Journal of International Dental and Medical Research ISSN 1309-100X Virtual Reality Distraction on Dental Anxiety http://www.jidmr.com Lekshmi R. Suresh and Christy George Volume ∙ 12 ∙ Number ∙ 3 ∙ 2019 Page 1004 Virtual Reality Distraction on Dental Anxiety and Behavior in Children with Autism Spectrum Disorder Lekshmi R. Suresh 1 *, Christy George 2 1. Department of Pedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India. 2. Undergraduate Program, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India. Abstract A large population of children with Autism Spectrum Disorders (ASD) fail to receive adequate dental care. The dental care of these patients poses great difficulties to dental practitioners. Although many of basic behavior management techniques can be employed to enable dental treatment in these patients, their success in reducing the children’s dental anxiety and improving behavior has been limited. Since the thought patterns of children with ASD favor the application of auditory and visual stimuli, we aimed to assess the effectiveness of Virtual Reality (VR) distraction in managing the anxiety and behavior of children with ASD in the dental environment. 68 children aged 8 – 15 years with a known diagnosis of ASD, requiring routine, non-invasive dental treatments were included in the study. These children were scheduled to undergo routine, non-invasive dental treatment procedures, in two dental visits, spaced 3 months apart. In both visits, the dental anxiety and behavior of all the children were measured using Venham’s Picture Test and Frankel’s Behavior Rating scales, respectively at the end of their dental treatment. Completion of dental treatment and data collection was carried out in 40 children whose results were analyzed. There was a significant reduction in patient reported anxiety scores and a significant improvement in their dental behavior was noted when VR distraction was used (p=0.042 and p=0.0001, respectively). Virtual Reality distraction can be used as a successful behavior management method in autistic children during routine dental treatment. Clinical article (J Int Dent Med Res 2019; 12(3): 1004-1010) Keywords: Autistic Disorder, Dental Care, Treatment Outcome, Behavior modification, Behavior Rating Scale. Received date: 11 February 2019 Accept date: 19 March 2019 Introduction As dental patients, children with Autism Spectrum Disorders (ASD) are often considered to pose great challenges to dental practitioners as their varied symptoms and complex set of clinical manifestations often interferes with the delivery of routine dental care. 1 It is commonly observed that patients with ASD are unable to cooperate in the dental setting as their developmental impairments lead to many difficulties that hamper their ability to interact with other people. Their altered cognitive abilities also lead to these individuals having difficulties in understanding and following instructions. Changes in the environment, daily schedule or other routines often elicit behavioral resistance and tantrums. 2 Many children with ASD do not receive dental care because of fear associated with dental procedures. 3 The dental care of these patients poses great difficulties, 4 and oftentimes they require general anesthesia for regular dental procedures, 5 placing them at high risk of associated complications. 3 Behavioral methods for dealing with patient stress and anxiety have become increasingly popular in dentistry. Behavioral management and prevention of dental diseases form the foundation of good pediatric dental practice. 6 A variety of basic behavior guidance techniques can be utilized to enable dental treatment in patients with ASD, including the presence of parents or aides, the use of Tell-Show-Do technique, short, clear commands, and positive and negative verbal *Corresponding author: Lekshmi R. Suresh Department of Pedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India. E-mail: romeenire_v@outlook.com