Table 1 Exclusion and inclusion criteria

Participant Exclusion Criteria

Current injury (including fractures, open cuts, or sores) on their dominant hand

Currently have a cardiovascular disorder or a pacemaker

Currently have a seizure disorder or epilepsy

Fixed dental or orthodontic appliance that would interference with fabrication of a mouthpiece

Are colorblind

Currently on any anti-depressant or anti-anxiety medications

Currently have an inner ear infection

Living in the same household or an immediate family member of a participant enrolled in this or prior studies in this series

Unwilling to remove facial cosmetics or attend sessions without facial cosmetics on

Currently have glasses or use contact lenses with a vision correction of ≥ ± 6

History of sensitivity to extreme cold or frostbite

Bleeding disorder or take blood thinners

Vasospastic disorder such as Raynaud’s disease or Raynaud’s syndrome

Gastrointestinal or vestibular disorders that may elevate susceptibility to nausea and dizziness such as hyperemesis gravidarum, Meniere’s disease, or severe migraines

Behavioral, developmental, or sensory disorder that would increase discomfort or ability to complete study tasks

Medical condition that requires them to avoid mild stress

Diagnosis of Temporomandibular Disorder along with a history of exacerbation of symptoms resulting from routine dental procedures

Prior negative outcome with virtual reality simulation

Any medical condition that elevates risk of falls, nausea, dizziness, or causes vasovagal reactions

Any other oral or general health concerns

Participant Inclusion Criteria

Be between the ages of 6 and 35 years old

At least 2 of their maxillary anterior 6 teeth present

All of their maxillary anterior 6 teeth are free of hypersensitivity to pressure or pain

All of their maxillary anterior 6 teeth are stable

All of their maxillary anterior 6 teeth are free of cavities

Able to read, write, and converse in English (English or Spanish at UTRGV site)

Willing and able to provide a signed and dated informed consent/assent form to participate

Willing and available to comply with all study procedures and available for the study duration