Pediatric patient using virtual reality
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By Jane Schmucker

Someday soon even your most nervous patients might find sitting in the dental chair to be a walk in the park.

Or a tour of an art museum. Or a gravity-free flight through space.

Not quite literally. But definitely, virtually.

“Forget dental avoidance. We could be swamped!” says Shantanu Lal, DDS.

His exclamation is facetious.

But Dr. Lal, the director of predoctoral pediatric dentistry and an associate professor of dental medicine at Columbia University Medical Center, is serious about the potential benefits of immersing patients in their favorite virtual reality program during procedures.

Late last year, he got a grant from Columbia’s provost to develop a patient management course called Sensory Adaptive Virtual Reality. So, in September, when Columbia’s 88 third-year dental students returned to the New York school, using immersive, virtual reality to help patients manage stress became part of their curriculum.

Dr. Shantanu Lal
Dr. Shantanu Lal

It is a short, hybrid course with both online and clinical components that allow dental students to use virtual reality equipment both as a practitioner and as a patient. And because it’s all so new, students won’t be tested on it specifically.

“We’re approaching this with baby steps,” Dr. Lal says.

But the early research – and it’s all very early – has him quite hopeful.

The idea is that a patient who dons a virtual reality headset will have a much higher level of distraction from the needles and drills at hand, and thus be a much easier patient. Maybe so much so that fewer drugs will be needed to calm nerves.

For the patient, it would go much like this:

Dental staff explains the procedures they’re about to perform. They also ask the patient, “What relaxes you?” If the patient says nature, for instance, the staff might choose that walk-in-the-park virtual reality program.

If the patient is willing, the headset goes on and the patient can feel like he or she is really looking at trees and flowers. A virtual reality headphone – in this case to hear the birds chirping and the wind blowing – only goes in one ear, the ear opposite the dentist. So the patient can still hear the dentist’s instructions to open wider and such.


They Never See the Needle Coming

But unlike watching a television screen or looking out the dental office’s picture window for distraction, the patients wearing a virtual reality headset never see that needle coming at them.

“Mind you: This is not just for anxiety management,” Dr. Lal says. “Hey, who wants to be at the dental office, really?”

Dr. Lal is a pediatric specialist, but he’s targeting teens and adults for the virtual reality studies, primarily because it can be hard to get the equipment to fit well on small children.

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Nor is he ready to try the virtual reality headset on patients with psychological issues. It might be helpful for such patients. But he wants to do more research first. In part, he worries that the virtual reality equipment, which carries a cost of roughly $500, could easily be flung across the room and damaged by an unstable patient.

For the dental students, who all seem to be “so much more tech-savvy than we are,” the hardest part of the new course is learning to use an anxiety assessment questionnaire with patients and then deciding which, if any, virtual reality program might help the most.

At the moment, Dr. Lal favors a program that synchronizes psychedelic patterns and colors. The virtual reality programs were designed for viewers to be sitting. But for many dental procedures, it’s best for patients to be flat on their back.

So when the chair reclines, a patient’s virtual reality can shift too. And on that virtual walk in the park where a patient was admiring the flowers, all of a sudden she’s looking at the sky. If the virtual reality program chosen was a tour of an art museum, a chair movement that threw the patients vision from a painting to the ceiling would be even worse (unless the virtual tour was through the Sistine Chapel, of course).

That’s a kink that Dr. Lal predicts will get worked out soon by the tech wizards putting virtual reality programs on the market.


child using virtual reality headset

Even then, the virtual reality headset itself undoubtedly will be seen as an issue by some dentists who will think it is in their way. Dentists who aren’t used to getting both their patients and themselves in the perfect ergonomic position will find the headset cumbersome to work around, Dr. Lal forecasts.


They Begged for More

Naysayers about virtual reality as a dental stress management tool also predict that it will quickly become obsolete and be too time-consuming to master for the short time that it might be a fad. “God knows what they’ll have next year,” Dr. Lal says some older dentists are likely to wonder.

But the students, he says, appear excited about the course, feeling that the pilot program is pioneering and that they’re getting a cutting-edge education for their massive investment in time and tuition.

He predicts patients will be enthusiastic, too.

In Columbia’s clinic, where the virtual reality programs have been used with about 40 patients, one youngster had no idea his teeth were pulled.

Another kid cried because it was time to go home. Yes, you read that right. A kid cried because it was time to leave the dental chair.

Dr. Lal has seen that before with immersive video games for young patients.

“I could not get these kids to leave the chair. They begged for five more minutes,” he says.

Author: Contributing writer Jane Schmucker is a veteran journalist who has covered health and business topics. Now freelancing, she reported and edited for more than 22 years at The Blade (Toledo, Ohio). She has also worked on the rewrite desk for USA Today in Arlington, VA.


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