Bring Your Avatar to the Dentist
December 16, 2009

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Some might see virtual reality set-ups — such as Second Life or Gaia Online — as pure entertainment. But they may provide drug-free pain relief at the dentist.

Researchers from Case Western Reserve University's dental school enrolled 38 adults in a study. All of them needed scaling and root planing. This is a common treatment for periodontal (gum) disease. It includes cleaning teeth above and below the gum line. It is usually done without anesthesia, but it can be painful. Scaling and root planing is done with metal hand instruments that scrape the tooth to remove bacteria and deposits from the root surface.

Each person in the study needed scaling and root planing in all four areas of the mouth: upper left, upper right, lower left and lower right. Each area was treated completely before commencing treatment with the next area. For two treatments, people were assigned to have some form of distraction. Each treatment took about 20 minutes. The distractions were:

• Watching 20 minutes of the movie "Cars"
• Being immersed in a virtual botanical garden in the virtual-reality program Second Life. Each person had an avatar — a graphic representation of himself or herself. People controlled the avatar with a mouse. The avatar could walk or fly through the garden, exploring it. There were sounds in the garden, such as chirping birds and waterfalls.

For the other two treatments, there were no distractions.

People received the treatments and distractions in variable order. Some watched the movie first, some had no distraction first, and some got the virtual reality first.

After each treatment, people answered questions about their pain level, time spent thinking about the treatment and general discomfort.

Both the movie and virtual reality reduced time spent thinking about the treatment, general unpleasantness, discomfort and pain. Virtual reality appeared to be better than the movie at reducing discomfort and pain.During the virtual reality segment, people reported less than half as much pain as with no distractions.

Two-thirds of the people in the study said they preferred the virtual reality segment to any other. One-third preferred the movie. Only one patient preferred no distraction.

The researchers had everyone in the study watch the same movie and the same virtual reality environment. They would like to explore if the virtual reality distractions could be even more effective if people are able to customize their experience.

Virtual reality has been shown to be effective during burn treatment and gastric procedures. Only one very small study before this one has tested its use in dentistry.

The study appears in the December issue of the Journal of the American Dental Association.