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Cureus May 2024Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown...
Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental intervention involved 10-minute sessions of binaural beats with visual stimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.
PubMed: 38736759
DOI: 10.7759/cureus.60154 -
Journal of Clinical and Experimental... Apr 2024The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic...
A pilot study analyzing the influence of the material and the size of the orthodontic archwire on the level of pain and anxiety in adult patients in treatment with brackets: A prospective triple-blind randomized clinical trial.
BACKGROUND
The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic treatment with brackets.
MATERIAL AND METHODS
A randomized prospective triple-blind clinical pilot study was conducted at the Dental Clinic of the University of Salamanca. The study sample comprised 30 adult patients who started orthodontic treatment with brackets. This sample was divided into two groups: the NiTi group (n=15) and Cu-NiTi group (n=15). Pain was analyzed with a visual analogue scale (VAS) and anxiety with the State-Trait Anxiety Inventory (STAI). Anxiety was assessed at the start of treatment (T0) and after one month (T1). Pain was analyzed at the start of treatment (T0), at different time points at the start (T01), and after 4 (T02), 24 (T03), and 48 hours (T04); these measurements were also recorded one month after starting orthodontic treatment (T11, T12, T13, and T14).
RESULTS
The mean age of patients was 31.3 (± 6.05) years old. The highest level of pain, at the beginning of treatment, was observed after 48 hours (5.57 ± 1.72) and at one month after starting treatment at 24 hours (5.13 ± 1.89), with no significant differences between the two groups. When analyzing anxiety, no differences were observed between groups; the anxiety levels were higher one month after starting treatment compared to the start. Regarding the correlation between pain and anxiety, the NiTi group showed a greater direct relationship (<0.05) between these two variables at the start of treatment in the anxiety trait in relation to pain at T02 and T03 and after a month in T12, T13, and T14.
CONCLUSIONS
In the sample studied, there was no significant influence of the size or material of the orthodontic archwire on pain and anxiety levels. Orthodontics, Brackets, Archwire, Pain, Anxiety, NiTi, Cu-NiTi.
PubMed: 38725824
DOI: 10.4317/jced.61428 -
JMIR Research Protocols May 2024Within hospital systems, diverse subsets of patients are subject to minimally invasive procedures that provide therapeutic relief and necessary health data that are...
BACKGROUND
Within hospital systems, diverse subsets of patients are subject to minimally invasive procedures that provide therapeutic relief and necessary health data that are often perceived as anxiogenic or painful. These feelings are particularly relevant to patients experiencing procedures where they are conscious and not sedated or placed under general anesthesia that renders them incapacitated. Pharmacologic pain management and topical anesthetic creams are used to manage these feelings; however, distraction-based methods can provide nonpharmacologic means to modify the painful experience and discomfort often associated with these procedures. Recent studies support distraction as a useful method for reducing anxiety and pain and as a result, improving patient experience. Virtual reality (VR) is an emerging technology that provides an immersive user experience and can operate through a distraction-based method to reduce the negative or painful experience often related to procedures where the patient is conscious. Given the possible short-term and long-term outcomes of poorly managed pain and enduring among patients, health care professionals are challenged to improve patient well-being during medically essential procedures.
OBJECTIVE
The purpose of this pilot project is to assess the efficacy of using VR as a distraction-based intervention for anxiety or pain management compared to other nonpharmacologic interventions in a variety of hospital settings, specifically in patients undergoing lumbar puncture procedures and bone marrow biopsies at the oncology ward, patients receiving nerve block for a broken bone at an anesthesia or surgical center, patients undergoing a cleaning at a dental clinic, patients conscious during an ablation procedure at a cardiology clinic, and patients awake during a kidney biopsy at a nephrology clinic. This will provide the framework for additional studies in other health care settings.
METHODS
In a single visit, patients eligible for the study will complete brief preprocedural and postprocedural questionnaires about their perceived fear, anxiety, and pain levels. During the procedure, research assistants will place a VR headset on the patient and the patient will undergo a VR experience to distract from any pain felt from the procedure. Participants' vitals, including blood pressure, heart rate, and rate of respiration, will also be recorded before, during, and after the procedure.
RESULTS
The study is already underway, and results support a decrease in perceived pain by 1.00 and a decrease in perceived anxiety by 0.3 compared to the control group (on a 10-point Likert scale). Among the VR intervention group, the average rating for comfort was 4.35 out of 5.
CONCLUSIONS
This study will provide greater insight into how patients' perception of anxiety and pain could potentially be altered. Furthermore, metrics related to the operational efficiency of providing a VR intervention compared to a control will provide insight into the feasibility and integration of such technologies in routine practice.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/52649.
Topics: Humans; Anxiety; Virtual Reality; Pain Management; Pilot Projects; Female; Male; Adult
PubMed: 38722681
DOI: 10.2196/52649 -
SAGE Open Medical Case Reports 2024Dental anxiety is common post-stroke, with many patients unable to receive standard anesthetics. Virtual reality has been increasingly used to manage pain and anxiety in...
Dental anxiety is common post-stroke, with many patients unable to receive standard anesthetics. Virtual reality has been increasingly used to manage pain and anxiety in dentistry, though its use in individuals with stroke is largely unexplored. A case series of two patients with a history of stroke and dental anxiety was conducted at a specialized dental clinic. Patients watched 360°-virtual reality videos in a dental chair using a head-mounted display. Outcomes (patient: dental anxiety and pain, reactions to virtual reality; dental team: system usability, impact on workflow) were assessed using a standard observation tool, questionnaires, and interviews. Both patients wore virtual reality throughout the procedure and reported that the device was comfortable, provided a distraction, and had potential to reduce anxiety/pain. The dentist reported a positive impact on patient anxiety and time to complete procedures, and intends to continue using virtual reality with other stroke patients and clinical populations.
PubMed: 38694905
DOI: 10.1177/2050313X241249910 -
Evaluation of salivary stress markers and inflammatory cytokine levels in peri-implantitis patients.Clinical Oral Investigations May 2024Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar...
BACKGROUND AND OBJECTIVE
Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar data for peri-implantitis. The aim of this study was to determine the relationship between interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)α inflammatory cytokines and the psychological stress-related markers, glucocorticoid receptor-α (GRα), and salivary α-amylase (sAA) gene expression levels in saliva samples obtained from healthy implants and peri-implantitis patients.
MATERIALS AND METHODS
The study included a total of 50 systemically healthy subjects. Peri-implant clinical parameters were recorded and psychological stress level was evaluated with the hospital anxiety and depression scale (HAD) and state-trait anxiety inventory (STAI) questionnaire forms. Following the evaluations, the patients were divided into 4 groups according their stress and clinical status (Ia, Ib, IIa, IIb). IL-1β, IL-6, IL-10, IFNα, GRα, sAA gene expression levels in the saliva samples were quantified by quantitative polymerase chain reaction (qPCR).
RESULTS
In the group of peri-implantitis who had a high score in stress level assessment scales, significantly higher IL-1β, IL-6, sAA expression levels were observed (p < 0.001). The IL-10 gene expression levels were lower in the groups with a high score in the stress level assessment scales (p < 0.001). GRα gene was expressed at lower levels in the group of peri-implantitis who had a high score in stress level assessment scales but the difference was not statistically significant (p = 0.065).
CONCLUSION
The study findings suggest that psychological stress may increase the inflammation associated with peri-implantitis by affecting cytokine expression levels.
CLINICAL RELEVANCE
To prevent peri-implantitis or reduce its prevalence, it could be beneficial to evaluate stress levels and identify individuals experiencing stress.
Topics: Humans; Peri-Implantitis; Saliva; Male; Female; Cytokines; Biomarkers; Stress, Psychological; Middle Aged; Adult; Surveys and Questionnaires
PubMed: 38691206
DOI: 10.1007/s00784-024-05692-5 -
National Journal of Maxillofacial... 2024The diagnosis of oral squamous cell carcinoma [OSCC] and its treatment phase is emotionally demanding for the patient and challenging for the surgeon. The induction of...
Effect of meditation and relaxation therapy on preoperative anxiety and stress in oral squamous cell carcinoma patients scheduled for oral and maxillofacial surgery: An experimental study.
CONTEXT
The diagnosis of oral squamous cell carcinoma [OSCC] and its treatment phase is emotionally demanding for the patient and challenging for the surgeon. The induction of stress and anxiety is unavoidable in these patients. It becomes very important for the patient to have psychological as well as physical stability during this treatment phase. Various studies have reported the beneficial effect of meditation along with relaxation therapy on healthy individuals but the beneficial effect of meditation and relaxation therapy [MRT] to reduce stress and anxiety preoperatively in OSCC patients has not been reported in scientific literature.
AIM
The aim of this study was to study the effect of MRT on preoperative anxiety and stress in OSCC patients undergoing for oral and maxillofacial surgery.
SETTINGS AND DESIGN
An experimental, parallel study design was carried out with randomization of patients into experimental[25] and control group[25] with allocation ratio 1:1 in 50 patients diagnosed with OSCC [stage II or III] scheduled for oral and maxillofacial surgery with general anesthesia.
MATERIALS AND METHODS
The biopsy which was the prerequisite for the diagnosis was taken. Twenty-one days before surgery in experimental group, patients were oriented about meditation and relaxation exercises. The reorientation of MRT was done from the day of admission twice a day till the day of surgery. Physiological parameters for stress and anxiety like heart rate [HR], blood pressure [BP], pulse rate [PR], and respiratory rate [RR] were evaluated on 1 day of MRT at 9 am and on the day of surgery. The serum cortisol which was quantitative parameter for stress was evaluated 1 day of MRT at 9 am fasting and on the day of surgery. The qualitative analysis for anxiety was done preoperatively using visual analog scale on the 1 day before MRT and compared with the values on the day of surgery after MRT at a specific time.
STATISTICAL ANALYSIS
Paired -test analysis was used intragroup whereas unpaired -test was used intergroup between experimental and control groups with significance at = 0.05 and highly significant at = 0.0001.
RESULTS
The serum cortisol was significantly less in the experimental group over control group with t = 7.04 and = 0.0001. The systolic and diastolic BP, pulse rate, respiratory rate, and anxiety in the experimental group reported significantly less rate compared to the control group with t = 5.66, t = 22.2, t = 11.93, t = 27.71, and = 0.0001.
CONCLUSION
In our study, MRT in the form of Sukhasana, Anulom Vilom, Omkar chanting, and Shavasana for 30 min twice daily has shown positive effect to reduce stress and anxiety. The serum cortisol as a quantitative parameter has been effectively evaluated in this benchmark study.
PubMed: 38690234
DOI: 10.4103/njms.njms_123_22 -
National Journal of Maxillofacial... 2024Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to...
INTRODUCTION
Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear.
MATERIAL AND METHODS
This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions.
RESULTS
The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2).
CONCLUSION
Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.
PubMed: 38690231
DOI: 10.4103/njms.njms_119_22 -
Medicina (Kaunas, Lithuania) Apr 2024Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its...
Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients.
Topics: Humans; Dental Anxiety; Female; Cross-Sectional Studies; Male; Adult; Surveys and Questionnaires; Middle Aged; Occupations; Self Concept
PubMed: 38674320
DOI: 10.3390/medicina60040674