{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:55:11Z","timestamp":1784120111383,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2025,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n \n This study aimed to compare the effects of virtual reality (VR) and nitrous oxide (N\n 2<\/jats:sub>\n O) sedation on anxiety and stress in patients with dental anxiety.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Eight patients with dental anxiety (five women; mean age, 41 years) with scores \u2265 19 on the Japanese version of the Modified Dental Anxiety Scale underwent three interventions: VR (natural landscapes and ambient music), N\n 2<\/jats:sub>\n O (30% N\n 2<\/jats:sub>\n O\/70% oxygen), and no intervention (control). Autonomic nervous activity, including low frequency (LF), high frequency (HF), and the LF\/HF ratio, was measured. VR significantly reduced LF and LF\/HF levels compared to those of the control (\n p<\/jats:italic>\n < 0.05), suggesting lower sympathetic nervous system activity, whereas N\n 2<\/jats:sub>\n O had no effect (\n p<\/jats:italic>\n = 0.88, 0.46, respectively). VR and N\n 2<\/jats:sub>\n O increased HF levels compared to those of the control (\n p<\/jats:italic>\n < 0.05), reflecting enhanced parasympathetic activity. Subjective anxiety was lower for VR and N\n 2<\/jats:sub>\n O interventions (\n p<\/jats:italic>\n < 0.05). VR immersion ratings indicated that most participants experienced moderate\u2010to\u2010high immersion levels.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n VR is an effective, noninvasive option for managing dental anxiety, suggesting greater reductions in sympathetic\u2010related markers than those of control and, in some analyses, N\n 2<\/jats:sub>\n O, in this small crossover sample. Its accessibility and lack of pharmacological side effects support its integration into patient\u2010centered care, particularly for mild\u2010to\u2010moderate dental anxiety.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/scd.70100","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T06:31:20Z","timestamp":1758522680000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Does Virtual Reality Reduce Dental Treatment Stress in Patients With Dental Anxiety? A Comparison With Nitrous Oxide Sedation: A Crossover Study"],"prefix":"10.1111","volume":"45","author":[{"given":"Hitoshi","family":"Ishitani","sequence":"first","affiliation":[{"name":"Osaka Dental University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Special Care Dentistry Osaka Dental University Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Department of Special Care Dentistry Osaka Dental University Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology Osaka Dental University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Momota","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology Osaka Dental University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Special Care Dentistry Osaka Dental University Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,21]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"164","article-title":"Dentists' Knowledge, Attitudes, and Assessment Practices in Relation to Fearful Dental Patients: A Pilot Study","volume":"43","author":"Weiner A. 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