pain Rating Scale. This validated pediatric pain scale consists of six facial expressions ranging from 0 ("No pain") to 10 ("Worst pain"). Children were asked to select the face that best represented their pain experience, which was then converted into a numeric score. Values are reported as mean ± standard deviation (SD)and were compared between study arms.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

60 participants

Primary outcome timeframe

Immediately after the dental extraction procedure.

Results posted on

2026-01-06

Participant Flow

Recruitment Status: Completed Actual Enrollment: 60 participants Start Date: May 15 2025 Primary Completion Date: July 30 2025 Study Completion Date: August 15 2025 Recruitment Locations: • Faculty of Dentistry, Assuit University, Egypt Eligibility Criteria: * Ages: 6-10 years * Sex: All * Accepts Healthy Volunteers: Yes * Inclusion Criteria: * Children requiring primary anterior tooth extractions * No prior experience of local anesthesia * Exclusion Criteria: * Previous local anesthesia

Number of Participants Screened: 60 eligible participants were enrolled after screening Reasons for Exclusions: * previous anesthesia experience, special needs, anxiety disorder diagnosis, recent root planing) * Declined to participate Number Assigned to Arms: * AR Group: 30 participants * Control Group: 30 participants

Participant milestones

Participant milestones
Measure
AR-based Distraction
Children aged 6-10 years (both sexes, Egyptian ethnicity) received augmented reality (AR) distraction during primary anterior tooth extraction under local infiltration anesthesia. Each child selected a cartoon video displayed through a head-mounted AR/VR device (IGY 360 headset connected to a smartphone). The device projected AR animations (e.g., 3D celestial bodies) into the child's view, diverting attention throughout topical anesthesia, injection, and extraction.
Standard Care (Tell-Show-Do Technique)
Children aged 6-10 years (both sexes, Egyptian ethnicity) received behavioral management using the Tell-Show-Do (TSD) technique during primary anterior tooth extraction under local infiltration anesthesia. The clinician explained the procedure in child-friendly language (Tell), demonstrated instruments in a non-threatening manner (Show), and then performed the extraction (Do) without augmented reality or audiovisual distraction.
Overall Study
STARTED
30
30
Overall Study
COMPLETED
30
30
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
AR-based Distraction
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received augmented reality (AR) distraction during primary anterior tooth extraction under local infiltration anesthesia. Each child selected a cartoon video displayed through a head-mounted AR/VR device (IGY 360 headset connected to a smartphone). The device projected AR animations (e.g., 3D celestial bodies) into the child's view, diverting attention throughout topical anesthesia andinjection.
Total
n=60 Participants
Total of all reporting groups
Standard Care (Tell-Show-Do Technique)
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received behavioral management using the Tell-Show-Do (TSD) technique during primary anterior tooth extraction under local infiltration anesthesia. The clinician explained the procedure in child-friendly language (Tell), demonstrated instruments in a non-threatening manner (Show), and then performed the extraction (Do) without augmented reality or audiovisual distraction.
Age, Continuous
7.8 Years
STANDARD_DEVIATION 1.2 • n=30 Participants
7.85 Years
STANDARD_DEVIATION 1.14 • n=60 Participants
7.9 Years
STANDARD_DEVIATION 1.1 • n=30 Participants
Sex: Female, Male
Female
14 Participants
n=30 Participants
29 Participants
n=60 Participants
15 Participants
n=30 Participants
Sex: Female, Male
Male
16 Participants
n=30 Participants
31 Participants
n=60 Participants
15 Participants
n=30 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
CFSS-DS
29.7 score on a scale
STANDARD_DEVIATION 4.8 • n=30 Participants
29.9 score on a scale
STANDARD_DEVIATION 4.97 • n=60 Participants
30.1 score on a scale
STANDARD_DEVIATION 5.2 • n=30 Participants
Heart Rate
95 beats per minute
STANDARD_DEVIATION 10 • n=30 Participants
94.5 beats per minute
STANDARD_DEVIATION 10.43 • n=60 Participants
94 beats per minute
STANDARD_DEVIATION 11 • n=30 Participants

PRIMARY outcome

Timeframe: Immediately after the dental extraction procedure.

Pain was assessed immediately after local anesthesia injection using the Wong-Baker FACES Pain Rating Scale. This validated pediatric pain scale consists of six facial expressions ranging from 0 ("No pain") to 10 ("Worst pain"). Children were asked to select the face that best represented their pain experience, which was then converted into a numeric score. Values are reported as mean ± standard deviation (SD)and were compared between study arms.

Outcome measures

Outcome measures
Measure
AR-based Distraction
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received augmented reality (AR) distraction during primary anterior tooth extraction under local infiltration anesthesia. Each child selected a cartoon video displayed through a head-mounted AR/VR device (IGY 360 headset connected to a smartphone). The device projected AR animations (e.g., 3D celestial bodies) into the child's view, diverting attention throughout topical anesthesia, injection, and extraction.
Standard Care (Tell-Show-Do Technique)
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received behavioral management using the Tell-Show-Do (TSD) technique during primary anterior tooth extraction under local infiltration anesthesia. The clinician explained the procedure in child-friendly language (Tell), demonstrated instruments in a non-threatening manner (Show), and then performed the extraction (Do) without augmented reality or audiovisual distraction.
Pain Score Using Wong-Baker FACES Scale
2.3 Score on a scale
Standard Deviation 1.2
4.5 Score on a scale
Standard Deviation 1.3

SECONDARY outcome

Timeframe: Immediately after the dental extraction procedure.

Population: The analysis population consisted of all enrolled and randomized children who completed the CFSS-DS questionnaire immediately after the dental extraction procedure (N = 60; AR-based Distraction n = 30, Standard Care n = 30). No exclusions occurred and complete data were available for all participants.

Dental anxiety was assessed immediately post-procedure using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The CFSS-DS is a validated 15-item questionnaire scored on a 5-point Likert scale (1 = not afraid to 5 = very afraid; total range 15-75, higher scores = greater anxiety). Values were compared between study arms (Augmented Reality distraction vs. Standard Care)

Outcome measures

Outcome measures
Measure
AR-based Distraction
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received augmented reality (AR) distraction during primary anterior tooth extraction under local infiltration anesthesia. Each child selected a cartoon video displayed through a head-mounted AR/VR device (IGY 360 headset connected to a smartphone). The device projected AR animations (e.g., 3D celestial bodies) into the child's view, diverting attention throughout topical anesthesia, injection, and extraction.
Standard Care (Tell-Show-Do Technique)
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received behavioral management using the Tell-Show-Do (TSD) technique during primary anterior tooth extraction under local infiltration anesthesia. The clinician explained the procedure in child-friendly language (Tell), demonstrated instruments in a non-threatening manner (Show), and then performed the extraction (Do) without augmented reality or audiovisual distraction.
1. Children's Fear Survey Schedule-Dental Subscale
17.6 score on a scale
Standard Deviation 3.9
26.8 score on a scale
Standard Deviation 4.5

SECONDARY outcome

Timeframe: Immediately post-procedure

Population: All randomized participants were included in the analysis of heart rate (N = 60; AR-based Distraction n = 30, Standard Care n = 30). No participants were excluded and no data were missing.

Heart rate was measured in beats per minute (bpm) using a finger pulse oximeter (CMS 50DL, China). Measurements were taken while the child was seated in the dental chair immediately post-procedure as a physiological indicator of anxiety. Values are reported as mean ± standard deviation (SD). The outcome was defined as the post-procedure heart rate value, compared between study arms.

Outcome measures

Outcome measures
Measure
AR-based Distraction
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received augmented reality (AR) distraction during primary anterior tooth extraction under local infiltration anesthesia. Each child selected a cartoon video displayed through a head-mounted AR/VR device (IGY 360 headset connected to a smartphone). The device projected AR animations (e.g., 3D celestial bodies) into the child's view, diverting attention throughout topical anesthesia, injection, and extraction.
Standard Care (Tell-Show-Do Technique)
n=30 Participants
Children aged 6-10 years (both sexes, Egyptian ethnicity) received behavioral management using the Tell-Show-Do (TSD) technique during primary anterior tooth extraction under local infiltration anesthesia. The clinician explained the procedure in child-friendly language (Tell), demonstrated instruments in a non-threatening manner (Show), and then performed the extraction (Do) without augmented reality or audiovisual distraction.
Heart Rate as Physiological Indicator of Anxiety
80 beats per minute (bpm)
Standard Deviation 8
89 beats per minute (bpm)
Standard Deviation 10

Adverse Events

AR Distraction

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Tell-Show-Do

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Ahmed Kamel Abdel Naser

Assuit university

Phone: 01061553007

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place