Abstract
BACKGROUND: Dental anxiety is a common psychological phenomenon that significantly influences patients' willingness to seek and undergo dental treatment. The Dental Operating Microscope (DOM), widely adopted for its precision and magnification, offers an additional feature: a live video output that can display the ongoing procedure to the patient. While DOM enhances the clinician's performance, its potential psychological effect on the patient, particularly in modulating intraoperative anxiety, remains underexplored. OBJECTIVE: To evaluate the effect of showing live video output of a DOM on anxiety levels in adult patients undergoing restorative procedures. MATERIALS AND METHODS: A comparative, randomized, crossover clinical study was conducted among 130 male adult patients aged 25-40 years who required bilateral restorative treatment in mandibular molars. Preoperative anxiety was assessed using the Modified Dental Anxiety Scale and customized anxiety scales. Patients were randomly allocated into two equal groups. Group A: Underwent the first restorative procedure using DOM with live video output, and the second procedure without DOM. Group B: Underwent the first procedure without DOM and the second with DOM. Pulse rate and oxygen saturation were recorded throughout. STATISTICAL ANALYSIS: Pre- and postoperative anxiety levels were compared within and between groups using the Wilcoxon signed-rank test, Mann-Whitney U-test, and Kruskal-Wallis ANOVA using SPSS software. RESULTS: Both groups exhibited a statistically significant reduction in anxiety levels postprocedure (P < 0.05). However, the reduction was more pronounced when the DOM with live video output was used. Group A showed a mean difference of 2.61 ± 1.08 with DOM versus 1.64 ± 1.00 without DOM (P < 0.05), while Group B demonstrated a similar pattern with significant anxiety reduction in DOM-assisted sessions (P < 0.05). Intergroup comparisons revealed that the DOM condition consistently produced lower postoperative anxiety scores than the non-DOM condition (P < 0.05). CONCLUSION: Displaying live video output of the DOM during restorative treatment significantly reduces intraoperative dental anxiety in adult patients. The enhanced visualization provides patients with a sense of control and understanding, leading to improved comfort and trust. Integrating a DOM live display may thus serve as a nonpharmacological adjunct in managing dental anxiety. CLINICAL SIGNIFICANCE: The use of live video output from a DOM enhances clinical precision while positively influencing patient psychology, thereby offering a dual benefit in modern restorative dentistry.