Effect of Aromatherapy on Dental Anxiety and Pain in Children Undergoing Local Anesthetic Administrations: A Randomized Clinical Trial

Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent)

Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.

The effect of aromatherapy with Lavender-Neroli oil and music in management of pediatric dental anxiety: a randomized control trial

AIM

This study aimed to evaluate the efficacy of aromatherapy with Lavender-Neroli essential oil combined with background music in reducing dental anxiety and pain during anesthesia in children.

MATERIALS AND METHODS

A total of 56 children aged 6-10 years old who needed dental treatment with inferior alveolar nerve injection (IANB) were randomly divided into two groups: Group 1 (Experimental, n = 28) aromatherapy with music group, and Group 2 (Control, n = 28) the placebo group. Children in the group 1 were asked to inhale the aromatic blend of Lavender-Neroli essential oil using a nasal mask similar to one that is used for nitrous oxide after modifying it by adding a 3D printed box on its circle hole and listening to their favorite music as a background before 5 min and during anesthesia, meanwhile in the placebo group children were asked to wear an empty nasal mask. Anxiety and pain were been assessed before and after anesthesia using the self-report anxiety scale Facial image scale (FIS), Observational pain assessment scale Face-Legs-Activity-Cry-Consolability (FLACC), heart rate, SPO2 saturation, diastolic and systolic blood pressure.

RESULTS

Dental anxiety and vital signs except SPO2 saturation were significantly lower in the aromatherapy with music group when compared to the control group (p < 0.05), with no differences in pain perception between groups (p = 0.176).

CONCLUSIONS

Aromatherapy with Lavender-Neroli oil combined with music seems to be a useful and safe non-pharmacologic technique for managing dental anxiety in children.

Use of Aromatherapy for Pediatric Surgical Patients

BACKGROUND

Children having surgery experience distress from a myriad of sources. Aromatherapy may present an opportunity to promote a healing environment and decrease distress for children following surgery.

AIM

Evidence regarding the use of aromatherapy with children is growing. The purpose of this project was to describe our implementation process, subsequent use of and response to aromatherapy for children undergoing surgery.

METHODS

This quality improvement project and subsequent retrospective chart review included all patients with documentation of aromatherapy use over an 8-month period. Data collection included demographic data, patient diagnosis, location, information about which oils were used, for which indications, and any outcome the nurse was able to observe (e.g., improved, no change, worsening of symptoms). A nurse-led workgroup developed and implemented a process for aromatherapy in a limited scope when discomfort, nausea/vomiting, nervousness, and sleep disturbances were reported . Charts of all patients with documented aromatherapy use were reviewed for indication/reason for use, oil, and patient response.

RESULTS

Results suggest a successful implementation process. Aromatherapy was used by 191 patients (aged 3-22 years). Upset stomach, discomfort, and nervousness were most frequently reported as leading to aromatherapy use. Lavender and peppermint were the most frequently used oils. Of those patients with documented responses, the majority reported improvement.

CONCLUSIONS

We were able to successfully implement a new aromatherapy program as an adjunct to care in children undergoing surgery. No adverse events were reported. Documentation is crucial to evaluating any new service.