December 2024

Objectives: This study aimed to assess the impact of virtual reality (VR) on reducing anxiety and pain in dental patients across all age groups and dental procedures. Methods: Systematic review with comprehensive search of PubMed and Cochrane Library databases for randomized controlled trials (RCTs) comparing VR interventions with non-VR methods in dental settings up to April 2024. The selection followed the PRISMA-P guidelines. Inclusion criteria were based on the PICOS framework, focusing on studies involving dental patients of any age, utilizing VR during dental treatments, and reporting outcomes on anxiety and pain. Data extraction and quality appraisal were performed independently by two reviewers using the ROB-2 tool and GRADE methodology. Meta-analyses used a random-effects model. Results: Twenty-seven studies met the inclusion criteria, encompassing several dental treatments. In meta-analysis VR reduced anxiety in children (SMD -1.44, 95% CI -2.24 to -0.63) but not adults (SMD -0.35, 95% CI -1.11 to 0.4). For pain reduction, VR was effective in both children (SMD -1.11, 95% CI -1.65 to -0.57) and adults (SMD -0.59, 95% CI -1.187 to -0.001). Heterogeneity was high across studies, and evidence quality ranged from low to moderate. Conclusions: VR is a promising intervention for reducing anxiety and pain in children during dental procedures. Its effectiveness in adults is limited to pain reduction. High heterogeneity and risk of bias suggest that findings should be interpreted with caution. Further research is needed to standardize VR content and explore its varying impacts across different age groups and dental procedures. Keywords: meta-analysis, technology, virtual reality, dental anxiety, dental pain, digital health