Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 4 2018 08 19 250 258 EN Razieh Meshki Assistant Professor, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Leila Basir Assistant Professor, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Fatemeh Alidadi Dentist in private practice, Ahvaz, Iran Azam Behboudi Pediatric Dentistry Resident, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Vahid Rakhshan PhD Student, Department of Cognitive Neuroscience, Institute for Cognitive Sciences, Tehran, Iran 2018 03 04 2018 05 31 Objectives: Studies on modeling a pre-exposure technique for the prevention of anxiety in children are rare, and there is no study on interactive modeling using computer games. We assessed the effect of playing a dental simulation game before operation on pain and anxiety in 4- to 7-year-old children during their first dental treatment session. Materials and Methods: In this double-blind randomized clinical trial, 50 children needing unilateral pulpotomy and placement of stainless-steel crowns (SSC) on mandibular primary first molars were enrolled and randomly divided into experimental (a simulation game) and control (no intervention) groups. The experimental group played the game twice a day for two weeks before the scheduled visit. At the dental session, their pre- and post-operative pains were recorded using the Wong-Baker Facial Rating Scale (W-BFRS). Also, heart rate (HR; as an indicator of anxiety) was measured using a finger pulse oximeter at six treatment stages: (1) baseline (at the initial session, two weeks before treatment) and (2-6) during different stages of treatment. Effects of playing the simulation on pain and HR were analyzed using t-test and repeated-measures two-way analysis of covariance (ANCOVA). Results: Game playing significantly reduced the HR (P=0.031). The interaction of playing with the treatment period was also significant (P=0.004). When the groups were compared in each of the six time points, the experimental group showed reduced HR during anesthetic injection and cavity preparation using a high-speed handpiece (P<0.003). Conclusions: Based on the results, playing certain dental simulation games before the first dental visit might reduce the anxiety felt during anesthetic injections and drilling. https://fid.tums.ac.ir/index.php/fid/article/view/2437 https://fid.tums.ac.ir/index.php/fid/article/download/2437/1018