Article

Hypnosis for children undergoing dental treatment.

Military Dental Centre, PO Box 454, PC 121, Seeb, Oman.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 01/2010; DOI: 10.1002/14651858.CD007154.pub2
Source: PubMed

ABSTRACT Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children, such us: 'tell, show & do', positive reinforcement, modelling and hypnosis. The use of hypnosis is generally an overlooked area, hence the need for this review.
This systematic review attempted to answer the question: What is the effectiveness of hypnosis (with or without sedation) for behaviour management of children who are receiving dental care in order to allow successful completion of treatment? Null hypothesis: Hypnosis has no effect on the outcome of dental treatment of children.
We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE (OVID), EMBASE (OVID), and PsycINFO. Electronic and manual searches were performed using controlled vocabulary and free text terms with no language restrictions. Date of last search: 11th June 2010.
All children and adolescents aged up to 16 years of age. Children having any dental treatment, such as: simple restorative treatment with or without local anaesthetic, simple extractions or management of dental trauma.
Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors of trials were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The methodological quality of randomised controlled trials (RCTs) was assessed using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2.
Only three RCTs (with 69 participants) fulfilled the inclusion criteria. Statistical analysis and meta-analysis were not possible due to insufficient number of studies.
Although there are a considerable number of anecdotal accounts indicating the benefits of using hypnosis in paediatric dentistry, on the basis of the three studies meeting the inclusion criteria for this review there is not yet enough evidence to suggest its beneficial effects.

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    ABSTRACT: The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.
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    ABSTRACT: Objective Hypnosis is widely used in medicine and dentistry, but many practitioners still consider it as a mysterious technique. Thus, a systematic review was conducted to assess the effects of hypnosis during dental treatment. Methods A literature search was conducted on PubMed (1981–2012) to retrieve references, written in French or English, reporting controlled clinical studies that have evaluated any type of hypnosis. The quality of included studies was assessed by evaluating randomisation, blindness and drop-outs. The effects of hypnosis on anxiety, physiological parameters, patients’ behaviour or pain were analysed descriptively. Results The electronic search retrieved 556 references. Nine studies, generally characterized by low methodological quality, were selected. Results indicated that hypnosis has significant positive effects on anxiety, pain, behaviour and physiological parameters when it is compared with no treatment. When hypnosis is compared with other psychological treatment such as cognitive behavioral therapy (CBT), the effects on anxiety and behaviour are almost identical with an advantage for CBT. Individualized hypnosis brings more benefits than standardized hypnosis with audio recordings. Conclusion This review demonstrated the effectiveness of hypnosis but the poor quality of the clinical studies and the multiplicity of evaluation outcomes limit the level of evidence. It is therefore necessary to conduct further clinical studies to confirm the effects of hypnosis during dental treatments.
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