A study on the prevalence of dental anxiety, pain perception, and their interrelationship in Chinese patients with oral implant surgery

Effects of Passiflora incarnata and Valeriana officinalis in the control of anxiety due to tooth extraction: a randomized controlled clinical trial

OBJECTIVE

This study evaluated the efficacy of Valeriana officinalis L. and Passiflora incarnata L. to control anxiety, surgical discomfort, and changes in vital signs of patients undergoing extraction of two unilateral third molars.

MATERIALS AND METHODS

This study is a randomized, triple-blinded clinical trial. Fifty-four patients were allocated into three groups (Valeriana officinalis L., Passiflora incarnata L., and placebo). Anxiety levels were assessed using the State-Trace Anxiety Inventory (STAI) index, surgical discomfort using the QCirDental, and through the measurement of vital signs. The surgical times evaluated were before (T0), during (T1), and after surgery (T2).

RESULTS

There was evidence that both Valeriana officinalis L. and Passiflora incarnata L., reduced STAY-S scores between T0 and T2 (p < .05), unlike placebo (p = .129). There was no change in surgical discomfort in all groups over time, and vital signs presented variable results.

CONCLUSION

Phytotherapy drugs showed a reduction in anxiety state compared to the placebo group during third molar extraction procedure.  CLINICAL TRIAL REGISTRATION: klRBR-6kcxvrc, March 10, 2022.

The Influence of Anxiety on Postoperative Quality of Life Regarding Implant Treatments: An Epidemiological Study

Dental treatment anxiety is highly prevalent worldwide. This is particularly important in the field of implantology since, in daily clinical practice, it translates into an increase in the difficulty of treatments, extending surgical times and having repercussions in the postoperative period. The aim of this multicentre, cross-sectional, epidemiological study was to determine the influence of anxiety levels in the postoperative period of an implant treatment on patients treated at two dental departments in Extremadura (Spain). To analyse anxiety levels, the modified Corah's Dental Anxiety Scale questionnaire was administered before surgical treatment. To analyse the postoperative period, another questionnaire was provided 7 days after surgery. The study was conducted on a total of 102 patients (55 men and 47 women), with a mean age of 47.99 years. The results indicated that patients with a high and severe degree of anxiety had a poorer quality of life in general. Patients with a higher degree of anxiety perceived greater swelling at 24, 48, 72 h and one week after surgery.

Associations between the perception of dental pain and pain anxiety, mental pain, and dental anxiety in Iranian sample

OBJECTIVE

This study examined the perception of dental pain and its relationship to pain anxiety, dental anxiety, and mental pain.

METHODS

This cross-sectional study was conducted on 328 patients referred to dental clinics in Kermanshah (Iran) from 2020 to 2021. The instruments used in this study included scales assessing pain anxiety, dental anxiety, mental pain, and pain perception.

RESULTS

There was a significant relationship (p = .001) between pain perception with dental anxiety (r = .38), pain anxiety (r = .45), and mental pain (r = .25).

CONCLUSION

Psychological factors are associated with the perception of dental pain. Given the importance of dental care to overall health, psychological interventions may help to reduce the perception of dental pain and fear of seeing dentists in Iran.

Changes of dental anxiety, aesthetic perception and oral health-related quality of life related to influencing factors of patients' demographics after anterior implant treatment: a prospective study

BACKGROUND

Accumulating evidence has revealed the effects of anterior implant procedures on dental anxiety (DA), aesthetic perception and oral health-related quality of life (OHRQoL). However, few reported the changes and influencing factors of the above outcomes before and after anterior implant treatment. This study was to evaluate the changes of DA, aesthetic perception and OHRQoL related to influencing factors of patients' demographics after anterior implant treatment.

METHODS

Thirty-nine patients satisfying the inclusion criteria were prospectively recruited before surgery. The subjects completed the Modified Dental Anxiety Scale (MDAS), the Orofacial Esthetic Scale (OSE) and the Oral Health Impact Profile-14 (OHIP-14), before implant surgery and after definitive prosthesis placement. Mann-Whitney U test and Kruskal-Wallis test by Bonferroni correction were applied for the data analysis and the influencing factors evaluation (p < 0.05).

RESULTS

Overall, 39 patients (mean age of 44.9 ± 12.0) completed the three scales. After anterior implant treatment, MDAS was not significantly changed (p > 0.05). The overall OSE (p < 0.001) and OHIP-14 (p < 0.05) were significantly improved. Females showed more improvement of overall OHIP score than males after anterior implant treatment (p < 0.05).

CONCLUSIONS

Anterior implant procedures did not change the level of patient's DA, while aesthetic perception and OHRQoL were enhanced. Only gender difference of overall OHIP change was found in our study. Thus, more related influencing factors with larger sample and long-term effective follow-up are needed.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05424458. Registered 13 June 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05424458 .

Patient-reported outcome measures following surgeries in implant dentistry and associated factors: a cross-sectional study

OBJECTIVES

We aimed to evaluate the patient-reported outcome measures (PROMs) of dental implant surgeries and analyse the associated indicators.

DESIGN

A cross-sectional study design was used.

SETTING

Department of Oral Implantology, Hospital of Stomatology, Wuhan University (May 2020-April 2021).

PARTICIPANTS

Participants with missing teeth in need of implant-supported rehabilitation.

INTERVENTIONS

Dental implant placement and/or bone augmentation procedures.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was discomfort on postoperative day 1, measured using a numerical rating scale (NRS). Secondary outcomes included pain and anxiety during surgery; discomfort on postoperative days 3, 7 and 14; and post-surgical complications.

RESULTS

A total of 366 participants were included, of which 288 (78.7%) and 328 (89.7%) reported no to mild pain and anxiety (NRS 0-3) during surgery, respectively. The proportion of patients reporting discomfort decreased from postoperative day 1 (57.7%) to day 3 (36.1%) and day 7 (17.5%). The most frequent postoperative adverse events were pain and swelling. Patient-related factors (age, sex, smoking, alcohol consumption, history of periodontitis, and pain and anxiety during surgery) and surgery-related factors (type and extent of surgical procedure) were analysed. The factors associated with the severity of discomfort after surgery included alcohol consumption, pain perception during surgery, bone augmentation procedures and age (p<0.05). Similarly, the factors associated with the duration of discomfort included alcohol consumption, pain perception during surgery and age (p<0.05).

CONCLUSIONS

PROMs related to dental implant surgeries can be predicted using certain risk indicators. Alcohol consumption, pain during surgery and age were associated with discomfort following dental implant surgery.

Psychodiagnostics as a Mandatory Element of Patient Protocols in Dentistry

Objectives:

This study aims at performing psychodiagnostics of the patients` condition with removable and fixed dentures both before and after dental treatment.

Materials and Methods:

The first group included 200 patients with fixed-type dentures, and the second group consisted of 200 patients with removable dental devices. The control group included 200 patients with healthy teeth. All patients were subjected to Fere’s skin-galvanic reaction procedure. Patients also filled out the Dental Status Questionnaire and were then tested following the Spielberger-Hanin Scale. For a comparison of differences, a two-sample t-test for independent samples was used. The Pearson correlation between features was calculated considering their distribution as normal.

Results:

In the control group, the hemispheric activity index increased 1.1 times after treatment. In Group 2, following the dental status questionnaire, the index of hemispheric activity increased 1.3 times in males with a positive emotional mood (P ≤ 0.01). A 2.2-fold and 2.1-fold (P ≤ 0.01) increase was observed among female and male patients with a negative emotional mood in Group 2, respectively. After the treatment, the hemispheric activity index in Group 1 increased by 1.1 times for males with a positive mood (P ≤ 0.01) and by 1.2 times for male and female patients with a negative mood (P ≤ 0.05). Direct correlation was recorded between the increase in the number of scores and emotional mood among males and females from Group 1 (0.72 and 0.73, respectively). After the survey, a correlation was established between the values of the hemispheric activity index and the increase in scores among males (0.82) and females (0.81). There was also a connection between the increase in scores and the level of personal anxiety in both male (0.57) and female (0.66) patients, as well as between the increase in scores and the level of reactive anxiety (0.56 and 0.57, respectively).

Conclusions:

Changes in the hemispheric activity index were shown to be related to the patient’s dental condition questionnaire. Besides, there is a relationship with the type of dental service. The practical application of this study implies that more reliable information about the patient’s satisfaction with the quality of dental care provided can be obtained using not only standard psychodiagnostic methods but also questionnaires on the patient’s dental status. Once the survey is completed and the data obtained analyzed, it is possible to define the correct strategy to restore the patient’s physical and mental health after dental treatment.

Hypnosis as sole anesthesia for oral surgery: The egg of Columbus

BACKGROUND AND OVERVIEW

Hypnosis, despite its effectiveness, has been neglected. The aim of this study is to show the effectiveness and manageability of hypnosis as a stand-alone technique in dentistry.

CASE DESCRIPTION

Three patients underwent 6 oral surgery procedures (surgical third-molar removal, implant surgery, maxillary bone augmentation, and mucogingival surgery) with hypnosis as the only anesthetic. Two of the 3 patients had difficulties: 1 was sensitive to multiple chemicals, had Addison disease, and had previously experienced anaphylactic reactions to local anesthetics; the other was allergic to lidocaine and had undergone a paradoxical reaction to pharmacologic sedation in the past. All 3 patients had 2 preoperative sessions each to assess their perioperative risk, level of anxiety, hypnotic susceptibility, and capacity to develop full hypnotic analgesia. On a surgery day, hypnosis was induced and hypnotic analgesia was obtained according to a standard protocol, a procedure taking no more than 9 minutes in each case. Each surgical procedure was then completed successfully with the patient in a painless condition of full relaxation and sense of well-being, with stable cardiovascular parameters. None of the patients required postoperative analgesics, which were prescribed for use as needed.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Hypnosis is a valuable tool in dentistry, enabling the safe and rapid relief of anxiety and phobia and raising patient pain thresholds to the level of surgical analgesia. Unlike drugs and equipment, it is always readily available, cost-free, and has no adverse effects when administered by competent professionals. Hypnosis can be used for sedation in most patients and as a stand-alone technique in those with appropriate hypnotic susceptibility, improving the well-being and safety of patients.

Effect of different factors on patient perception of surgical discomfort in third molar surgery

The aim of this study was to evaluate patient perception of surgical discomfort in third molar surgery and the association with clinical variables and polymorphisms associated with the FKBP5, SLC6A4, and COMT genes. This cross-sectional observational study was carried out on 196 participants aged between 18 and 64 years at the Federal University of Paraná in 11 months. The intensity of surgical discomfort was assessed using the QCirDental questionnaire. Data on surgical and individual procedures were also cataloged. The oral health related quality of life was assessed by the Oral Health Impact Profile questionnaire (OHIP-14). The DNA sample was obtained from cells of the oral mucosa. Five markers of the FKBP5, SLC6A4, and COMT genes were genotyped. The data were submitted to statistical analysis with a significance level of 5%. Women reported greater intensity of discomfort associated with third molar surgery compared to men (p = 0.001). In the recessive model, the AA genotype of the rs3800373 marker was associated with greater surgical discomfort (p = 0.026). Therefore, women and individuals of the AA genotype for the rs3800373 marker in the FKBP5 gene reported greater surgical discomfort associated with third molar surgery.