Effects of virtual reality relaxation on anxiety levels of adolescents and adults during orthodontic bonding: a randomized controlled trial

Objectives: To assess the effectiveness of virtual reality relaxation (VRR) as an intervention for reducing anxiety in adolescents and adults during the orthodontic bonding procedure. Materials and Methods: This prospective clinical study included 53 patients undergoing fixed orthodontic treatment at the Indiana University School of Dentistry. Participants were randomly assigned to one of two groups: the experimental group using VRR during orthodontic direct bonding or the control group receiving no distraction. Physiological measures (blood pressure [BP], heart rate [HR], and oxygen saturation) and psychological assessments (5-item State-Trait Anxiety Inventory-Short Form, and the Visual Analog Scale for Anxiety [VAS-A]) were collected at baseline (T0) and 30 minutes into the bonding procedure after bonding of one arch (T1). Repeated measures of analysis of variance were used to compare groups and timepoints. Results: At T0, no statistically significant differences were found between the control and VRR groups across any psychological or physiological measures (P > .05). Although both groups showed significant reductions for physiological and psychological measures from T0 to T1 (P < .01), the VRR group reported significantly lower VAS-A scores, HR, and diastolic BP at T1 than the control group (P < .05). Conclusions: VRR effectively reduced psychological and physiological anxiety during orthodontic bonding procedures, supporting VRR as a promising adjunctive tool in managing dental anxiety during orthodontic care.