## 5 Discussion  
Fear and anxiety are commonly experienced during dental visits, particularly among children. There are several treatments for dental anxiety in children, such as behavior management techniques including distraction and tell-show-do [19]. Moreover, pharmacological management, including nitrous oxide (laughing gas) and oral sedation [50], can be used to help children feel more relaxed and comfortable during dental procedures. In addition, cognitive behavioral therapy (CBT) [51], which is a type of talk therapy, can be used to help children manage anxiety and fear related to dental procedures. Still, fear and anxiety are widespread among children [6]. Fortunately, advances in technology have enabled the development of interactive augmented and virtual reality systems that can help manage anxiety. These systems provide an immersive experience that can reduce fear and anxiety related to dental visits. AR and VR systems can create a virtual dental office, dental chair, and other equipment [52], making the environment more familiar and less intimidating for young patients. Additionally, AR and VR systems can provide relaxation techniques and distraction strategies, such as calming visuals and sounds, to reduce anxiety. Research has been conducted on the application of AR and VR in various areas of dentistry, but only a few studies have examined the results. Our study introduces a system designed for Arabic-speaking children aged 7 to 10 years to manage dental anxiety using VR and AR technologies. The system's performance and effectiveness were evaluated using unit, integration, performance, and user acceptance testing. Dental anxiety was measured using the CFSS-DS, a widely adopted international scale to assess children's anxiety during dental care [53]. The results demonstrate that the proposed solution performed reasonably, met usability requirements, decreased negative emotions in the clinic, and was engaging for learning about dental hygiene. The user acceptance testing showed positive results among different children, indicating that the system achieved its goal. Furthermore, the system encountered no crashes, demonstrating its stability and reliability. Additionally, the results of the second phase of the study suggest that the use of VR/AR technologies has a positive impact on managing anxiety in children, as evidenced by the lower CFSS-DS scores in the VR group compared to the control group. These findings are consistent with previous studies [54; 55] that have shown the potential of VR technology in reducing anxiety in various medical settings, including dentistry. One possible explanation for the effectiveness of VR technology is that it provides a distraction from the dental procedure, which can help to reduce anxiety and pain. By immersing the child in a different environment, VR technology can also help to create a sense of control and safety, which can further reduce anxiety levels. This study also contributes to the Arabic content in the field of AR and VR technologies. Dr. Barea is primarily intended for use in dental clinics; however, the application will also be available on smartphones, providing easy access from any location. Overall, the proposed system proved to be advantageous in the dental environment, alleviating the worries and stress of pediatric patients. Despite the promising results in terms of anxiety management, the current system and research have certain limitations. First, the feasibility study only included a small number of participants for one session, which limits the generalizability of the findings. Our long-term aim is to conduct a longitudinal study with a larger cohort and multiple trials to further validate the effectiveness of our proposed system.