Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: A randomized controlled clinical trial

What do Brazilian paediatric dentists know about bruxism in children? Cross-sectional study

PURPOSE

Little is known about the knowledge of paediatric dentists on bruxism in children. The aim of this cross-sectional study was to assess the knowledge of paediatric dentists on the concept, associated factors of bruxism and management of sleep bruxism (SB) in children'.

METHODS

An electronic questionnaire was sent to paediatric dentists in the state of Goiás, Brazil. Information was collected on (1) characteristics of the participants; (2) the concept of bruxism; (3) diagnosis; (4) associated factors; (5) strategies for the management of SB; and (6) updated knowledge on bruxism in children. The data were analysed descriptively.

RESULTS

Fifty-seven paediatric dentists participated (10.7% of the total number of professionals). A high level of agreement was found with statements on the concepts of SB (94.7%) and awake bruxism (96.5%). The main strategy for the diagnosis was the combination of a parental report and a clinical examination (79.0%). Most participants indicated that bruxism is associated with anxiety/stress (96.5%), screen use (93%), airway obstruction (91.2%), and sleep apnoea (91.2%). In suspected cases of bruxism, the dentists would send the child for assessment by other health care providers (87.7%). The management options frequently indicated were the use of an occlusal splint, aromatherapy, and homeopathy. More than 70% of them considered themselves to be updated on the issue and sought information through scientific articles and discussions with colleagues.

CONCLUSION

Paediatric dentists have knowledge on the concept of bruxism and associated factors. However, further information is needed on the management of this condition in children.

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.

Assessing the usability of aromatic mouthwashes in alleviating physiological stress responses

Background

Mouthwashes play a pivotal role in oral care, and their efficacy has been explored extensively across various dimensions. As a contribution to the development of novel oral care products, this study aims to investigate the psychophysiological effects of aromatic mouthwashes during the resilience period from a short-term cognitive stressor utilizing biological signals and subjective evaluations.

Methods

A within-participant experimental design with 22 healthy females was conducted with four mouthwashes; peppermint (Mint), peppermint + bergamot (MB), peppermint + sweet orange (MO), and peppermint + lavender (ML), and water as the control (Ctl), after a 20-min calculation task. Subjective evaluations and physiological responses including skin conductance level and electrocardiogram were recorded throughout the experiment.

Results

Citrus mouthwashes (MO and MB) showed a greater decrease in heart rate and a significant increase in the high-frequency component of heart rate variability. The participants indicated a significant effect in terms of "flavor preference" and "refreshing sensation" for mouthwash use compared to the Ctl.

Conclusion

The results suggest that rinsing with citrus-flavored mouthwashes has a positive impact in alleviating the physiological stress response (in terms of cardiac activity). These findings may have implications for the development of innovative, novel oral care products that promote stress reduction and improve oral health.

Effect of aromatherapy with peppermint essential oil on the gag reflex: a randomized, placebo-controlled, single-blind, crossover study

BACKGROUND

Sensitive gag reflexes prevent dental patients from receiving appropriate treatment. Aromatherapy helps patients relax during dental procedures. However, the effect of aromatherapy on the gag reflex caused by the stimulation of the oral cavity is unknown. This study aimed to evaluate whether aromatherapy reduces gag reflexes during oral stimulation.

METHODS

In this randomized, placebo-controlled, single-blind, crossover study, the gag reflexes of 24 healthy individuals (12 females and 12 males; mean age: 34.3 ± 9.5 years) were quantified. A standard saliva ejector was slowly guided down the participant's throat to determine the maximum tolerance of the gag reflex, and the insertion distance was measured to quantify the gag reflex. All individuals participated in an aromatherapy session with peppermint essential oil and a placebo session with distilled water. The gag reflex was quantified before (baseline) and after each session. Another measurement was performed using nitrous oxide/oxygen inhalation as a positive control.

RESULTS

Gag reflex values significantly increased after aromatherapy with both peppermint essential oil and placebo compared to baseline values (paired t-test, P < 0.001 and P = 0.014, respectively). The gag reflex value also increased significantly during nitrous oxide/oxygen inhalation (paired t-test, P < 0.001). There was no significant difference in the increase rate of gag reflex values between the positive control and aromatherapy interventions, but it was significantly lower after the placebo intervention (repeated measures analysis of variance, P = 0.003; post-hoc test, P = 0.83 and P = 0.02).

CONCLUSION

Aromatherapy with peppermint essential oil has the potential for reducing gag reflex during dental procedures.

TRIAL REGISTRATION

The study was registered in the University hospital Medical Information Network Clinical Trials Registry under the code UMIN000050616 (approved 17/03/2023).

Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial

The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.

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.

Aromas Influencing the GABAergic System

Aromas have a powerful influence in our everyday life and are known to exhibit an array of pharmacological properties, including anxiolytic, anti-stress, relaxing, and sedative effects. Numerous animal and human studies support the use of aromas and their constituents to reduce anxiety-related symptoms and/or behaviours. Although the exact mechanism of how these aromas exert their anxiolytic effects is not fully understood, the GABAergic system is thought to be primarily involved. The fragrance emitted from a number of plant essential oils has shown promise in recent studies in modulating GABAergic neurotransmission, with GABA_A receptors being the primary therapeutic target. This review will explore the anxiolytic and sedative properties of aromas found in common beverages, such as coffee, tea, and whisky as well aromas found in food, spices, volatile organic compounds, and popular botanicals and their constituents. In doing so, this review will focus on these aromas and their influence on the GABAergic system and provide greater insight into viable anxiety treatment options.

Impact of a Dietary Citrus Extract on the Behavior and Production of Lactating Dairy Cows Following Regrouping: A Preliminary Study

Exposure of lab animals, humans, and pigs to olfactory sensory feed additives may reduce response to stress and anxiety. The objective of this preliminary study was to determine if feeding a citrus-based olfactory sensory functional feed extract (derived from Citrus sinensis) reduces the negative impact of regrouping of lactating dairy cows. Thirty-two (parity = 2.0 ± 1.2; mean ± SD), mid-lactation Holstein dairy cows (169.8 ± 16.8 DIM) were enrolled as focal cows in this study and housed individually in a tie-stall facility where they were randomly assigned to 1 of 2 treatment diets: (1) control total mixed ration (TMR) (control; n = 16; primiparous = 7; multiparous = 9), or (2) control TMR with 4 g/d of citrus extract (CE) (Phodé, Terssac, France) (CE; n = 16; primiparous = 7; multiparous = 9). Cows were fed their experimental diets for 7 d in the tie-stall facility (baseline), then moved to 1 of 2 experimental free-stall pens (containing 29 other cows) for a period of 7 d, where they remained on the same treatment diet as before. Compared with their baseline, primiparous control cows had decreased rumination time on d 1 and 2, had decreased lying time on d 1, and tended to have decreased lying time on d 2 and 3 following regrouping. In contrast, primiparous cows fed the CE diet did not experience a change in rumination and lying time. Primiparous CE cows had greater feeding time on d 1 and tended to have greater feeding time on d 2 after regrouping compared to primiparous control cows. Primiparous control cows had greater idle standing time, as compared to the CE cows, across the 7 d after regrouping. Primiparous CE cows initiated less total competitive behavior after regrouping, but were also displaced more frequently from the feed bunk and from the free stalls on d 1 after regrouping, as compared to the primiparous control cows. For multiparous cows, CE supplementation was not consistently associated with any benefits to behavior or production after regrouping, possibly because these cows were more experienced with social stressors. Results indicate that feeding CE to mid-lactation naïve primiparous dairy cows may reduce the initiation of competitive interactions and lessen the reduction in rumination and lying time after regrouping. These results need to be verified in further studies where potential confounding effects (e.g., pen social dynamics, pen location) are minimized.

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

Introduction: In dentistry, local anesthetic (LA) administration in children is often associated with behavioral problems. Hence, the present study evaluated the efficacy of aromatherapy in reducing the dental anxiety and pain during LA procedure.

Methods: This clinical trial was conducted upon 150 children in the age range of 8-12 years. Subjects were randomly divided into five groups; Group 1: Lavender essential oil using nebulizer; Group 2: Lavender essential oil using inhaler; Group 3: Orange essential oil using nebulizer; Group 4: Orange essential oil using inhaler; Group 5: Control (without aromatherapy). For all the children, baseline anxiety was recorded followed by aromatherapy (except for children in the control group). Following the standard protocol, LA was administered. The procedural pain was assessed using Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). Finally, anxiety was again recorded. Data were analyzed using SPSS version 17.0.

Results: A significant difference in ANOVA test was observed among anxiety scores after LA in aromatherapy groups 1, 3, and 4 compared to control. When the FLACC scores were analyzed using Kruskal-Wallis, there were significantly lower values in aromatherapy groups compared to the control group. The pain scores, as reported in FPS-R, were also lower in aroma groups 1, 3, and 4.

Conclusion: Aromatherapy with lavender or sweet orange, using either nebulizer or inhaler, decreased the dental anxiety of children, whereas, only sweet orange could reduce the pain as self-reported by children.

Preliminary Study on Citrus Oils Antibacterial Activity Measured by Flow Cytometry: A Step-by-Step Development

Essential oils of Citrus sinensis and Citrus latifolia have shown biological functions as antiseptics, anti-inflammatories, antioxidants, antifungal and antimutagenic, so the evaluation of their antibacterial capacity, by themselves or in combination with standard antibiotics, presents an alternative for infection treatment. Flow cytometry opens the door for the design of faster and more accurate measurement of antibacterial activity. We use a SYTO9/PI staining system on E. coli ATCC 25922 to determine antibacterial activity by counting live and dead cells through flow cytometry. We found that dual staining showed highly variable results due to wavelength overlapping and instead we used fluorochrome individual staining that highly correlated with viable counts. Chloramphenicol and cefotaxime treatments did not present a dose-response behavior, rendered diffuse readings and/or gave filament formation on fluorescence microscopy. Amikacin was a better comparison standard because it presented a dose-response behavior. Essential oils had low antibacterial activity as compared to amikacin, with a maximum of 10% and 20% for C. latifolia and C. sinensis, respectively. Combinations of essential oils with antibiotic resulted in an unforeseen strong inhibition of amikacin activity. Although a low antibacterial activity was found, a series of standardization steps are proposed for antibacterial activity measurement by flow cytometry.

Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study

Background

Managing a child's anxiety is most critical for the success of treatment in the pediatric dental setup. Present trend advocates the use of non-aversive behavior management techniques.

Aim and objective

To compare and evaluate the efficacy of aromatherapy using orange essential oil with that of music distraction in the management of anxious pediatric dental patients.

Design

One hundred and fifty children of the age 6–8 years were divided into three groups of 50 each and performed restorative treatment under aromatherapy, with music distraction, without aromatherapy, or music distraction, respectively. Venham's picture test and facial image scale (FIS), pulse rate, respiratory rate, and oxygen saturation were recorded before and after the procedure.

Results

Compared with controls, both the aromatherapy group and music distraction group showed significant posttreatment change in anxiety levels with respect to Venham's picture test and FIS, along with the reduction in pulse rate and respiratory rate. When compared between music distraction and aromatherapy, it did not yield statistical significance, though music distraction showed better results compared to aromatherapy.

Conclusion

Both music distraction and aromatherapy using orange essential oil are effective in anxiety management of which music distraction presents a comparatively better result. Either these non-invasive techniques alone or a combination of both may be employed in the dental setup of pediatric dentists for molding cooperative patients.

How to cite this article

James J, Retnakumari N, Vadakkepurayil K, et al. Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study. Int J Clin Pediatr Dent 2021;14(2):249–253.

Neuroprotective Potential of Limonene and Limonene Containing Natural Products

Limonene is a monoterpene confined to the family of Rutaceae, showing several biological properties such as antioxidant, anti-inflammatory, anticancer, antinociceptive and gastroprotective characteristics. Recently, there is notable interest in investigating the pharmacological effects of limonene in various chronic diseases due to its mitigating effect on oxidative stress and inflammation and regulating apoptotic cell death. There are several available studies demonstrating the neuroprotective role of limonene in neurodegenerative diseases, including Alzheimer's disease, multiple sclerosis, epilepsy, anxiety, and stroke. The high abundance of limonene in nature, its safety profile, and various mechanisms of action make this monoterpene a favorable molecule to be developed as a nutraceutical for preventive purposes and as an alternative agent or adjuvant to modern therapeutic drugs in curbing the onset and progression of neurodegenerative diseases. This manuscript presents a comprehensive review of the available scientific literature discussing the pharmacological activities of limonene or plant products containing limonene which attribute to the protective and therapeutic ability in neurodegenerative disorders. This review has been compiled based on the existing published articles confined to limonene or limonene-containing natural products investigated for their neurotherapeutic or neuroprotective potential. All the articles available in English or the abstract in English were extracted from different databases that offer an access to diverse journals. These databases are PubMed, Scopus, Google Scholar, and Science Direct. Collectively, this review emphasizes the neuroprotective potential of limonene against neurodegenerative and other neuroinflammatory diseases. The available data are indicative of the nutritional use of products containing limonene and the pharmacological actions and mechanisms of limonene and may direct future preclinical and clinical studies for the development of limonene as an alternative or complementary phytomedicine. The pharmacophore can also provide a blueprint for further drug discovery using numerous drug discovery tools.

The effects of foot massage on hemodialysis patients' sleep quality and restless leg syndrome: a comparison of lavender and sweet orange essential oil topical application

OBJECTIVES

Hemodialysis (HD) patients suffer more sleep problems (poor sleep quality and restless leg syndrome [RLS]). Complementary therapy, especially massage with aromatherapy oil is one of the non-pharmacological treatment options with less adverse effects than routine methods. The purpose of this study was to determine the effects of foot massage with of lavender and orange essential oil on HD patients' sleep quality and RLS.

METHODS

This is a double blind randomized controlled trial on 105 HD patients was conducted at a large educational hospital in Iran, Hamadan province between January and September 2017. Patients divided into three groups with random allocation (35 participants per groups in lavender, orange, and control group). Foot massage during HD with lavender and orange essential oil was administered to the patients three times a week for three weeks, and every massage lasted half an hour. The control group received routine care. Before the intervention, the end of the first, second, and third weeks Pittsburgh Sleep Quality Index (PSQI) and RLS questionnaire were completed for all three groups. Data were statistically analyzed with Independent Samples t-test, chi-square test and repeated-measures analysis of variance (ANOVA) by SPSS version 16.

RESULTS

The mean score of sleep quality and RLS in the intervention groups were significantly different compare with the control group in all three time of data collecting (p<0 001).

CONCLUSIONS

Aromatherapy prepared with lavender oil and sweet orange may be recommended to increase sleep quality and RLS level of the HD patients.

[Investigation and analysis of children's choice of environment in oral clinics]

OBJECTIVES

To investigate and analyze children,s choice of environment in oral clinics so as to provide evidence for improving the oral clinic environment.

METHODS

A total of 110 children in the Pediatric Dentistry of Qingdao Stomatological Hospital Affiliated to Qingdao University were selected as the research subjects from September to December 2019 to conduct a questionnaire survey, and the results were statistically analyzed by using a Chi-square test.

RESULTS

A total of 107 effective questionnaires were collected. The children surveyed liked the room with pink and blue walls (61.68%), cartoon murals (57.94%), and arranged toys (61.68%). Most of them did not dislike the special smell in the room (62.62%) and liked the smell of orange essential oil (52.34%). During treatment, the children liked watching cartoons the best (61.68%), expected doctors to be dressed in white (51.40%), and expected doctors to be treated by female doctors (68.22%). Most children wanted to be accompanied by family members during treatment (62.62%). The Chi-square test showed statistically significant differences in seven questions between preschool and school-age children: the environment of the clinic room, the color of the walls, the clinic decoration, the entertainment during treatment, color of the doctors' dress and gender, and company of the family members during treatment (P<0.05). The difference of children's choice of color of the wall and clinic decoration during the first and subsequent visit was statistically significant (P<0.05). However, no significant difference was observed in the choice of clinic environment between different genders (P>0.05).

CONCLUSIONS

Children have their own preferences for the environment in the oral clinic. For preschool children, we need to create a soothing and warm atmosphere with warm colors liked by children. For school-age children, a calm and relaxed clinic atmosphere with cold colors should be created.

The calming effect of roasted coffee aroma in patients undergoing dental procedures

Coffee beverage consumption is well-known to exert various health benefits; however, the effects of coffee aroma are rarely explored. This study aimed to investigate the calming effect of inhaling coffee aroma while the patients underwent dental procedures (probing and scaling). Salivary α-amylase (sAA) and cortisol (sCort) levels were measured as proxies of sympathetic nervous system and hypothalamic–pituitary–adrenal axis responses to stress respectively. Blood pressures and pulse rates were recorded. The results showed that undergoing dental procedures could increase sAA and sCort levels of the patients inhaling sham aroma while those inhaling coffee aroma had significantly decreased sAA and sCort levels (40% and 25% differences, respectively). The pulse rates of those inhaling coffee aroma were also lower. Subjective assessment using visual analog scale was in line with objective measures as well. The preference for coffee aroma or the frequency of coffee drinking had no effect on the sAA and sCort responses. This is the first study to provide evidence on the effect of coffee aroma on sAA and sCort levels in patients undergoing dental procedures.

Regular exposure to a Citrus-based sensory functional food ingredient alleviates the BOLD brain responses to acute pharmacological stress in a pig model of psychosocial chronic stress

Psychosocial chronic stress is a critical risk factor for the development of mood disorders. However, little is known about the consequences of acute stress in the context of chronic stress, and about the related brain responses. In the present study we examined the physio-behavioural effects of a supplementation with a sensory functional food ingredient (FI) containing Citrus sinensis extract (D11399, Phodé, France) in a pig psychosocial chronic stress model. Female pigs underwent a 5- to 6-week stress protocol while receiving daily the FI (FI, n = 10) or a placebo (Sham, n = 10). We performed pharmacological magnetic resonance imaging (phMRI) to study the brain responses to an acute stress (injection of Synacthen^®, a synthetic ACTH-related agonist) and to the FI odour with or without previous chronic supplementation. The olfactory stimulation with the ingredient elicited higher brain responses in FI animals, demonstrating memory retrieval and habituation to the odour. Pharmacological stress with Synacthen injection resulted in an increased activity in several brain regions associated with arousal, associative learning (hippocampus) and cognition (cingulate cortex) in chronically stressed animals. This highlighted the specific impact of acute stress on the brain. These responses were alleviated in animals previously supplemented by the FI during the entire chronic stress exposure. As chronic stress establishes upon the accumulation of acute stress events, any attenuation of the brain responses to acute stress can be interpreted as a beneficial effect, suggesting that FI could be a viable treatment to help individuals coping with repeated stressful events and eventually to reduce chronic stress. This study provides additional evidence on the potential benefits of this FI, of which the long-term consequences in terms of behaviour and physiology need to be further investigated.

Assessment of dental anxiety in children between 5 and 10 years of age in the presence of a therapy dog: a randomized controlled clinical study

PURPOSE

Children are often afraid to visit a dentist. Dental anxiety is a worldwide issue and a barrier to successful treatment outcome. Pet therapy, especially through dogs, has been demonstrated to be beneficial in reducing anxiety. In today's generation, where dopamine is prevalent, attention is hijacked, and children are tethered to screens-this research on animal-assisted therapy outlines the impact on children undergoing simple dental procedures, and to evaluate its use in long-term behavior management, and child and parental acceptance of this technique.

METHODS

One hundred and two children between five and 10 years of age and requiring simple dental procedures were selected randomly and divided into two groups. In Group A, dental treatment was carried out in the presence of a therapy dog, and in Group B (the control group), dental treatment was carried out in a regular dental setup. Anxiety levels were evaluated by pulse rate and anxiety rating scale. Prior to exiting the room, the parents were asked to rate the child's interaction with therapy dogs.

RESULTS

According to an independent t test, reduction in anxiety was highly significant (p < 0.001).

CONCLUSION

Animal-assisted therapy is an effective behavior management strategy.

Aroma Acupoint Therapy for Symptom Management with Adolescent Patients: Early Experiences from School-Based Health Centers

Objectives: The American Academy of Pediatrics has long recognized a need for more resources for integrative medicine for health care providers and for patients. The aim of this study was to introduce Aroma Acupoint Therapy (AAT)-a relatively new integrative medicine modality using essential oils to activate acupoints-and to describe the early experiences of providers using AAT for adolescents at school-based health centers (SBHCs). Materials and Methods: This was a case series of 15 adolescents treated with 1 of 2 AAT specific protocols plus standard medical therapy between April 2018 and February 2019 at SBHCs. Of these 15 patients, ages 12-19, 14 were female. Clinical characteristics and treatment courses were abstracted by retrospective review of the patients' electronic medical records. The main outcomes and measures for this research were clinical characteristics, treatment courses and pre- and post-treatment pain scores for adolescents treated with AAT. Results: All 15 patients had nonspecific symptoms, including headaches, menstrual cramps, nausea, shortness of breath, chest pain, back pain, or dizziness. Pain scores were recorded in 8 of 15 encounters, and suggested improvements in most patients. Subjective documentation by the providers also suggested that most of these patients had reduced symptoms. Conclusions: With the call for nonopiate and integrative approaches to pain management, there is an urgent need to study the effectiveness of such modalities, such as AAT. It is safe, inexpensive, easy to learn, and is well-received by both health care providers and patients.

The effects of lavender aromatherapy on stress and pain perception in children during dental treatment: A randomized clinical trial

BACKGROUND AND PURPOSE

Reducing dental anxiety is a major aspect of childmanagement in dental visits. This crossover randomized clinical trial was designed to determine the effect of lavender aromatherapy on anxiety level during dental treatment and pain perception during dental injection in children.

MATERIALS AND METHODS

Twenty-four children aged 7-9 years received restorative treatment with lavender aromatherapy in the intervention session and without aroma in the control session. Salivary cortisol and pulse rate were measured to evaluate child's anxiety level and the Face Rating Scale (FRS) was used for assessing the pain perception during injection in both visits.

RESULTS

The treatment effect on salivary cortisol, pulse rate, and FRS score was -8.01 ± 0.92 nmol/l, -11.17 ± 1.28 (in minutes), and -2.00 ± 0.41 respectively, which was statistically significant (P < 0.001).

CONCLUSION

Lavender aromatherapy can decrease dental anxiety and experienced pain in dental setting.

Effects of essential oils on central nervous system: Focus on mental health

Essential oils have been used as remedies since ancient times for the treatment of numerous illnesses on account of their wide range of biological activities. Recent preclinical and clinical studies have shown varying pharmacological responses in the nervous system leading to anxiolytic, antidepressant, sedative, and anticonvulsant effects. Experimentation in animal models has evidenced the involvement of multiple neurotransmitter systems in the mode of action of essential oils, resulting in measurable physiological effects in the brain. Additionally, clinical trials have demonstrated the influence of essential oils in physiological parameters such as blood pressure, heart rate, respiratory rate, brain waves composition, and cortisol serum levels with concomitant psychological effects. Although there is growing evidence of measurable effects of essential oils in animal brains, more clinical research is required to validate their influence in the human central nervous system. This will enable the development of essential oil-based drugs for the treatment of mental illnesses such as depression, anxiety and dementia.

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

Comparison the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue in hemodialysis patients: a randomized clinical trial

OBJECTIVES

Fatigue, regardless of the causes, could leave a negative impact on individual performance. The aim of this study was to compare the effects of inhalation and massage aromatherapy with lavender and sweet orange on fatigue among hemodialysis patients.

METHODS

This study was a randomized controlled trial. The patients (96 patients) were allocated to three groups (control, an inhalation aromatherapy, and an aromatherapy massage group). A demographic questionnaire as well as the rhoten fatigue scale (RFS) was used to collect the data. The data were analyzed by descriptive and analytical statistics using SPSS version 18.

RESULTS

Before the intervention, there was no significant difference among the groups regarding fatigue level (p=0.54). However, eight and 16 weeks after the study, the levels of fatigue in both experimental groups were significantly lower than the control group (p < 0.05).

CONCLUSIONS

Interventions with essential oils are effective in reducing fatigue in hemodialysis patients, although the effects of aromatherapy massage on fatigue are stronger than the effects of inhalation aromatherapy.

Efficacy of aromatherapy on dental anxiety: A systematic review of randomised and quasi-randomised controlled trials

OBJECTIVES

To evaluate the efficacy of aromatherapy on dental anxiety.

METHODS

A detailed protocol was registered a priori (PROSPERO: CRD42019141093). PubMed, EMBASE, CDSR, CENTRAL, CNKI and grey literature databases were searched from inception to 10 January 2020. Randomised controlled trials (RCTs) and quasi-randomised controlled trials (CCTs) that examined the effects of aromatherapy on dental anxiety, compare to either negative control (i.e. no aromatherapy) or other positive control approaches (e.g. music), were included. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration's tool and ROBINS-I, while the certainty of evidence was assessed using GRADE. A narrative synthesis was performed, rather than meta-analysis, due to the high level of heterogeneity across studies.

RESULTS

Eleven RCTs and six CCTs were included. The risk of bias was identified as either high or unclear in RCTs, and moderate to serious in CCTs. Performance bias and detection bias were the most prevalent in RCTs, followed by selection bias and reporting bias. As to CCTs, greater risk of bias was found in the selection of participants into the study and in the measurement of outcomes. Based on the selected studies, the most commonly used aromatherapy for dental anxiety management was lavender fragrance, followed by orange. Compared to the negative control condition, aromatherapy might reduce the anxiety-related physiological parameters and psychometric rating, pain, and mood, alertness, and calmness compared to the negative control condition; and there might be no intergroup difference in such outcomes between aromatherapy and music. However, GRADEs of the relevant evidence were judged as low to very low.

CONCLUSIONS

Compared to the negative control condition, aromatherapy is more effective to reduce dental anxiety and has comparable effects on dental anxiety compared to music intervention; however, the certainty of evidence is relatively limited. Further high-quality randomised trials with robust study design and large sample size are warranted to confirm our findings and to confirm the role of aromatherapy in relieving dental anxiety.

Influence of lavender oil inhalation on vital signs and anxiety: A randomized clinical trial

OBJECTIVE

To investigate the effectiveness of lavender oil (Lavandula angustifolia Mill) inhalation on anxiety, mood, and vital signs (blood pressure, respiratory rate, heart rate, and saturation) of patients undergoing oral surgery. Vital signs were considered as primary outcome measures. Paired anxiety tests were used as secondary outcome measures.

METHODS

Patients who had dental anxiety according to the Dental Anxiety Questionnaire (DAQ) were enrolled in the study. One hundred twenty-six patients who were undergoing wisdom tooth removal under local anaesthesia were randomly assigned to the lavender oil and control groups. Paired anxiety tests (Modified Dental Anxiety Scale and State-Trait Anxiety Inventory-State Scale were performed. Vital signs were noted pre-, intra-, and post-operatively. Visual analogue scale (VAS) results were assessed. The patients' degree of satisfaction was noted.

RESULTS

Pre-operative anxiety levels were similar in both groups. Significant changes in blood pressure were observed in the lavender oil group post-operatively (p < .05). Most (79.4%) of the patients in the lavender oil group enjoyed the scent, 89.68% were satisfied with their experience, and 97.62% of the patients stated that they would prefer the same protocol when needed.

CONCLUSION

Inhalation of lavender oil, which is one of the most powerful anxiolytic essential oils, reduces peri-operative anxiety and can be prospectively considered in future studies for its potential sedative characteristics in patients undergoing surgical procedures under local anaesthesia.

TRIAL REGISTRATION NUMBER

NCT03722771 (Influence of Lavender Oil on Vital Signs in Oral Surgery Patients) https://clinicaltrials.gov/ct2/show/NCT03722771.

Aromatherapy improves nausea, pain, and mood for patients receiving pediatric palliative care symptom-based consults: A pilot design trial

OBJECTIVE

The role of aromatherapy in supportive symptom management for pediatric patients receiving palliative care has been underexplored. This pilot study aimed to measure the impact of aromatherapy using validated child-reported nausea, pain, and mood scales 5 minutes and 60 minutes after aromatherapy exposure.

METHODS

The 3 intervention arms included use of a symptom-specific aromatherapy sachet scent involving deep breathing. The parallel default control arm (for those children with medical exclusion criteria to aromatherapy) included use of a visual imagery picture envelope and deep breathing. Symptom burden was sequentially assessed at 5 and 60 minutes using the Baxter Retching Faces scale for nausea, the Wong-Baker FACES scale for pain, and the Children's Anxiety and Pain Scale (CAPS) for anxious mood. Ninety children or adolescents (mean age 9.4 years) at a free-standing children's hospital in the United States were included in each arm (total n = 180).

RESULTS

At 5 minutes, there was a mean improvement of 3/10 (standard deviation [SD] 2.21) on the nausea scale; 2.6/10 (SD 1.83) on the pain scale; and 1.6/5 (SD 0.93) on the mood scale for the aromatherapy cohort (p < 0.0001). Symptom burden remained improved at 60 minutes post-intervention (<0.0001). Visual imagery with deep breathing improved self-reports of symptoms but was not as consistently sustained at 60 minutes.

SIGNIFICANCE OF RESULTS

Aromatherapy represents an implementable supportive care intervention for pediatric patients receiving palliative care consults for symptom burden. The high number of children disqualified from the aromatherapy arm because of pulmonary or allergy indications warrants further attention to outcomes for additional breathing-based integrative modalities.

Integrative Approaches to Stress, Anxiety, and Resilience

Anxiety is one of the most common psychiatric conditions affecting adolescents and youth in the United States, with over 30% of adolescents having an anxiety disorder of any type. The conventional approach to anxiety management can include medications that in some patient populations can increase the risk of suicidality. Untreated anxiety and sequela of anxiety can have a significant impact on the life of a child and can impact them into adulthood. Integrative treatments in the setting of anxiety and stress management can be used along with conventional approaches to evoke the relaxation response. Integrative approaches can also teach children and youth tools that may serve to help them learn to better manage the symptoms of anxiety and build resilience throughout their lifetime. [Pediatr Ann. 2019;48(6):e226-e230.].

Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

Objective

The aim of this review is to analyze preclinical and clinical studies investigating the anxiety effects of Citrus aurantium or Citrus sinensis essential oils (EOs).

Design

The bibliographic research was made on the major scientific databases. Analysis included only articles written in English and published on peer-reviewed scientific journals describing preclinical experiments and clinical trials carried out to investigate the antianxiety effects of Citrus aurantium or Citrus sinensis EOs on anxiety disorders. Clinical studies reporting the antianxiety effects of products containing Citrus aurantium or Citrus sinensis EOs in combination with other active substances, including medicinal plants, were excluded. Nine clinical studies fulfilled the criteria adopted for analysis.

Results

Data show that Citrus aurantium or Citrus sinensis EOs produce anxiolytic effects both in preclinical experiments and in different clinical conditions. Citrus aurantium EO aromatherapy reduced anxiety level in the great part of stress conditions studied (subjects affected by chronic myeloid leukemia and preoperative patients) except for a sample of patients subjected to colonoscopy. Exposition to Citrus sinensis EO in clinical studies shows to be positive in reducing anxiety level in patients waiting for dental treatment as well as in healthy volunteers submitted to an anxiogenic situation.

Conclusions

Overview of clinical trials conducted with Citrus aurantium or Citrus sinensis on people with anxiety showed that inhalation or oral administration of Citrus aurantium and inhalation of Citrus sinensis can exert beneficial effects on anxiety; however, because of incomplete accuracy in the reporting of methodology, further more complete clinical studies are warranted.

Long-term exposure to sensory feed additives during the gestational and postnatal periods affects sows' colostrum and milk sensory profiles, piglets' growth, and feed intake

This study investigated the effect of feed supplementation in sows and/or their progeny with 2 sensory feed additives (FA1: limonene and cinnamaldehyde; FA2: menthol, carvone, and anethole) on sows' feed intake, body weight, fat deposition, and colostrum/milk composition, as well as piglets' feed intake growth and feed efficiency from birth to slaughter at postnatal day 160 (PND160). During the last third of gestation and the whole of lactation, sows were subjected to a control diet (C) or the same diet containing FA1 or FA2 at 0.1% of complete feed content. Colostrum/milk samples were taken at days 1, 14, and 28 of lactation for gas chromatography-mass spectrometry analyses. After weaning, the progeny was subjected to a control diet (C) or experimental diets with a sweetener (0.015%) but no other additive (S), or to diets with a sweetener and the additive FA1 (FA1S) or FA2 (FA2S). There was no effect of dietary treatment on sows' feed intake, body weight, or adiposity (P > 0.15 for all), but the sensory characteristics of their colostrum/milk were modified by the diet and diet*time interaction. Limonene concentrations were higher in FA1 samples from PND1 to PND28, whereas carvone and anethole concentrations were higher in FA2 samples from PND1 to PND28. The concentration of these 3 compounds increased with time in the respective groups where they were mostly detected. Menthol concentrations were higher in FA2 samples at PND14 and PND28, but there was no time effect. Overall, cinnamaldehyde was always below the detection range. Piglets born from FA1 and FA2 sows had higher body weight (P = 0.034 at PND160), average daily gain (ADG; P = 0.036 for PND0-160), and average daily feed intake (ADFI; P = 0.006 for PND28-160) than piglets born from C sows. Overall, piglets that were never exposed to FA or only after weaning had lower ADG (P = 0.030 for PND0-160) and ADFI (P = 0.016 for PND28-160) than piglets that were exposed to FA only via the maternal diet, the condition combining both pre- and post-natal exposure being intermediary. In conclusion, FA1 and FA2 provided to gestating and lactating sows increased the progeny's feed intake and growth, suggesting nutritional programming and/or sensory conditioning during the perinatal period. Addition of FA only in the progeny's diet was not beneficial.

Pediatric Nurses' Usage and Experience Toward Complementary Health Approaches

OBJECTIVES

The usage of Complementary Health Approaches (CHA) and its popularity have been increasing among both children and pediatric nurses. The aims of this study were to (1) determine the knowledge and usage levels of pediatric nurses about CHA, (2) describe the experiences of nurses about CHA, and (3) evaluate the attitudes of nurses toward CHA.

METHODS

This was multicenter study. A total of 1,450 pediatric nurses who are working at the pediatric departments of different hospitals in Turkey participated in the study between June 2013 and February 2014. Around 1,303 female and 147 male pediatric nurses, in total 1,450, were included in the study. The semi-structured questionnaire had three sections. The first section composed of 14 questions about sociodemographic characteristics. The second section contained seven questions about the nurses' professional practices with respect to CHA. The third section contained eight questions about the nurses' attitudes to CHA.

RESULTS

The study revealed that 90.6% of the nurses used CHA, and primarily made use of praying (82.3%), massage (76.6%), and vitamins (60.2%), respectively. Most of the nurses used CHA for relaxation. Approximately half of the nurses did not asked the families of their CHA usage. More than half of the nurses (58.8%) stated that nurses were not responsible for informing patients about CHA. It was found that the nurses had negative experiences with CHA such as allergies, pain, and being upset. The most frequently indicated positive experience was "feeling better both physically and psychologically."

CONCLUSIONS

It is extremely important that nurses have knowledge about CHA. Nurses should question parents' use of CHA and inform parents about CHA' benefits and potential risks. Considering the personal/professional experiences, it is necessary to evaluate the positive/negative effects of CHA. Research may contribute to increased awareness of the potentially important role of nurses in the delivery of CHA.

The Effect of Aromatherapy with the Essential Oil of Orange on Pain and Vital Signs of Patients with Fractured Limbs Admitted to the Emergency Ward: A Randomized Clinical Trial

BACKGROUND AND OBJECTIVE

Pain is an emotional and unpleasant experience associated with actual or potential tissue damage. The literature shows no study on the effect of aromatherapy with the essential oil of orange on unpleasant feelings of patients with fractured limbs. In this regard, this paper aims at studying the effect of aromatherapy with the essential oil of orange on patients with fractured limbs admitted to the emergency ward.

METHODS

Sixty patients admitted to the emergency ward of Vali-e-Asr Hospital were selected by purposive sampling method and then were divided into two groups of control and experiment by block method. This study was done in one shift work (morning or afternoon). Four drops of the orange oil were poured on a pad and were pinned with a plastic pin to the patient's collar, about 20 cm distant from head. The old pad was replaced by the new one every 1 h. The patients' pain and vital signs were checked every 1 h for at last 6 h. The data were analyzed by SPSS Version 21.

RESULTS

Forty (66.7%) patients were male and twenty (33.3%) were female. Their age average was 37.93 ± 18.19 years old. The most fractured cases were in the scapular (11 patients [18.3%]). Friedman test showed that pain in the experiment group (P = 0.0001) decreased significantly rather than the control group (0.339). However, in vital signs, there could be found that no significant change between the two groups was seen.

CONCLUSION

Aromatherapy with orange oil can relieve pain in patients with fractured limbs but has no effect on their vital signs. Therefore, aromatherapy with orange oil can be used as a complementary medicine in these patients.

Aroma oil therapy in palliative care: a pilot study with physiological parameters in conscious as well as unconscious patients

OBJECTIVE

The aim of this pilot study is to analyze the reactions of healthy test persons and conscious as well as unconscious palliative patients to aroma stimuli.

PATIENTS AND METHODS

In a randomized controlled study, healthy probands, conscious and unconscious palliative patients were exposed to two essential oils (lemon, lavender). Water was used as the control stimulus. Physiological parameters (breathing rate and heart rate, oxygen saturation, systolic, diastolic and mean arterial pressure) were measured.

RESULTS

10 test persons (control group), 15 conscious patients and 5 unconscious palliative patients were exposed to the stimuli. Healthy test persons reacted to lemon oil with a significant increase in respiration rate, heart rate and diastolic blood pressure, whereas to lavender oil with a significant decrease in respiration rate was measured. There were no significant reactions concerning the other parameters. Conscious and unconscious patients reacted with a significant increase in all measured parameters to lemon oil and with a significant decrease in all parameters except for oxygen saturation to lavender oil. No significant differences in the reactions were measured between the conscious and unconscious patients and no significant reactions to control stimuli were detected. All physiological reactions were very short and only detectable during stimulus presentation.

CONCLUSION

Significant physiological reactions were measured after simulation with aroma oils in all three groups in this study. Healthy probands showed different reactions than palliative patients irrespective to their conscious state.

Bergamot Essential Oil Attenuates Anxiety-Like Behaviour in Rats

Preclinical studies have recently highlighted that bergamot essential oil (BEO) is endowed with remarkable neurobiolological effects. BEO can affect synaptic transmission, modulate electroencephalographic activity and it showed neuroprotective and analgesic properties. The phytocomplex, along with other essential oils, is also widely used in aromatherapy to minimize symptoms of stress-induced anxiety and mild mood disorders. However, only limited preclinical evidences are actually available. This study examined the anxiolytic/sedative-like effects of BEO using an open field task (OFT), an elevated plus-maze task (EPM), and a forced swimming task (FST) in rats. This study further compared behavioural effects of BEO to those of the benzodiazepine diazepam. Analysis of data suggests that BEO induces anxiolytic-like/relaxant effects in animal behavioural tasks not superimposable to those of the DZP. The present observations provide further insight to the pharmacological profile of BEO and support its rational use in aromatherapy.

Preferences and choices of a child concerning the environment in a pediatric dental operatory

Background:

The aim of this cross-sectional descriptive study was to determine children's preferences in a dental clinic so as to reduce anxiety during dental procedures. In this study survey methodology was used.

Materials and Methods:

A questionnaire was designed to evaluate the child's preference in a dental hospital so as to remove anxiety during a dental procedure. This study was carried out on 50 children aged 6–10 years. The children were randomly selected based on their first dental visit in a private dental college.

Results:

A large number of children preferred listening to rhymes and watching cartoons while undergoing dental treatment. They also preferred the walls painted with cartoons, the dental chair full of toys, a scented environment, and the presence of their parents during the treatment.

Conclusion:

The results of this study will help the dental team decide on the appropriate design of the pediatric dental operatory room in order to provide a comfortable dental environment which will reduce anxiety in children and improve the quality of health care.

Familiarity to a Feed Additive Modulates Its Effects on Brain Responses in Reward and Memory Regions in the Pig Model

Brain responses to feed flavors with or without a feed additive (FA) were investigated in piglets familiarized or not with this FA. Sixteen piglets were allocated to 2 dietary treatments from weaning until d 37: the naive group (NAI) received a standard control feed and the familiarized group (FAM) received the same feed added with a FA mainly made of orange extracts. Animals were subjected to a feed transition at d 16 post-weaning, and to 2-choice feeding tests at d 16 and d 23. Production traits of the piglets were assessed up to d 28 post-weaning. From d 26 onwards, animals underwent 2 brain imaging sessions (positron emission tomography of 18FDG) under anesthesia to investigate the brain activity triggered by the exposure to the flavors of the feed with (FA) or without (C) the FA. Images were analyzed with SPM8 and a region of interest (ROI)-based small volume correction (p < 0.05, k ≥ 25 voxels per cluster). The brain ROI were selected upon their role in sensory evaluation, cognition and reward, and included the prefrontal cortex, insular cortex, fusiform gyrus, limbic system and corpus striatum. The FAM animals showed a moderate preference for the novel post-transition FA feed compared to the C feed on d 16, i.e., day of the feed transition (67% of total feed intake). The presence or absence of the FA in the diet from weaning had no impact on body weight, average daily gain, and feed efficiency of the animals over the whole experimental period (p ≥ 0.10). Familiar feed flavors activated the prefrontal cortex. The amygdala, insular cortex, and prepyriform area were only activated in familiarized animals exposed to the FA feed flavor. The perception of FA feed flavor in the familiarized animals activated the dorsal striatum differently than the perception of the C feed flavor in naive animals. Our data demonstrated that the perception of FA in familiarized individuals induced different brain responses in regions involved in reward anticipation and/or perception processes than the familiar control feed flavor in naive animals. Chronic exposure to the FA might be necessary for positive hedonic effects, but familiarity only cannot explain them.

Children's preferences concerning ambiance of dental waiting rooms

AIM

Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment.

STUDY DESIGN

This was a cross-sectional descriptive study using survey methodology.

METHODS

A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females).

STATISTICS

The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender.

RESULTS

A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious.

CONCLUSIONS

The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.

Possible use of essential oils in dentistry

How to cite the article: Dagli N, Dagli R. Possible use of essential oils in dentistry. J Int Oral Health 2014;6(3):i-ii.

Essential oils for complementary treatment of surgical patients: state of the art

Aromatherapy is the controlled use of plant essences for therapeutic purposes. Its applications are numerous (i.e., wellbeing, labour, infections, dementia, and anxiety treatment) but often they have not been scientifically validated. The aim of the present study is to review the available literature to determine if there is evidence for effectiveness of aromatherapy in surgical patients to treat anxiety and insomnia, to control pain and nausea, and to dress wound. Efficacy studies of lavender or orange and peppermint essential oils, to treat anxiety and nausea, respectively, have shown positive results. For other aspects, such as pain control, essential oils therapy has shown uncertain results. Finally, there are encouraging data for the treatment of infections, especially for tea tree oil, although current results are still inconclusive. It should also be considered that although they are, allergic reactions and toxicity can occur after oral ingestion. Therefore, while rigorous studies are being carried out, it is important that the therapeutic use of essential oils be performed in compliance with clinical safety standards.