Comparing Two Distraction Techniques with Illumination Caps for Assessing Dental Anxiety in Pediatric Patients during Single-visit Pulpectomies Based on the Perfusion Index Parameter

based tools such as specialized caps and laser light, as well as audiovisual distraction (AVD) techniques, has been explored for their calming effects on patients during dental and medical interventions.3 Peripheral perfusion index (PI) is a noninvasive measurement with the ratio of pulsatile and nonpulsatile photoplethysmography signals obtained from pulse oximetry.This noninvasive and easily applicable technique can be used before or after anesthesia to obtain information about the fluid status and vascular tone of the patients.4 IntroductIonPain and anxiety management during local anesthesia (LA) administration remains a significant challenge in clinical practice, particularly among pediatric and anxious patients.The anticipation of pain often exacerbates physiological responses such as elevated heart rate and blood pressure, which can negatively impact the overall treatment experience and outcomes.In recent years, the integration of nonpharmacological distraction techniques has gained considerable attention for their potential to mitigate these responses.Although modern dentistry has developed rapidly, dental anxiety (DA) and pain caused by dental treatment still commonly affect the patient's experience of scoring the pain.Anxiety is related to the mental and emotional state characterized by various emotional, perceptual, and behavioral changes. 1 It is an important matter in the dental care of adults, children, and adolescents.DA affects 10-20% of adults and 43% of children and adolescents.2 One in every six children reporting to the dentist has anxiety issues, and management is an intricate balancing act involving the triad of child, parent/caregiver, and the dentist. 1 Various sensory-based modalities, including visual and auditory stimuli, have shown promise in reducing patient discomfort during invasive procedures.These methods function by diverting the patient's attention away from the nociceptive stimulus, thereby modulating the perception of pain and altering associated physiological parameters.Among these, the use of illumination-1,2,4-