The use of virtual reality glasses to reduce anxiety in fixed orthodontic treatments

Dental anxiety is not always considered a major barrier to initiating orthodontic treatment; however, children who have never experienced invasive dental procedures often experience increased stress due to the unfamiliar nature of the process.. This study was designed as a prospective, randomized controlled clinical trial to evaluate the effectiveness of virtual reality (VR) glasses in reducing anxiety and discomfort during bracket bonding, the first session of fixed orthodontic treatment, in young patients. The sample size was calculated using G*Power, indicating a minimum of 13 participants per group at 95% power. Twenty-six children aged 10–15 years presenting to Biruni University Dental Hospital were randomly allocated into two groups using a sealed-envelope method: the VR group (n=13), who watched an animation through VR glasses during bracket bonding, and the control group (n=13), who received standard treatment. Anxiety levels were assessed using the Childhood Anxiety Sensitivity Index (CASI), the State–Trait Anxiety Inventory (STAI), and the Visual Analog Scale (VAS). Heart rate and oxygen saturation were recorded at three time points (T0: before, T1: during, T2: after the procedure). Data were analyzed using Independent Samples t-test, Mann–Whitney U, Paired t-test, Wilcoxon test, Repeated Measures ANOVA, Friedman test, Bonferroni correction, Pearson correlation, and Chi-square test (α = 0.05). STAI and VAS scores decreased significantly in the VR group compared with the control group (p=0.024; p=0.008). Although both groups demonstrated a reduction in post-treatment heart rate, the decrease was statistically significant only in the VR group (p=0.004). SpO₂ values remained within normal limits in both groups with no significant differences. VR application significantly reduced anxiety in young patients and may be considered an effective, feasible, and non- pharmacological method during the initial stages of orthodontic treatment.