Letting patients go on a virtual reality “walk” while undergoing dental treatment can reduce pain and anxiety, a team of European and Australian researchers has found.
But those benefits occurred only if the “walk” was in a natural setting — specifically along a coastal pathway. Walking around a virtual city had no similar effect on patients.
The study’s findings are intriguing, for they support other research that has found virtual reality to be a useful distraction from pain in health-care situations. A growing body of research in recent years has also reported small, but measurable, health benefits to patients when natural elements, such as hospital gardens and bedside windows with views of leafy trees, are introduced into medical settings.
“The use of virtual reality in health care settings is on the rise but we need more rigorous evidence of whether it actually improves patient experiences,” said Karin Tanja-Dijkstra, the current study’s lead author and an environmental psychologist at Vrije Universiteit Amsterdam in the Netherlands, in a released statement. “Our research demonstrates that under the right conditions, this technology can be used to help both patients and practitioners.”
For the study, Tanja-Dijkstra and her colleagues conducted two experiments, one in a controlled laboratory setting and the other in a real-world dentist’s office.
In the lab experiment, 85 student-volunteers were randomly assigned to one of three groups. One group was given a virtual reality headset and handset controls, which enabled them to explore a virtual reality environment — a beautiful, deserted beach in the English county of Devon. Another group donned the headset, but watched only a video replay of a coastal walk; they had no control over it. The third group wore virtual reality headsets that were switched off.
While wearing the headsets, all three groups were asked to place one of their hands in a tub of water that was cold enough (44 degrees Fahrenheit) to cause mild pain, but not so cold that they would immediately pull it out.
The results showed that the volunteers who had the virtual reality experience, whether “active” or “passive,” reported less pain than the control group — an average of about one point less on an 11-point scale.
In the second experiment, 70 consenting dental patients who needed tooth extractions or fillings were divided into three groups: one received standard care (no virtual reality technology); another used a virtual reality headset and handheld controllers to “walk” along the Devon beach while being treated; and the third did the same, although this time the “walk” was around an anonymous city.
The researchers found that the group of patients whose virtual reality walk was in the natural setting reported less pain than both the group that had standard care and the group that walked through the urban setting — an average of about 1.5 to 2 points on an 11-point scale. The “nature walkers” also recalled less pain from their visit to the dentist’s office when they were asked about it one week later.
The pain scores (both immediate and recalled) were essentially the same, however, for the standard-care and urban-setting groups.
These findings held even after adjusting for possible confounding factors, such as age, gender, dental anxiety, and type and duration of treatment.
“That walking around the virtual city did not improve outcomes shows that merely distracting the patients isn’t enough, “said study co-author Sabine Paul, a social psychologist at the University of Plymouth, in a released statement. “It would be interesting to apply this approach to other contexts in which people cannot easily access real nature such as the workplace or other healthcare situations.”
Limitations and implications
The study comes with several caveats. Most notably, it involved a small number of patients who lived in the same area of England. Whether or not the findings would hold in larger, more diverse populations is unknown.
Still, for people who avoid or delay needed dental care (or other health-related procedures) because of fear or anxiety, the study suggests that virtual reality may be a helpful tool — if it places patients in the right environment, that is.
“Our results demonstrate that the content of [virtual reality] is pivotal: A virtual walk along a coastline was most beneficial in reducing experienced and recollected pain,” the study’s authors write.
“With the fast growing technological possibilities, this research points to the need to carefully consider [virtual reality] content and existing theories of nature and well-being when applying a [virtual reality] distraction in clinical pain management,” they add.