Background: Administration of local anesthesia remains one of the most anxiety-provoking procedures in pediatric dentistry. Inferior alveolar nerve block (IANB) is frequently associated with fear, discomfort, and pain perception among children. Virtual reality (VR) distraction has emerged as a promising non-pharmacological behavior guidance technique that may reduce anxiety and pain during dental procedures.

Aim: To evaluate the effectiveness of virtual reality distraction in reducing pain and anxiety during inferior alveolar nerve block administration in children aged 8–10 years.

Materials and Methods: A randomized controlled clinical study was conducted among 32 children aged 8–10 years requiring IANB for dental treatment. Participants were randomly allocated into two groups: Control group (n=16) and VR group (n=16). Baseline anxiety was assessed using the Modified Child Dental Anxiety Scale (MCDAS). Anxiety before and after IANB administration was evaluated using the Venham Clinical Anxiety Scale. Pain perception was assessed using the FLACC scale and Wong–Baker Faces Pain Rating Scale. Children in the VR group viewed the animated cartoon “Shiva: The Cycle” using a VR headset before and during administration of local anesthesia. Statistical analysis was performed using non-parametric tests. Intergroup comparison was carried out using the Mann–Whitney U test and intragroup comparison using the Wilcoxon signed-rank test. Statistical significance was set at p<0.05.

Results: No statistically significant difference was observed between groups regarding baseline anxiety scores assessed by MCDAS (p=0.432) and preoperative Venham scores (p=0.675). However, postoperative Venham anxiety scores were significantly lower in the VR group compared with the control group (p<0.001). FLACC scores and Wong–Baker pain scores were also significantly lower in the VR group (p<0.001).