Effect of Immersive and Conventional Audio-Visual Distraction on Self-Reported Dental Anxiety in Adult Patients Undergoing Extraction

Abstract

Background: Dental anxiety can adversely affect patient cooperation and physiological responses during tooth extraction. Distraction techniques provide a simple, non-pharmacological approach to anxiety management; however, the relative effects of audio, video, and combined audio-visual distraction in adult patients undergoing extraction require further evaluation.

Aim: To evaluate and compare the effectiveness of audio, video, and combined audio-visual distraction with conventional treatment in reducing self-reported dental anxiety and physiological stress among adults undergoing routine tooth extraction.

Materials and Methods: A single-centre, parallel-arm comparative clinical study was conducted among 80 adults undergoing routine tooth extraction under local anaesthesia. Participants were allocated equally into four groups (n=20 each): Control, Audio distraction, Video distraction, and combined Audio-Visual distraction. Anxiety and distress were assessed preoperatively and postoperatively using the Visual Analogue Scale (VAS) and Subjective Units of Distress Scale (SUDS). Systolic blood pressure, diastolic blood pressure, and heart rate were recorded as physiological indicators of anxiety.

Results: The Control group demonstrated significant increases in VAS (4.65 ± 2.25 to 6.90 ± 0.97), SUDS (53.35 ± 15.40 to 73.50 ± 9.96), and heart rate (85.30 ± 6.54 to 88.60 ± 6.71 beats/min; all p<0.001). In contrast, all distraction groups showed significant reductions in subjective anxiety and physiological parameters. The largest numerical reductions were observed with combined Audio-Visual distraction, with VAS decreasing by 5.20 points and SUDS by 51.75 points, accompanied by reductions of 18.05 mmHg in systolic blood pressure, 12.00 mmHg in diastolic blood pressure, and 14.90 beats/min in heart rate (all p<0.001). Video distraction demonstrated the next largest reductions, followed by Audio distraction.

Conclusion: Audio, video, and combined audio-visual distraction were effective in reducing subjective anxiety and physiological stress responses during routine tooth extraction. Combined Audio-Visual distraction produced the greatest numerical improvement across the assessed outcomes, suggesting that multisensory distraction may be a useful non-pharmacological adjunct for improving patient comfort during dental extraction.