Impact of binaural beats audiovisual aid with or without conceptualized immersive projection experience on dental anxiety during dental treatment in children - A randomized crossover trial.

BACKGROUND: Dental anxiety in children can compromise the delivery of effective dental care. Audiovisual (AV) distraction and binaural beats have demonstrated anxiolytic effects; however, evidence regarding their combined use with immersive projection remains limited. AIM: To evaluate the effect of Binaural Beats AV distraction with and without conceptualized immersive projection experience (CIPE) on dental anxiety in children undergoing dental restoration. MATERIALS AND METHODS: This single-centre randomized crossover trial included 25 children aged 6-12 years with moderate-to-high dental anxiety (Modified Child Dental Anxiety Scale score ≥30). Participants received two interventions across separate visits: (1) Binaural beats audiovisual distraction (BB-AV) and (2) binaural beats audiovisual distraction with CIPE (BB CIPE), with a washout period of 2 weeks. The primary outcomes were skin conductance and Face, Legs, Activity, Cry, and Consolability (FLACC) scores. Secondary outcomes included heart rate and oxygen saturation during dental treatment. Data were analyzed using paired t -tests. RESULTS: BB-CIPE significantly reduced heart rate during treatment compared with BB-AV alone (81.88 ± 1.96 vs. 86.64 ± 2.22 bpm; P < 0.001). Behavioral distress was also significantly lower with BB-CIPE, reflected by reduced FLACC scores (1.76 ± 0.60 vs. 3.08 ± 0.76; P < 0.001). Skin conductance responses and oxygen saturation values showed significant improvement with immersive projection ( P < 0.001). CONCLUSIONS: BB-CIPE reduces dental anxiety in children and provides additional benefit by improving both behavioral and physiological responses. This nonpharmacological approach may serve as an effective adjunct for pediatric dental behavior management. TRIAL REGISTRATION: The trial was registered with the Clinical Trials Registry-India (CTRI/2025/10/095894) on 10 October, 2025.