Columbia Offers Virtual Healing in the Dental Chair

Nobody loves going to the dentist. 60 percent of people report dental anxiety and the rest could probably think of better ways to spend the afternoon.

To make the experience a little better, Columbia University dental professor Shantanu Lal, DDS, introduced Virtual Reality (VR) headsets to the dental office through a new course at CDM. After students complete the course, they can offer patients wearable technology to relax into virtual experiences in nature, all while completing their dental appointment. An hour spent getting teeth scraped just got palatable.

“I’ve always known that, for some patients, distraction is the best medicine for dental anxiety,” says Dr. Lal, a pediatric dentist and associate professor at the Columbia University College of Dental Medicine. “I’ve experimented with video eyewear before but the immersive experience of VR takes it to a whole new level."

The new VR Training Initiative launched at Columbia in late January teaches dental students to use such technology to create a sensory adaptive virtual reality (SAVR) environment, an immersive digital space incorporating healing elements of nature and tailored to a patient's personality and anxiety levels. The goal is to encourage relaxation and well being in adolescent and adult patients. The course combines on-line, self-paced learning followed by hands-on clinical instruction.

One of the earliest applications for VR in health care was to treat different types of phobias or help people recover from post-traumatic stress disorder by processing the triggering experience. Dr. Lal had a hunch that the immersive experiences could help to distract people who struggle with dental phobias. He started using 3D video eyewear in his Upper West Side pediatric dentistry private practice—especially when working with anxious patients—in 2015.

Lal credits a grant he received as the impetus for creating the new VR training program to a Columbia University Provost’s Teaching and Learning grant. “Students complete basic coursework online via carefully sequenced video modules,” he explains. “The next step is in the clinic, where we demonstrate use on a patient under direct supervision.”

The provost’s grant provided stipends for several current students to help Lal develop pedagogy and training modules. All told, the process took 12 months to complete. Of the five students who signed on to assist Lal, two had done independent research projects investigating the effects of VR in dental medicine. Their work was recognized with a research award and selected to compete at a prestigious American Association for Dental Research research competition.

The students' projects, and the larger VR initiative, reflect the school's direction, says Christian S. Stohler, DMD, DrMedDent, dean of the College of Dental Medicine. "The VR Training Initiative is a prime example of how we can lead innovation in oral healthcare," said Stohler. "And by involving students in the research and development process, we inspire the next generation to be leaders in their own right." 

Long Island native Daniel Nassimi ’20, who helped develop the clinical practices and protocols module of the course, says his only exposure to virtual reality prior to enrolling at Columbia was playing video games with his nieces and nephews. Then he decided to conduct research on techniques to help patients manage anxiety and his advisor, Lynn Tepper, clinical professor of behavioral sciences, urged him to approach Lal about incorporating VR.

Nassimi’s resulting study collected vital signs, as well as subjective reports of anxiety, among 10 patients who used a Google Daydream headset with relaxing imagery during dental procedures. All of the participants had lower blood pressure and heart rate after procedures during which they used VR than when their exams began. What really sold Nassimi on the technology—and spurred his participation in the course designed to bring along his classmates—was the dramatic effect he witnessed in one of his most anxious patients: During a root canal with only a local anesthetic and a VR headset, the man fell asleep.

“He was snoring,” says Nassimi, “and we had to wake him up.”