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... Music is used in clinics by professionals as a strategy to improve patient well-being [5,6]. It may be an alternative to reduce anxiety and provide a relaxing and comfortable environment for the child, thereby reducing cortisol levels [7][8][9]. Music has been used to reduce anxiety in various health areas, since it acts physiologically in lowering systolic and diastolic blood pressure [10,11]. In addition, music also acts emotionally by increasing serotonin levels and activating brain areas responsible for reward and can modify brain activity during pain stimulus [12,13]. ...
... This method is not invasive, and it is economical and well accepted by patients. It elevates mood, is reinforcing and motivating and decreases stress levels [5,8,15]. ...
... Music has been used as a tool for welcoming, relaxing and in non-pharmacological methods for the control of anxiety, pain and stress in dentistry [8,17,27]. Another possibility found in the literature is the use of music to stimulate children during brushing [22]. This work examined music as a non-pharmacological method for the reduction of anxiety in children as in the works of Marwah The present study included 40 children, 20 children in each group, agreeing with Marwah et al. [16] and Aitken et al. [28] In this study, the number of 20 children for each group was based on the sample calculation using the statistical ANOVA test, with a power of 0.80 and alpha of 0.05. ...
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Objective: The objective of this study was to evaluate the impact of music on anxiety in children during dental care Methods: A total of 40 children 5 to 11 years old were selected; they were randomized into 2 groups (n = 20): group 1: experimental, children were subjected to music therapy; group 2: control, children were not subjected to music therapy. We measured oxygen saturation, heart rate and levels of Corah anxiety scale and pain scale. The results for heart rate were evaluated by ANOVA. The Kruskal Wallis (Dunn) test was used to evaluate the oxygen saturation results and the Wilcoxon test for Corah anxiety and pain scores Results: There was a significant decrease in heart rate (pulse) in children who listened to music during dental treatment (p = 0.05). In the group without music, heart rate remained unchanged throughout the care (p = 0.53). There was no significant difference in oxygen saturation or Corah anxiety and pain scores in children who listened to music during dental care (p > 0.05) Conclusion: It can be concluded that music is a non-pharmacological alternative that reduces anxiety levels in children during dental treatment.
... As a result, greater attention currently focuses on the use of non-pharmacological strategies to reduce preoperative anxiety, such as music therapies and interventions. Music is believed to lessen anxiety thanks to its relaxing or distracting effects, which in turn reduce the activity of the neuroendocrine and sympathetic nervous systems [8][9][10][11]. ...
... Music therapy has been used as an alternative for reducing patient anxiety in different fields such as psychology, medicine, and dentistry [4,12]. Music not only has an emotional impact but also acts directly upon the sympathetic nervous system, reducing its activity [6,9]. As a result, patients experience psychological as well as physiological benefits such as lowered blood pressure, heart rate, and respiratory frequency [9,[16][17][18]22]. ...
... Music not only has an emotional impact but also acts directly upon the sympathetic nervous system, reducing its activity [6,9]. As a result, patients experience psychological as well as physiological benefits such as lowered blood pressure, heart rate, and respiratory frequency [9,[16][17][18]22]. ...
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Objective: To evaluate the effect of a music intervention upon anxiety, blood pressure, and heart rate in adult patients with potentially malignant oral disorders. Methods: Eighty consecutive adults (mean age: 68.3 years) consulting a Unit of Oral Medicine (Murcia Spain) were randomized to a study group (n = 40) that listened to music through headphones during 10 minutes or to a control group (n = 40). Corah's dental anxiety score, blood pressure, heart rate, oxygen saturation (oximetry), skin temperature, and salivation were recorded at different timepoints before and after patient consultation. Results: Significant pre- versus post-consultation reductions were observed in blood pressure (p < 0.001) and heart rate (p < 0.001), though not in temperature, salivation, and oxygen saturation (p > 0.05). There were no significant differences between the study group and the controls (p > 0.05). Conclusions: The applied music intervention had no apparent effect upon anxiety. Further studies using different music intervention strategies and/or analytic parameters are needed to explore the benefits of this approach to decreasing anxiety.
... On the other side, in the neuroscience field, there is also an abrupt increased awareness regarding music therapy, with 2 papers for examples being published on this matter in Lancet [89] and Nature [90] only in the last years, as well as specific studies in this matter in our country with Miu group showing, for example, the influence of music in empathy, visual imagery, mood, general psychophysiological, or other affective approaches [91][92][93][94]. Even more, the aforementioned interactions could be observed in this case also, with papers demonstrating a clear correlation between music therapy and dental anxiety [95], as well as between dental pretreatment anxiety, stress levels, and dental hygiene [96]. ...
... Music therapy has a positive effect in the control of dental anxiety. Salivary cortisol, blood pressure, heart rate, and body temperature during dental treatment are significantly decreased with calming music compared with the treatment without music [95]. Waiting for a medical treatment can induce anxiety and may lead to the experience of stress. ...
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Although the connections between neuropsychiatric and dental disorders attracted the attention of some research groups for more than 50 years now, there is a general opinion in the literature that it remains a clearly understudied and underrated topic, with many unknowns and a multitude of challenges for the specialists working in both these areas of research. In this way, considering the previous experience of our groups in these individual matters which are combined here, we are summarizing in this minireport the current status of knowledge on the connections between neuropsychiatric and dental manifestations, as well as some general ideas on how oxidative stress, pain, music therapy or even irritable bowel syndrome-related manifestations could be relevant in this current context and summarize some current approaches in this matter.
... Environment and ambience of a dental clinic has been suggested as one of the factor that can influence patient's anxiety while waiting for treatment. The effect of music, was reported to have reduced patients' systolic and diastolic blood pressure (Mejía-Rubalcava et al., 2015, Roohy et al., 2005. Instrumental music such as those composed by Enya have been shown to successfully reduced stress (Khalfa et al., 2003, Grocke & Wilgram, 2007. ...
... Therapeutically, music intervention has been found to be very useful to lessen anxiety (Kaempf & Amodei, 1989;Lahmann, 2008;Lai et al, 2008;Nilsson, 2008;Mejía-Rubalcava et al, 2015;Chandure et al., 2017;Maulina et al., 2017;Bradt and Teague, 2018;Maybodi et al. 2018). In 1989, Kaempf and Amodei found that their experimental group had a significantly lower respiration rate than the control group. ...
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Objectives: To evaluate the influence of music in reducing patients' anxiety during periodontal surgery. Methods: This is a clinical trial of involving fifteen patients undergoing periodontal surgery. Patients indicated for periodontal surgery were invited to participate in the study, and randomly assigned to music (n=8) or control (n=7) groups. Participants' dental anxiety were determined using the Corah Dental Anxiety Scale (CDAS) before and after the surgery, while their blood pressure (BP) and heart rate (HR) were recorded at pre-, intra-and post-procedures. Paired t-test was used to compare the statistical significant difference between pre-and post-procedural anxiety for both groups. Result: The participants of this study consist of 22 patients that underwent periodontal surgery procedures, with majority of the subjects (53.3%) were males (n=8) and the mean age was 50.8 (SD=13.21). The measurement of blood pressure increased in patients allocated in music group compared to control group were statistically significant with (p<0.05).Conclusion: Our study suggests that music may reduce patients' anxiety while undergoing periodontal surgery. More details on the type and intensity of music may provide further value to the finding.
... In dentistry, deviations in salivary cortisol from the sound patient's levels has been found to be associated with periodontitis [12], temporomandibular disorders [13], and dry mouth [14], and dental anxiety of treatment [15][16][17]. Morning changes in salivary cortisol levels also have been observed in dento-maxillary prostheses wearers [18]. However, multiple testing and measurements of salivary cortisol during the phase of dento-maxillary prosthesis adjustment has not been investigated. ...
... Additional fine adjustments were needed in a few cases, but no participants complained of pain at the fourth adjustment. Decreased salivary cortisol has been reported in certain therapies [10,17], and consequently relief of symptoms may had a positive effect on the level of salivary cortisol. From this point of view, it was considered that release from the discomfort symptoms may affected the salivary cortisol levels during dento-maxillary prosthesis adjustment. ...
Article
Purpose: The purpose of this study was to investigate the influence of dento-maxillary prosthesis adjustment procedure on levels of salivary cortisol. Methods: Nine participants (six men, three women, mean age 65.9 years) took part in this study. Saliva samples were collected before and after dento-maxillary prosthesis adjustment during the four different visits. Free cortisol levels were determined using a salivary cortisol immunoassay kit (expanded-range high-sensitivity salivary cortisol enzyme immunoassay kit, Salimetrics). Besides, original self-report sheets, a 35-item food intake questionnaire, the University of Washington Quality of Life (UW-QOL) questionnaire version 4, and the Geriatric Oral Health Assessment Index (GOHAI) questionnaire were also administered. The changes of salivary cortisol levels were analyzed using 2-level multilevel linear regression, with adjustment for age, sex, and time. Wilcoxon signed-rank test was used to compare scores of the food intake questionnaire, UW-QOL questionnaire, and GOHAI questionnaire. Results: Salivary cortisol levels decreased significantly after carrying out the dento-maxillary prosthesis adjustment procedure. During the third adjustment, the salivary cortisol levels were significantly low. In addition, salivary cortisol levels of participants aged 70 years and over were significantly higher than other aged groups. The total scores for grade III-V of the food intake questionnaire increased significantly. Other questionnaires had a trend toward increasing scores, yet the differences were not significant. Conclusions: Within the limitations of this study, the results suggest that a reduction in symptoms of discomfort may have an influence on the decrease of salivary cortisol levels in dento-maxillary prosthesis wearers.
... 8 The few studies that have examined anticipatory anxiety levels in dental waiting areas, however, do appear promising. Mejia-Rubalcava et al. 17 examined the effects of music listening in adults prior to dental extractions by measuring heart rate, blood pressure, and salivary cortisol levels, a biomarker of stress and anxiety. Their findings of lower heart rates, blood pressures, and cortisol levels in the music intervention group suggest that music listening reduces anticipatory dental anxiety. ...
... Their findings of lower heart rates, blood pressures, and cortisol levels in the music intervention group suggest that music listening reduces anticipatory dental anxiety. 17 While these results appear promising, more studies are warranted to validate these findings and further examine the effects of music listening on anticipatory dental anxiety. ...
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Background and purpose: Dental anxiety is particularly problematic for individuals with Intellectual and Developmental Disabilities (IDD), resulting in a greater reluctance to undergo dental procedures and exacerbating poor oral health. Drugs commonly used for dental anxiety have undesirable side effects and may not be preferred by patients and guardians. Alternative methods for managing dental anxiety are needed. The purpose of this study was to evaluate the effects of music listening on anxiety levels of patients with IDD awaiting dental procedures. Materials and methods A convenience sample of 15 patients with IDD listened to piano music for 10 minutes before scheduled outpatient dental procedures. Preprocedural dental anxiety levels as measured by Revised ADAMS scores, pulse rates, and blood pressures were compared pre and post music listening. Participants’ premedication requirements for the procedure with music listening was compared to their respective previously scheduled procedure with no music listening. Results Post music listening, patients demonstrated reduced anxiety levels as evidenced by lower Revised ADAMS scores (p=0.001), mean arterial pressures (p=0.09), pulse rates (p=0.02), and reduced premedication requirements. Conclusion Study results suggest that music listening offers an effective, nonpharmacologic alternative to reducing preprocedural dental anxiety in patients with IDD. Keywords Dental Anxiety Dental Care Intellectual Disability Music Therapy
... However, studies indicate that adult patients as well as parents of pediatric patients with dental anxiety prefer non-pharmacological interventions because of perceived medical risks (Aitken et al, 2002;Halvorsen and Willumsen, 2004). Moreover, pharmacological methods of sedation significantly raise the cost of dental treatment (Mej ıa- Rubalcava et al, 2015). For these reasons, behavioral management techniques are increasingly used in dental care. ...
Article
Anxiety is a significant issue in the dental care of adults and children. Dental anxiety often leads to avoidance of dental care which may result in significant deterioration of oral and dental health. Nonpharmacological anxiety management interventions such as music listening are increasingly used in dental care. Although efficacy for music's anxiolytic effects has been established for pre-operative anxiety, findings regarding the use of music listening for dental anxiety are inconclusive, especially for children. The use of music for passive distraction may not be adequate for children and highly anxious adults. Instead, interventions offered by a trained music therapist may be needed to optimize music's anxiolytic impact. Music therapy interventions are individualized to the patient's presenting needs and geared at enhancing patients’ active engagement in the management of their anxiety. Interventions may include 1) active refocusing of attention, 2) music-guided deep breathing, 3) music-assisted relaxation, and 4) music-guided imagery. In addition, music therapists can teach patients music-based anxiety management skills prior to dental treatments, offer them the opportunity to express emotions related to the upcoming procedure and help them gain a sense of control and safety. Clinical guidelines for the use of music listening by dental practitioners are offered. This article is protected by copyright. All rights reserved.
... Previously, a study stated that music has a beneficial effect in controlling anxiety to dental treatment. The authors found significant differences in salivary cortisol levels, systolic and diastolic pressure, HR, body temperature, and stimulated salivary flow for the group treated with musical treatment [32]. Likewise, our findings reinforce the beneficial use of music during endodontic treatment. ...
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We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.
... These interventions have typically been used during treatment and rehabilitation. To date, many studies have reported the use of music as an intervention during dental procedures, surgery, chemotherapy, and injections [7][8][9][10][11][12]. Music interventions have also been used to manage pain and anxiety in patients during medical procedures for many years. ...
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Background The treatment of burn patients is very challenging because burn injuries are one of the most severe traumas that can be experienced. The effect of music therapy on burn patients has been widely reported, but the results have been inconsistent. Thus, we performed a systematic review and meta-analysis of randomized controlled trials in burn patients to determine the effect of music during treatments. Methods We searched a variety of electronic databases, including MEDLINE (via PubMed), EMBASE, Cochrane Library, Psychinfo, VIP Database for Chinese Technical Periodicals (VIP) and China National Knowledge Infrastructure (CNKI) for relevant trials on the basis of predetermined eligibility criteria. from their first available date through February 2016. Our search focused on two key concepts: music interventions (including music, music therapy and music medicine) and physical activity outcomes (including pain, anxiety, burn characteristics, dressing changes, wound care, debridement and rehabilitation). Two reviewers independently screened records and extracted data from all eligible studies. Statistical heterogeneity was determined using Q-test and the I2 statistic. The endpoints included standardized mean differences (SMDs) and 95% confidence intervals (CIs). Publication bias was tested by Begg’s funnel plot and Egger’s test. ResultsA total of 17 studies met the inclusion criteria, for a total of 804 patients. A statistically significant difference in pain relief was demonstrated between music and non-music interventions (SMD = −1.26, 95% CI [−1.83, −0.68]), indicating that music intervention has a positive effect on pain alleviation for burn patients. The results indicated that music interventions markedly reduced anxiety in individuals compared to non-music interventions (SMD = −1.22, 95% CI [−1.75, −0.69]). Correspondingly, heart rate decreases were found after treatments that included music interventions (SMD = −0.60, 95% CI [−0.84, −0.36]). Conclusion In summary, a positive correlation was found between treatments including music interventions and pain alleviation, anxiety relief, and heart rate reduction in burn patients. However, additional high-quality studies with carefully considered music interventions for burn patients are still needed.
... Further, when tabulating the results from such studies, even if significant differences were found across time in the music group, if there was not a timeby-group analysis with the control group, the results are listed in our tables as 'no significant difference' (e.g. Khalfa et al. 2003, Kunikullaya et al. 2016, Mejía-Rubalcava et al. 2015, Stefano et al. 2004. It is acknowledged that had a time-by-group analysis been performed, significant results may have been noted, but in the absence of such analyses we could not assume such a result. ...
Chapter
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This systematic review explored the evidence base on the impact of listening to music on biological response in both clinical and nonclinical settings. Human studies exploring the effects of listening to recorded music on biological markers were included. Studies had to involve a non-music control condition. Keyword searches were carried out of five major databases (Cochrane/Wiley, PsycINFO, PubMed, Sage, and Science Direct) and bias was assessed using the Cochrane Risk of Bias Tool for Randomized Studies (RoB 2.0). Forty-four studies assessing the biological impact of music listening were identified: 27 in clinical settings and 17 in nonclinical settings. Eighty-two percent had examined the effects of short-term listening interventions, while the remainder had looked at longitudinal interventions. Thirteen of 33 biomarkers tested were reported to change in response to listening to music. The most commonly analyzed biomarker was the stress hormone cortisol, with half of clinical studies demonstrating a stress-reducing effect of music listening. Blood glucose was also found repeatedly to reduce in response to music listening. Many of the other biomarkers analyzed are also part of biological stress pathways, which suggests that the primary way by which music listening affects us biologically is via modulations of stress response. Effects were shown irrespective of genre, self-selection of the music, or duration of listening, although a majority did use classical music. The evidence base for understanding biological responses to music is still developing, but there is support for the application of listening to music, especially within clinical settings for stress reduction.
... The efficacy of various sedatives such as midazolam (Jerjes et al. 2005, Isik et al. 2008, Pereira-Santos et al. 2013, Gomez et al. 2015, Shanmugaavel et al. 2016, nitrous oxide, diazepam, cyclooxygenase-2 (COX-2) inhibitors or ineffective melatonin (Seet et al. 2015) have been tested using cortisol levels. Music therapy also has a positive effect in the control of dental anxiety (Mejía-Rubalcava et al. 2015). The perception of pain and dental anxiety can be also altered by the use of oral contraceptives (Rezaii and Ernberg 2010). ...
Article
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Dental management behavior problems are thought to be both multifactorial and multidimensional, consisting of physiological, behavioral and cognitive components. The stress response to pain or even the anticipation of distress initiates activation of the hypothalamic-pituitary-adrenal axis and causes an increase of cortisol and catecholamines. The literature on the role of hormones in dental management behavior problems comprises about one hundred papers, which have mainly been focused on this activation of the HPA axis in various situations in dental care. They have generally used salivary cortisol as a marker of the activity of the HPA axis, sometimes combined with salivary alpha amylase. Here we summarize the literature data on the role of stress hormones in dental management behavior problems. © 2017 Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
... Considering the above, it is extremely important to counted dental anxiety and fear using both psychological and pharmacological methods [12][13][14][15]. ...
Article
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Dental anxiety is a very important factor affecting the efficacy of prevention, diagnosis and treatment of dental diseases, both in patients in the developmental age and in young adults. Anxiety is considered an emotional state with negative connotations. The aim of the study was to determine the level of dental anxiety in first year university students, the intent being to help to develop an individual treatment plan in this group of patients. The study involved 280 students including 230 females and 50 males. Of these, 122 patients were from the Medical University of Lublin, 79 from University of Life Sciences and 79 from University of Maria Curie-Skłodowska. The mean age of the study subjects was 21 years and 8 months ± 3,9 months. No differences in the level of dental anxiety between women and men were observed. The highest level of dental anxiety was observed among students of University of Life Sciences, while the lowest level was observed among students of the Medical University.
... -between all the groups: -for the mean pulse rate, a significant difference was observed, with an increase in subsequent visit -no significant difference was observed in the VPT and VCRS scores -audio aids in general reduced anxiety in comparison to the control group -the most significant reduction in anxiety level was observed in the audio stories group Mejía-Rubalcava et al., 2015 (Mexico) [27] PURPOSE: to evaluate the effect of music on anxious patients in relation to dental care. METHODS: -34 patients (18 years and older) randomly assigned -2 groups: (1) control; (2) experimental -salivary cortisol, stimulate salivary flow, blood pressure, heart rate, oxygen saturation and body temperature were measure -Student t-test and Chi2 were applied to analyze significant differences between the studied variables before and after the unpleasant stimulation causes anxiety for dental treatment. ...
Article
OBJECTIVE: Integrative review on the influence of music on parameters of fear, pain and anxiety during dental care.METHODS: Search for articles on the databases MEDLINE, PubMed, LILACS, Scielo and Google Scholar, using the terms “music”, “dentistry”, “music therapy”, “fear”, “pain”, “anxiety” and “music therapy and dentistry”. Inclusion criteria were: randomized clinical trials with primary data surveys that were related only to dentistry. The exclusion criteria were: any other experimental and observational study design, literature reviews and studies in which it was not possible to identify a relation with the subject.RESULTS: Of the 11 randomized trial studies reviewed, all observed beneficial effects in patients who were listening to music during dental care. Studies have shown a reduction of pain during orthodontic treatment, reduction of postoperative recovery time and reduction of anxiety level in pediatric patients.CONCLUSION: It was possible to observe that the use of music is recommended as an accessory therapy in dental care. Nevertheless, for the professional’s success in the treatment of fear, pain and anxiety, dialogue with the patient is essential, giving simple explanations and demonstrations, thus reducing the anxiety caused by the unknown and, in this way, controlling fear and pain. However, it is necessary to carry out more research in this field, in order to obtain better scientific evidence regarding music therapy applied to dental practice.
... They registered significant difference in the salivary cortisol concentration, systolic and diastolic pressure, heart rate, body temperature and stimulated salivary flow for music therapy treated group. [45] Choon Yoong Wong et al. assessed a combination of non-pharmaceutical psychological interventions like muscular relaxation, pscycho-education and music distraction to reduce dental anxiety and found reduction in anxiety levels in the experimental group. [46] Sung et al., suggested that the familiarity of the music might recall certain pleasant memories associated with the music and that it might elicit the patient's positive feeling, and therefore is responsible for the reduced anxiety. ...
Article
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Background and aims: Dental anxiety has been found to be a significant problem faced by patients undergoing extractions. Anxious patients tend to avoid dental care ultimately leading to complications. Treatment of anxious patients can be very challenging to the dentists, prolonging the treatment duration. There has been various methods to reduce anxiety of which non pharmacological ways include music and aroma therapy. Music has been known to reduce fear, stress and is a form of meditation and relaxation. Hence effect of music on the reduction of anxiety levels for patients undergoing extractions were assessed. The aim of this study is to assess the effect of music therapy on dental anxiety levels of patients undergoing extractions. Methods: 50 patients visiting the outpatient department of Saveetha Dental College for dental extractions were randomly selected and allocated to Test group and Control group. The test group (N = 25) were subjected to music during extractions and Control (N = 25) were not exposed. Dental anxiety levels and hemodynamic changes namely systolic pressure, diastolic pressure and heart rate were assessed before and after extraction. The data was collected and analyzed using SPSS software with Paired t Test. Results: The study showed that the control population had elevated hemodynamic changes with regard to systolic, diastolic blood pressure and heart rate, of which the diastolic pressure rise was significant. In the test population, there was fall in the hemodynamic changes with respect to systolic diastolic blood pressure and heart rate, all of which were statistically significant. This was evident in the modified dental anxiety scale as well. Conclusion: Music seems to be a psychological and spiritual way to calm oneself down. Hence music therapy can be used as an anxiolytic agent for stressful dental procedures.
... The same convection heat flux was set for the dental staff and drivers because they had similar postures and behaviours. Moreover, patients often experience physiological changes such as increased tension and heart rate during treatment [39]; therefore, a convection heat flux of 58.5 W/m 2 was also selected. ...
Article
Dental clinics have a potential risk of infection, particularly during the COVID-19 pandemic. Multi-compartment dental clinics are widely used in general hospitals and independent clinics. This study utilised computational fluid dynamics to investigate the bioaerosol distribution characteristics in a multi-compartment dental clinic through spatiotemporal distribution, working area time-varying concentrations, and key surface deposition. The infection probability of SARS-CoV-2 for the dental staff and patients was calculated using the Wells–Riley model. In addition, the accuracy of the numerical model was verified by field measurements of aerosol concentrations performed during a clinical ultrasonic scaling procedure. The results showed that bioaerosols were mainly distributed in the compartments where the patients were treated. The average infection probability was 3.8% for dental staff. The average deposition number per unit area of the treatment chair and table are 28729 pcs/m² and 7945 pcs/m², respectively, which creates a possible contact transmission risk. Moreover, there was a certain cross-infection risk in adjacent compartments, and the average infection probability for patients was 0.84%. The bioaerosol concentrations of the working area in each compartment 30 min post-treatment were reduced to 0.07% of those during treatment, and the infection probability was <0.05%. The results will contribute to an in-depth understanding of the infection risk in multi-compartment dental clinics, forming feasible suggestions for management to efficiently support epidemic prevention and control in dental clinics.
... As extractions result in a particularly high incidence of systemic adverse events [2], it is important to perform dental treatment in a safe and reassuring manner to reduce patient anxiety during extractions. Therefore, attempts have been made in clinical dentistry to eliminate patient anxiety including informed consent wherein patients are shown X-ray images and models to improve their understanding of the treatment that they are about to undergo [3,4], music sedation wherein patients listen to quiet, slow music during sedation [5][6][7], and aromatherapy wherein patients are exposed to the scents of essential oils that offer sedative effects while present in the treatment room [8][9][10]. Studies evaluating these methods have used the State-Trait Anxiety Inventory (STAI; comprising STAIY-1 and STAIY-2) [11]. ...
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Background Dental extractions can cause significant anxiety making patients feel sick. In serious cases, extractions can cause unconsciousness and even death. Therefore, systemic adverse events must be completely avoided. We herein developed a method to predict dental extraction-related adverse events in patients. Methods The State-Trait Anxiety Inventory (STAIY-1) was administered before calculus removal and extraction, and STAIY-2 was administered before calculus removal in 93 patients (men, 44; women, 49). These patients were at a dental clinic for outpatient treatment. The vital signs like blood pressure, pulse rate, and arterial oxygen saturation and salivary amylase activity were measured at 2- and 4-min intervals before calculus removal as well as before extraction. Results Of the 93 patients, one man and one woman suffered from an adverse event. Maximum points for raw STAIY-1 scores were measured before extraction for both men and women, suggesting that performing the STAIY-1 survey prior to extraction is effective in predicting extraction-related adverse events. We also investigated rate changes (rate change = mean value during extraction − mean value during calculus removal/mean value during calculus removal) and mean pre-extraction pulse rates in patients who suffered from an adverse event. Adverse events occurred in men when there was a rate change of ≥ 0.225 and mean pre-extraction pulse rate was ≥ 90.0 bpm and in women when there was a rate change of ≥ 0.200 and the mean pre-extraction pulse rate was ≥ 95.0 bpm. We used these pulse rates as cutoff values. Conclusions Thus, the combined use of pre-extraction STAIY-1 results and pulse rate cutoff values could increase the success of predicting adverse events in such patients.
... Therefore, to try to regulate hypertension, relaxation techniques were embraced through biofeedback, meditation in addition to respiratory exercises (11). Meanwhile, heart rate serves as a dependable indicator of children's stress and dental anxiety (12,13). ...
... Furthermore, listening to music can reduce subjective stress levels, decrease salivary cortisol secretion, and increase salivary alpha-amylase activity, which is higher [26,55]. In addition, music therapy has a positive effect in controlling salivary cortisol concentrations, systolic and diastolic pressure, heart rate, body temperature in anxious dental patients [56]. Listening to soft, relaxing music for an hour in the postoperative period has beneficial effects on the stress response, such as a much more significant reduction in cortisol levels [57]. ...
Chapter
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Stress is a physiological and psychological response to the perception of danger and threat. Stress can occur due to a physical injury, mechanical disturbance, chemical change, or emotional factor. Stress can occur at all ages, including children and adolescents. Various physical and psychological events can cause stress in children, for example suffering from an illness, injury/trauma, parental divorce, parental death, sexual abuse, natural disasters, war, etc. Various exposures to physical and psychological stress harmful to the body can cause it to carry out defense mechanisms against these threats, one of which is changes in the cortisol hormone. Cortisol hormone is used as a biochemical marker for acute and chronic stress. The increase in this hormone as an indicator of stress can be changed through psychosocial interventions, one of which is by the provision of music therapy. Music therapy can manage stress problems of people at various ages with minimal side effects and a small amount of money. It is also easy to apply and does not require any intellectual ability to interpret. There are no limitations for users to use music therapy.
... State anxiety levels in the music group decreased significantly as compared to the control group. Mejia-Rubalcava et al. (2015) found that patients who listened to music preoperatively had significant lower HR, SBP and DBP than the control group. Thus, considering those facts, further research needs to be conducted on the effects of music played both preoperatively and peri-operatively, as a combination of music played during the treatment and in the waiting room could prove to be a more viable anxiolytic treatment. ...
Article
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The purpose of this study was to systematically review the scientific literature concerning the effect of playing background music on anxiety and physiological parameters in patients undergoing dental treatment. MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE were searched for papers up to September 2020. Inclusion criteria were randomized clinical trials (RCTs) or controlled clinical trails (CCTs) among adolescents and adults that assessed anxiety (AX), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), or respiratory rate (RR). Data before and after treatment were extracted and the potential risk of bias was estimated. Descriptive analysis and meta-analysis were performed. Thirteen eligible studies (12 RCTs, 1 CCT) were retrieved, with an estimated low to high risk of bias. Descriptive analysis showed an effect on AX in favor of music intervention, while no effect on SBP and DBP was found. The effect on HR and RR was inconsistent among studies. Meta-analysis showed a significant difference of means (DiffM) for the end scores of AX (State-Trait Anxiety Inventory and Corah’s Dental Anxiety Scale (CDAS)) and incremental scores (CDAS) in favor of music intervention. Dental care professionals may consider playing background music while treating adolescent and adult patients. There is a moderate certainty that this can provide a small reduction in dental anxiety. With very low to moderate certainty, no effect on physiologic parameters can be expected.
... This finding is in accordance with a study done by Mejia-Rubalcava et al. 19 who reported marked decrease in all physiologic parameters including PR and BP for subjects receiving music therapy during dental treatment. Studies by Olszewska and Zarow, 20 kim et al., 21 and Tran et al. 22 also concluded in their research paper that music therapy reduced dental anxiety remarkably in patients undergoing dental procedure. ...
Article
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BACKGROUND AND AIM: The purpose of the present study was to evaluate the impact of passive music intervention in patients with moderate to high dental anxiety undergoing ultrasonic scaling procedure.
... With regard to the music, from the tribal one to the Gregorian chants of the Middle Ages, from the eastern one to Vivaldi's compositions, it has always had an extraordinary effect on men: now we know that it's able to stimulate production of endorphins, which have a beneficial effect on mood as well on psychological well-being [23][24][25][26][27][28][29][30]. ...
Article
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Few studies have evaluated interventions to decrease a woman’s anxiety awaiting or undergoing mammography. Focused on Quantum PNEI, this paper reports a review of most common complementary and alternative therapies and their implementation aimed to reduce anxiety in women waiting or undergoing mammography. The goal is lighten the psychological burden of the mammography experience as well make positioning easier. Further considerations are made about the practice of meditation among the medical and paramedical staff to promote awareness.
... This finding is in accordance with a study done by Mejia-Rubalcava et al. 19 who reported marked decrease in all physiologic parameters including PR and BP for subjects receiving music therapy during dental treatment. Studies by Olszewska and Zarow, 20 kim et al., 21 and Tran et al. 22 also concluded in their research paper that music therapy reduced dental anxiety remarkably in patients undergoing dental procedure. ...
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Background and Aim The purpose of the present study was to evaluate the impact of passive music intervention in moderate to high dental anxiety patients undergoing ultrasonic scaling procedure. Methods Eighty healthy subjects with an anxiety score of 13-25 by Modified Dental Anxiety Scale (MDAS) in a randomised controlled trial were recruited into study and control group. Study group of forty subjects, underwent ultrasonic scaling procedure with pre-recorded instrumental music intervention. Forty subjects in control group received same dental treatment without music intervention. Physiologic parameters such as Pulse rate (PR) and systolic and diastolic Blood pressure (BP) were recorded twice (Before, and at the end of procedure) for both the groups. Dental anxiety experience was recorded using visual analogue scale (VAS) for all the subjects at the end of study program. Repeated measure ANOVA is used to test the significant mean difference between pre and post measurements of all clinical parameters among study and control groups. Independent sample t-test was applied to analyses VAS intergroup significance. Results Result of the study showed the mean values of PR (pre and post), systolic and diastolic BP (pre and post)were statistically significant for study group as compared to control group Mean values of PR (pre and post) and systolic and diastolic BP (pre and post ), showed statistically significant reduction in study group compared to control group. Post therapy VAS score was significantly lower in the study group as compared to the control group. p value was maintained at < 0.05. Conclusion Music intervention, during ultrasonic procedure helps to reduce dental anxiety in subjects with moderate to high dental anxiety levels.
... For highly anxious patients, conscious sedation and anxiolytic drugs were generally employed. However, pharmacological methods significantly raise the cost of dental treatment [15]. For these reasons, behavior management techniques are increasingly used in dental care. ...
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Background: Dental visits are a significant fear among five to six percent of the population. Music distraction has been demonstrated as an effective destraction method in reducing dental anxiety. This study aimed to determine the effect of music on children's anxiety during dental treatment. Materials and Methods: This study was a cross-sectional survey, in which we included a convenience sample of 50 children aged between five and 14 years. The sample consisted of children who attended the female outpatient pediatric dentistry clinics at the College of Dentistry, King Khalid University, Abha, Saudi Arabia. Data was collected using a survey questionnaire given to patients before and after the treatment procedure. The questionnaire asked about the anxiety levels related to dental treatment using the Modified Child Dental Anxiety Scale faces version (MCDASf). The study data was collected and then analyzed using the Statistical Package for the Social Sciences (SPSS 20). Results: Thirty-one participants (62%) were relaxed when asked about their feelings toward dentists in general after music therapy, compared to 22 (44%) before music therapy. Thirty six participants (72%) were relaxed, when asked about their feelings toward checking their teeth after music therapy, compared to 24 (48%) before music therapy. Thirty nine participants (78%) felt relaxed when the treatment was done with music therapy, compared to 25 (50%) before music. Forty participants (80%) reported that they felt calm and comfortable when they listened to music during treatment. Conclusions: Dental treatment for an anxious pediatric patient is challenging. Many non-pharmacological behavior management techniques were introduced, including distraction. This study indicated that music distraction could decrease the anxiety and stress levels of pediatric patients during dental treatment.
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The dental surgery induces some degree of anxiety in many patients: 12% of the UK adult population who had visited a dentist were extremely dentally anxious. Such patients can be unco-operative and difficult to manage as they avoid dental visits and suffer a greater amount of dental disease. Furthermore, patients believe that their oral health has an impact on their quality of life. Sedation is an option to relieve anxiety, however this is associated with risks, including respiratory depression and over sedation. Erdal et al found that music was as effective as midazolam in terms of its sedative and anxiolytic properties during surgery. CPD/Clinical Relevance: Music has demonstrated its usefulness in terms of calming anxious patients.
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Neuroscientific pursuit of music is of growing interest. Literature shows that music enhances neurochemical release, activating the pleasure center of the brain; promotes the secretion of an antibody, enhancing immunity; as well as attenuates and prevents the release of a stress hormone, helping to cope with stressors. These findings demonstrate that music can potentially serve as a scientifically proven medium to exert positive effects on physical and psychological health and well-being. However, research on neurochemical responses to music is still in its infancy and further research is critically needed to determine more specific effects of music. This chapter summarizes existing literature investigating central and peripheral molecular responses to music including neurotransmitters, neuropeptides, hormones, and immune biomarkers, discusses the limitations, and warrants more neuroimaging studies to aim to expand interdisciplinary research in music and neuroscience. http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780198804123.001.0001/oxfordhb-9780198804123
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Purpose: The purpose of this study was to determine the music genre reducing anxiety best in patients whose third molars were extracted. Materials and methods: Eighty patients were included in this prospective, observational, randomized controlled trial. They were divided into 4 groups: group 1, Turkish music; group 2, classical music of a Western culture; group 3, soft rock music; and group 4, no music (control group). The preoperative blood pressure, heart rate (HR), and oxygen saturation of each patient were measured, and the Corah Dental Anxiety Scale (CDAS) questionnaire was applied, with the values being measured and recorded at 5-minute intervals. Descriptive and bivariate statistics were computed, and the P value was set at .05. Results: Of the 80 patients, 44 were women and 36 were men. The average age was 24.1 ± 5.9 years. No significant differences between the groups were found in terms of age; gender; or preoperative HR, mean arterial pressure, oxygen saturation (as measured by pulse oximetry), and CDAS values (P > .05). Although no significant correlations was found between anxiety levels and age (P = .330), HR (P = .694), or mean arterial pressure (P = .775), it was detected that anxiety was high in women (P < .05). Anxiety levels decreased at all times in all groups, but the postoperative CDAS values of the classical music group were significantly lower than those of the other groups (P = .024). Conclusions: This study found that classical Western music that was started in the preoperative period and continued until the end of the operation significantly reduced the anxiety associated with third molar extraction in patients aged between 18 and 30 years.
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Dental anxiety has become one of the most important problems affecting patients’ timely consultation and visiting experience. The purpose of this study is to help patients who have the emotion of dental anxiety to relieve anxiety by a virtual reality product based on computerized cognitive behavioral therapy. The study collected MDAS, GSR, and HRV data of 24 adults with dental anxiety through experiments to evaluate the degree of dental anxiety, and evaluated the user experience by user experience questionnaire. According to the data analysis, MDAS, GSR, and HRV has been decreased after the intervention, which confirmed the effectiveness of the virtual reality dental anxiety mitigation tool based on computerized cognitive behavioral therapy. At the same time, direct exposure to the virtual dental environment also has certain utility, but the effect is not equal to the former.
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Objectives: This study estimated the prevalence of dental fear/anxiety (DFA) in Southeast Asian youths and established their dental environment and practitioner preferences. Methods: A convenience sample of youths were enrolled from a local polytechnic. The Index of Dental Anxiety and Fear (IDAF-4C) was used to ascertain the presence and severity of DFA. Socio-demographic and IDAF-4C data, along with participants' dental environment and practitioner partialities were gathered electronically. Statistical evaluations were performed with Kruskal-Wallis and Chi-square tests (α = 0.05). Results: Data from a total of 215 participants were appraised. The mean age of the study sample was 18.9 ± 2.0 years (87.4% women). Of these, 12.6% had moderate-to-high DFA and 6.0% had high-to-extreme DFA. As a group, Southeast Asian youths generally liked dental clinics with adorned walls, cooler temperatures, magazines/books, background music, and audio-visual devices. In addition, they favored female practitioners who are younger (≤45 years old), friendly, talkative, and maintain a professional relationship. However, those with high-to-extreme DFA preferred a warmer clinic environment and to have an informal relationship with their dental practitioners (p = 0.01). Conclusions: The prevalence of moderate-to-extreme DFA in Southeast Asian youths was 18.6%. Individuals with high-to-extreme DFA may have disparate dental environment and practitioner preferences compared to those with no-to-moderate DFA.
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Objective The aim of this study was to compare the effects of music at 432 Hz, 440 Hz, and no music on the clinical perception of anxiety and salivary cortisol levels in patients undergoing tooth extraction. Methodology A parallel-group randomized clinical trial was conducted. Forty-two patients (average age: 23.8±7.8 years, 27 women) with a moderate level of anxiety were distributed in three groups: use of music for 15 minutes at a frequency of 432 Hz (n=15), at 440 Hz (n=15) and a control group without music (n=12). The CORAH Dental Anxiety Scale and salivary cortisol levels, estimated by the solid phase enzyme-linked immunosorbent assay (ELISA), were measured and compared before and after the music intervention between groups (two-way ANOVA-Tukey p<0.05, RStudio). Results Significantly lower anxiety level values were observed at 432 Hz (8.7±2.67) and 440 Hz (8.4±2.84) compared to the control group (17.2±4.60; p<0.05). The salivary cortisol level at 432 Hz (0.49±0.37 μg/dL) was significantly lower than 440 Hz (1.35±0.69 μg/dL) and the control group (1.59±0.7 μg/dL; p<0.05). Conclusion The use of music significantly decreased clinical anxiety levels, and the frequency of 432 Hz was effective in decreasing salivary cortisol levels before tooth extraction.
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Purpose: The purpose of this cross-sectional study was to evaluate the association between parents' dental anxiety (DA) and independent variables. Methods: One hundred sixty-eight dyads of parents and six- to 12-year-old children who were undergoing treatment at a university pediatric dentistry clinic were recruited. Two examiners evaluated parents' DA and oral health literacy (OHL) using the Brazilian version of Corah's dental anxiety scale and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), respectively. Children's DA was reported by parents through the dental anxiety question (DAQ). Demographic data was also collected. A single examiner used the decayed, missing, and filled permanent teeth and primary teeth (DMFT/dmft) indices to assess the children's oral health status. The data analysis involved univariate and multivariate Poisson regression. Results: In the multivariate regression, higher levels of parents' DA were associated with a household income equal to or less than the Brazilian monthly minimum wage (prevalence ratio [PR]=4.9; 95 percent confidence interval [CI]=2.1 to 11.7) and a lower degree of OHL (PR=1.68; 95 percent CI=1.01 to 2.8). Associations between parents' DA and children's DA and DMFT/dmft index were not found. Conclusion: Parents' dental anxiety was related to a low household income and low oral health literacy.
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BACKGROUND: Patients’ conditions can worsen if stress and pain are not appropriately managed. Conventional therapy ignores psychological and spiritual aspects. Both influence the body’s response to various stimuli. AIM: This study aimed to assess how Dreamer’s spiritual therapy can affect the cortisol and pain in the intensive care unit (ICU) patients. METHODS: It involved 86 ICU patients in a true-experimental study. Respondents were divided into the intervention and the control group randomly. The intervention group received Dreamer spiritual therapy (DST) for 30 min but not for the control group. Saliva samples and pain scores were taken from both groups before and after treatment. The comparison of two groups cortisol decreases using Wilcoxon test. Differences in pre- and post-pain scores in each group were analyzed using paired t-test. RESULTS: According to Levene’s test, the two groups were homogeneous (p > 0.05). The Wilcoxon test revealed a statistically significant difference in cortisol level reduction between the intervention (3.88 ng/mL) and control (3.82 ng/ml) groups (p = 0.024), with a large effect size (Cohen’s d value = 59.5). The paired t-test revealed a statistically significant decrease in the intervention group’s pain score from 2.6 to 1.95 (p = 0.001), with a moderate effect size (Cohen’s d value = 0.49). The control group’s pain score did not significantly decrease (p = 0.75). CONCLUSIONS: A DST is effective in reducing salivary cortisol levels and pain scores of ICU patients.
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Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system.1,2 Dental anxiety is common and presents before, during or after dental treatment.3 The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output.1,2 Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health.4 Dental anxiety can generate a variety of negative consequences for both the dentist and the patient.4 Evidence‐based strategies are essential for mitigating and relieving anxiety in the dental clinic.2,3 Psychotherapeutic behavioural strategies can modify the patient’s experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations.2,3 These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilising biofeedback, hypnosis, acupuncture, distraction and desensitisation. Pharmacological intervention utilises either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment.5 © 2022 Australian Dental Association.
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Intensive care units are a stressful milieu for patients, particularly when under mechanical ventilation which they refer to as inhumane and anxiety producing. Anxiety can impose harmful effects on the course of recovery and overall well-being of the patient. Resulting adverse effects may prolong weaning and recovery time. Music listening, widely used for stress release in all areas of medicine, tends to be a reliable and efficacious treatment for those critically ill patients. It can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication. This relaxation response can lower cardiac workload and oxygen consumption resulting in more effective ventilation. Music may also improve sleep quality and reduce patient’ pain with a subsequent decrease in sedative exposure leading to an accelerated ventilator weaning process and a speedier recovery.
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https://link.springer.com/chapter/10.1007/15695_2018_134 Wound healing is a complex process formed of various overlapping stages, namely, clot formation, inflammation, proliferation, and remodeling, which depend on the systemic health and a competent immune system. Negative cognitive processes such as pain and stress can induce the stress response, which delays wound healing by deteriorating health and modulating the immune function through the activation of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes. Hence, it seems that practices capable of mitigating stress or pain might accelerate wound healing. This chapter reviews the effects of relaxation and meditation, music therapy, expressive writing, hypnosis, and placebo on physiological health and wound recovery.
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Objectives: This study aimed to estimate the prevalence of dental anxiety and examine the socio-demographic associations of dental anxiety among a representative sample of UAE college populations. Materials and Methods: Four hundred and thirteen college students of Sharjah University in the UAE completed Modified Corah′s Dental Anxiety Scale (MDAS) (47% males and 53% females). The survey also included questions in a yes/no format with which respondents rated attributions for their anxiety. Results: Prevalence of dental anxiety (MDAS score of 13 or more) was 36%, with overall severity represented by a mean score of 11.52 (SD: 4.88). Students who visited their dentist more than two years ago had significantly higher MDAS scores compared with those who visited their dentist less than two years ago (t-test, P=0.02). Compared with female students, a significantly higher proportion of males indicated that their last visit to the dentist was more than two years ago (17% vs. 30%, respectively, χ2 -test, P=0.002). In addition, more than half of the students (55%) perceived a need for a checkup and 54% indicated that they visited the dentist because of problems with their teeth. Conclusions: The findings of this study indicate that although dental anxiety was not associated with gender and frequency of dental visits, feeling of lack of control and pain anticipation were strong predictors of anxiety. These results highlight the important role that dental healthcare providers could play in counseling anxious patients to reduce the impact of these factors on seeking dental care.
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Dental anxiety is a major barrier for dental care utilization. Hence, identifying anxious individuals and their appropriate management becomes crucial in clinical practice. The study aims to assess dental anxiety, factors influencing dental anxiety, and anxiety towards tooth extraction procedure among patients attending a dental hospital in India. The study sample consisted of 1,148 consecutive patients aged 18-70 years. The assessment tools consisted of a consent form, history form, a questionnaire form containing the Modified Dental Anxiety Scale (MDAS) which was used to assess the level of dental anxiety, and an additional question on anxiety towards dental extraction procedure. Among the study group, 63.7% were men and 36.3% were women. Based on the MDAS score, 45.2% of the participants were identified to be less anxious, 51.8% were moderately or extremely anxious, and 3% were suffering from dental phobia. Mean MDAS total score was 10.4 (standard deviation (SD) = 3.91). Female participants and younger subjects were more anxious (P < 0.001). Subjects who were anxious had postponed their dental visit (P < 0.001). Participants who had negative dental experience were more anxious (P < 0.05). Notably, 82.6% reported anxiety towards extraction procedure. Significant association was seen between anxiety towards extraction procedure and the respondents gender (P < 0.05), age (P < 0.001), education level (P < 0.05), employment status (P < 0.001), income (P < 0.001), self-perceived oral health status (P < 0.05), and their history of visit to dentist (P < 0.05). Significant percentage of population was suffering from dental anxiety in this study population. A plethora of factors like age, gender, education level, occupation, financial stability, and previous bad dental experience influences dental anxiety to various levels. Extraction followed by drilling of tooth and receiving local anesthetic injection provoked more anxiety.
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Aim To explore the impact of dental anxiety on daily living.
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In the USA, hypertension affects one in three adults, and anxiety disorders are the most commonly diagnosed mental health disorders. Both hypertension and anxiety have been studied extensively. Yet, a full understanding of anxiety's relationship to hypertension has been elusive. In this review, we discuss the spectrum of anxiety disorders. In addition, we consider the evidence for acute and long-term effects of anxiety on blood pressure. We review the effect on blood pressure of several "real-world" stressors, such as natural disasters. In addition, we review the effect of anxiety treatments on blood pressure. We explain the American Heart Association's recent recommendations regarding meditation and other relaxation methods in the management of hypertension. We conclude that novel research methods are needed in order to better elucidate many aspects of how anxiety relates to hypertension.
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The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.
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Aim: To explore the impact of dental anxiety on daily living. Method: Twenty people attending a dental sedation clinic completed the Modified Dental Anxiety Scale, and were interviewed privately using a reflexive, in-depth technique. All interviews were audio-tape recorded and transcribed. The transcripts were analysed to identify the impact of dental anxiety upon the participants' daily lives. Twenty-five per cent of the qualitative data was reviewed by an independent researcher to ensure the reliability of the analysis. Results: The mean age of participants was 41 years (range 23 to 60). The mean MDAS score was 21.5 (range 14 to 25). Five main impacts of dental anxiety were identified: physiological; cognitive; behavioural; health; and social. Subsumed under these broad categories were: the fright response; a vast array of negative thoughts, feelings and fears; avoidance behaviour and behaviours related to eating, oral hygiene, and self-medication; and other manifestations of anxiety in the dental environment including muscular tension, crying and aggression were all identified. Dental anxiety was also found to disturb sleep and to have a profound affect socially, interfering with work and personal relationships. Conclusion: The impact that dental anxiety can have on people's lives is wide-ranging and dynamic.
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Context: Treatment of pain in palliative care patients is challenging. Adjunctive methods of pain management are desirable. Music therapy offers a nonpharmacologic and safe alternative. Objectives: To determine the efficacy of a single music therapy session to reduce pain in palliative care patients. Methods: Two hundred inpatients at University Hospitals Case Medical Center were enrolled in the study from 2009 to 2011. Patients were randomly assigned to one of two groups: standard care alone (medical and nursing care that included scheduled analgesics) or standard care with music therapy. A clinical nurse specialist administered pre- and post-tests to assess the level of pain using a numeric rating scale as the primary outcome, and the Face, Legs, Activity, Cry, Consolability Scale and the Functional Pain Scale as secondary outcomes. The intervention incorporated music therapist-guided autogenic relaxation and live music. Results: A significantly greater decrease in numeric rating scale pain scores was seen in the music therapy group (difference in means [95% CI] -1.4 [-2.0, -0.8]; P<0.0001). Mean changes in Face, Legs, Activity, Cry, Consolability scores did not differ between study groups (mean difference -0.3, [95% CI] -0.8, 0.1; P>0.05). Mean change in Functional Pain Scale scores was significantly greater in the music therapy group (difference in means -0.5 [95% CI] -0.8, 0.3; P<0.0001) [corrected]: A single music therapy intervention incorporating therapist-guided autogenic relaxation and live music was effective in lowering pain in palliative care patients.
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Routine assessment of the hypothalamic-pituitary-adrenal axis relies on the measurement of total serum cortisol levels. However, most cortisol in serum is bound to corticosteroid-binding globulin (CBG) and albumin, and changes in the structure or circulating levels of binding proteins markedly affect measured total serum cortisol levels. Furthermore, high-affinity binding to CBG is predicted to affect the availability of cortisol for the glucocorticoid receptor. CBG is a substrate for activated neutrophil elastase, which cleaves the binding protein and results in the release of cortisol at sites of inflammation, enhancing its tissue-specific anti-inflammatory effects. Further tissue-specific modulation of cortisol availability is conferred by corticosteroid 11β-dehydrogenase. Direct assessment of tissue levels of bioavailable cortisol is not clinically practicable and measurement of total serum cortisol levels is of limited value in clinical conditions that alter prereceptor glucocorticoid bioavailability. Bioavailable cortisol can, however, be measured indirectly at systemic, extracellular tissue and cell levels, using novel techniques that have provided new insight into the transport, metabolism and biological action of glucocorticoids. A more physiologically informative approach is, therefore, now possible in the assessment of the hypothalamic-pituitary-adrenal axis, which could prove useful in clinical practice.
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To evaluate the associations between dental caries classified according to the index for decayed, missing and filled teeth (DMFT) and stimulated salivary flow, salivary capacity for oxidation reduction and academic stress in undergraduate dental surgery students aged 18-22 years. This research was performed at three time-points: March 2010, September 2010 and March 2011. The sample was composed of 73 students, including 15 male and 58 female subjects. Data were obtained using the DMFT index to detect incident dental caries, the RD test Showa for salivary capacity for oxidation reduction, the Sisco academic stress inventory, and sterile polyethylene to stimulate salivary flow. Logistic regression analysis showed that: subjects with stimulated salivary flow of <1 ml/min are at increased risk for developing caries compared with those with stimulated salivary flow of ≥1 ml/min; those with moderate or high levels of academic stress are at greater risk for developing carious lesions than those with low academic stress; women are at greater risk for developing carious lesions than men, and, of the subjects studied, younger students were more likely to develop caries. Moderate to high levels of academic stress, younger age and lower salivary flow rate represent risk factors for the development of dental caries in students.
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The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. Randomised controlled trial. Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.
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Hispanics comprise the largest ethnic minority group in the United States. Previous work with the Spanish Modified Dental Anxiety Scale (MDAS) yielded good validity, but lower test-retest reliability. We report the performance of the Spanish MDAS in a new sample, as well as the performance of the Spanish Revised Dental Beliefs Survey (R-DBS). One hundred sixty two Spanish-speaking adults attending Spanish-language church services or an Hispanic cultural festival completed questionnaires containing the Spanish MDAS, Spanish R-DBS, and dental attendance questions, and underwent a brief oral examination. Church attendees completed the questionnaire a second time, for test-retest purposes. The Spanish MDAS and R-DBS were completed by 156 and 136 adults, respectively. The test-retest reliability of the Spanish MDAS was 0.83 (95% CI = 0.60-0.92). The internal reliability of the Spanish R-DBS was 0.96 (95% CI = 0.94-0.97), and the test-retest reliability was 0.86 (95% CI = 0.64-0.94). The two measures were significantly correlated (Spearman's rho = 0.38, p < 0.001). Participants who do not currently go to a dentist had significantly higher MDAS scores (t = 3.40, df = 106, p = 0.003) as well as significantly higher R-DBS scores (t = 2.21, df = 131, p = 0.029). Participants whose most recent dental visit was for pain or a problem, rather than for a check-up, scored significantly higher on both the MDAS (t = 3.00, df = 106, p = 0.003) and the R-DBS (t = 2.85, df = 92, p = 0.005). Those with high dental fear (MDAS score 19 or greater) were significantly more likely to have severe caries (Chi square = 6.644, df = 2, p = 0.036). Higher scores on the R-DBS were significantly related to having more missing teeth (Spearman's rho = 0.23, p = 0.009). In this sample, the test-retest reliability of the Spanish MDAS was higher. The significant relationships between dental attendance and questionnaire scores, as well as the difference in caries severity seen in those with high fear, add to the evidence of this scale's construct validity in Hispanic samples. Our results also provide evidence for the internal and test-retest reliabilities, as well as the construct validity, of the Spanish R-DBS.
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The Modified Dental Anxiety Scale (MDAS) is a brief, self-complete questionnaire consisting of five questions and summed together to produce a total score ranging from 5 to 25. It has reasonable psychometric properties, low instrumental effects and can be integrated into everyday dental practice as a clinical aid and screen for dental anxiety. The objectives were to (i) produce confirmatory evidence of reliability and validity for the MDAS, (ii) provide up-to-date UK representative norms for the general public to enable clinicians to compare their patients' scores, (iii) to determine the nature of the relationship between dental anxiety and age. Telephone survey of a representative quota sample of 1000 UK adults (>18 years of age) conducted between 7-21 April, 2008. Attrition of potential participants was high in the recruitment process, although bias was minimal. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Dental anxiety was four times greater in the youngest age group (18-39 yrs) compared to older participants (60+ yrs), controlling for sex, social class and self-reported dental visiting behaviour confirming previous developed-world reports. The scale's psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Dental anxiety was high in younger compared to older people.
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The purpose of the present study was to estimate the point prevalence of dental fear and dental phobia relative to 10 other common fears and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR subtypes of specific phobia. Data were also analysed to examine differences with regard to severity, presence of distressing recollections of fear-related events, gender, and prevalence across age. Data were obtained by means of a survey of 1,959 Dutch adults, 18-93 yr of age. Phobias were assessed based on DSM-IV-TR criteria, whereas severity of present fears was assessed using visual analogue scales. The prevalence of dental fear was 24.3%, which is lower than for fear of snakes (34.8%), heights (30.8%), and physical injuries (27.2%). Among phobias, dental phobia was the most common (3.7%), followed by height phobia (3.1%) and spider phobia (2.7%). Fear of dental treatment was associated with female gender, rated as more severe than any other fear, and was most strongly associated with intrusive re-experiencing (49.4%). The findings suggest that dental fear is a remarkably severe and stable condition with a long duration. The high prevalence of dental phobia in the Netherlands is intriguing and warrants investigation in other countries.
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Background: A growing body of literature describes the performance of dental fear questionnaires in various countries. We describe the psychometric properties of Greek versions of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS) in adult Greek patients. Methods: Greek versions of the MDAS and DFS were administered to two samples of adult dental patients. In the first sample, 195 patients attending one of three private practice dental offices in a large city in Greece completed the questionnaires in the waiting room before dental treatment. After treatment, their dentists (who did not know how the patients had answered the questionnaire) rated their anxiety during dental treatment. In the second sample, 41 patients attending a Greek university dental school clinic completed the questionnaire twice at two separate visits, in order to provide test-retest data. Cronbach's alpha was used to compute the internal consistencies, while Spearman's rho was used to compute the test-retest reliabilities. Construct validity was assessed by correlating the responses to the MDAS and DFS by Spearman's rho. Spearman's rho was also used to examine the criterion validities, by comparing the questionnaire responses with the dentists' ratings of anxiety. Results: The internal consistencies for the MDAS were 0.90 and 0.92 in the two samples; for the DFS, the internal consistencies were 0.96 in both samples. The test-retest reliabilities were 0.94 for the MDAS and 0.95 for the DFS. The correlation between the two questionnaires was 0.89. The patients' responses to both questionnaires were significantly related to the dentists' ratings of their anxiety during dental treatment (both p values <0.001). Conclusion: The results indicate that the Greek versions of the MDAS and DFS have good internal consistencies and test-retest reliabilities, as well as good construct and criterion validities. The psychometric properties of the Greek versions of these questionnaires appear to be similar to those previously reported in other countries.
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We evaluated the stress relief effect of lavender aroma by measuring sensitive salivary endocrinological stress markers, cortisol and chromogranin A (CgA). Thirty healthy students performed a serial arithmetic task for 10min and then rested for 10min. During the resting period, 16 students (aroma group) were exposed to airborne organic essential oil of lavender. Saliva samples were collected immediately before and after the arithmetic task, and at 5 and 10min after that. Salivary cortisol and CgA levels were determined by enzyme-linked immunosorbent assay. In the aroma group, levels of CgA that had been elevated at the end of the arithmetic task were statistically significantly lower 10min later. The control group showed no such change. During the protocol, no statistically significant changes in levels of cortisol were detected in either the aroma group or the control group. These findings suggest that lavender aroma has a stress relief effect.
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Unlabelled: EXECUTIVE SUMMARY: Background: Anticipation of an invasive procedure in hospital is likely to provoke feelings of anxiety and stress in patients. An unfamiliar environment, loss of control, perceived or actual physical risk, dependence on strangers and separation from friends and family are all factors that can contribute to the development of such feelings. Recently, there has been considerable interest in the anxiolytic potential of music listening in a variety of clinical settings, yet thus far, little is known about the impact of music listening on the pre-procedural patient population. A systematic review of all literature to date was indicated to improve understanding of outcomes and impact of music listening on pre-procedural anxiety, thus helping nurses decide whether or not to incorporate music listening into practice and to highlight a need, or otherwise, for a related primary research agenda. Objective: The objective of this review was to determine the best available evidence on the effectiveness of music listening in reducing adult hospital patients' pre-procedural state anxiety. Inclusion criteria: Types of studies This review included randomised controlled trials and quasi-experimental research designs that examined the efficacy of music listening in reducing state anxiety among pre-procedural hospital patients published between January 1985 and February 2006. The search was limited to publications after 1985 to coincide with the increasing interest and use of complementary therapies within health care during the 1980s and 1990s. Types of participants Participants of interest to the review were adult day patients, ambulatory patients and inpatients who were about to undergo any type of clinical procedure. Types of intervention The review focused on studies that investigated pre-procedural music listening employed and prescribed as a potentially therapeutic activity. It excluded any other form of music therapy. Types of outcome measures The primary outcome measures examined were alterations in state anxiety and a variety of physiological variables such as blood pressure and respiration and heart rates. Search strategy: A search for published and unpublished literature between January 1985 and February 2006 was conducted using all major electronic databases. A three-step search strategy was devised which consisted of using high-precision MeSH terminology and keywords to ensure that all material relevant to the review was captured. CRITICAL APPRAISAL: The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using the standard Joanna Briggs Institute (JBI) critical appraisal tools. Data extraction and synthesis: Data were extracted from the studies that were identified as meeting the criteria for methodological quality using a data-extraction tool developed for the review. Studies were grouped by outcome measure and summarised using tabular and narrative formats. Results: The review demonstrated that state anxiety is defined and measured using both psychological and physiological parameters. Music listening had a consistently positive and statistically significant effect on reducing psychological parameters of pre-procedural state anxiety. However, the results from the measurement of various pre-procedural physiological parameters failed to reveal any consistent positive changes in patients who had listened to music. This calls into question the adequacy of the theories in this area which link anxiety and the automated and central nervous systems and the effect that music listening may have on these processes and physiological responses. Conclusions/implications for practice: 1 In order to reduce anxiety, it is likely that patients will benefit psychologically from having the opportunity to listen to music in the immediate pre-procedural period. 2 Patients do not appear to experience any alteration in physiological status as a result of listening to music. 3 Further research is indicated in order to replicate existing studies, to strengthen the evidence to support such interventions and to establish intervention parameters. 4 Further research is needed analysing the physiological mechanisms by which music listening is believed to reduce state anxiety and the contribution of the automated and other nervous systems to this reduction.
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To compare the prevalence of high dental anxiety across a variety of past distressing experiences with a previously reported Dutch sample. University students from the UK (N=1024) completed an online survey containing; the Modified Dental Anxiety Scale, and the Level of Exposure-Dental Experiences Questionnaire (LOE-DEQ). Adjusted odds ratios (OR) were calculated to assess the association of self-reported distressing experiences and dental anxiety. The percentage of respondents with high dental anxiety (HDA) (total MDAS score≥19) was 11.2%. Significant prevalence of HDA across several distressing experiences was shown in both UK and Dutch samples notably: extreme helplessness during dental treatment, lack of understanding of the dentist and extreme embarrassment during dental treatment. There were little or no effects of non-dental trauma, with the exception of sexual abuse in the UK sample. Trauma from various past experiences may be implicated in an increased risk of high dental anxiety.
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The present study aimed to evaluate the effect of one and five sessions of treatment for intra-oral injection phobia in 55 subjects fulfilling the DSM-IV criteria for specific phobia. The subjects were randomly assigned to one or five sessions of cognitive behavioural therapy (CBT) performed by dentists. Assessments included behavioural tests and self-report instruments used pretreatment, post-treatment, and at 1 yr of follow-up. The dental anxiety scale (DAS), the injection phobia scale-anxiety, and the mutilation questionnaires were applied. Mean avoidance duration of intra-oral injections before treatment was 7.0 yr. The results showed that 89% of the subjects had received intra-oral injections from a regular dentist during the 1-yr follow-up. The only significant difference between the one- and the five-session groups was that the five-session group reported less anxiety (as measured using the DAS) at 1 yr of follow-up. It was concluded that both treatments performed by dentists specially trained in CBT have a significant treatment effect on the intra-oral injection phobia.
Article
To investigate the relationship of dental anxiety with oral health status and oral health-related quality of life (OHQoL) among dentate subjects living in Hong Kong. One thousand Hong Kong residents who were aged 25-64 years and predominantly Chinese were asked to complete the Chinese short-forms of the Dental Anxiety Inventory (SDAxI) and Oral Health Impact Profile (OHIP-14S). Dental (DMFT index) and periodontal statuses [full-mouth clinical attachment level (CAL)] were also assessed. Ninety-six (9.6%; mean SDAxI, 9.6), 799 (79.9%; mean SDAxI, 15.0), and 105 (10.5%; mean SDAxI, 27.4) participants had low, average, and high dental anxiety, respectively. The mean DMFT/CAL scores of each SDAxI subgroup were 8.5/1.4, 9.3/1.9, and 9.8/3.6, respectively. The corresponding mean OHIP-14S scores for each SDAxI subgroup were 4.0, 8.1, and 13.2, respectively. Post hoc analysis, adjusted for possible confounding factors, revealed statistically significant differences in DMFT and CAL scores in subjects with low versus high level of SDAxI, and significant differences in OHIP-14S scores between all 3 SDAxI categories. The trait disposition of dental anxiety may be a significant risk indicator of poor dental and periodontal status and is associated with a worse OHQoL.
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Building on earlier research on psychosocial predictors of dental anxiety, this study examined the predictive ability of several demographic and personality variables. To accomplish this goal, a combined sample of 89 dental patients and 55 college students completed a self-report survey. Results indicated that greater age, female gender, lower income, greater satisfaction with life, greater thought suppression, and a stronger internal health locus of control predicted higher levels of dental anxiety. Possible strategies for reducing both thought suppression and exaggerated levels of internal health locus of control were discussed.
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In this study, we examined HPA axis responses to acute psychosocial stress in relation to effort-reward-imbalance (ERI) and overcommitment (OC) to test whether chronic stress at work is accompanied by altered HPA axis stress responses in teachers. According to Siegrist's work stress model, ERI reflects stress due to a lack of reciprocity between personal costs and gains at work, whereas OC is conceptualized as a personality trait mainly characterized by the inability to withdraw from work obligations. Fifty-three medication-free, non-smoking, healthy teachers (33 women, 20 men, 29-63 years, mean age 49.9+/-8.58 years) were confronted with the Trier Social Stress Test (TSST), a widely used standardized stress protocol to induce acute psychosocial stress in the laboratory. ACTH (five samples), total plasma (six samples) and free salivary cortisol (eight samples) were repeatedly measured before and after challenge. In the total group, ERI and OC were only marginally associated with HPA axis responses to acute stress. However, in the subgroup of responders (N=30) high levels of OC were significantly associated with lower ACTH (p=0.03) as well as plasma (p=0.02) and salivary cortisol (p<0.001) responses and results remained significant controlling for depressive symptoms. When additionally controlling for acute perceived stressfulness of the TSST, significant associations between OC and HPA axis responses emerged in responders as well as the total study sample. In respect to ERI, higher stress levels were solely related to significantly stronger plasma cortisol increases after TSST exposure, but this effect became non-significant controlling for depressive symptomatology. In sum, our findings support the notion of HPA axis hyporeactivity in highly overcommitted schoolteachers.
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The purpose of this study was to compare the effects of music assisted progressive muscle relaxation (M + PMR), progressive muscle relaxation (PMR), music listening, and silence/suggestion on measures of anxiety and perceived relaxation. The study also examined participant responses to a posttreatment questionnaire to identify relationships between musical and nonmusical elements in relaxation techniques. Sixty university students participated in the study. Fifteen participants were randomly assigned to each treatment condition. Subjects were tested individually using the same relaxation script for M + PMR and PMR conditions. One-way analyses of covariance were computed to compare pre and posttest differences among groups. Results of the ANCOVA revealed no differences among groups for the State Trait Anxiety Inventory (STAI) or the Visual Analog Scale (VAS). Analysis of variance, however, revealed each treatment condition to be equally effective in producing significant changes in anxiety and perceived relaxation from the pre to posttest period. Additionally, mean score differences revealed decreases for all conditions with M + PMR eliciting the greatest amount of change. A content analysis of posttreatment questionnaire items revealed detailed information about each participant's relaxation experience, state of mind, and use of self-generated relaxation techniques.
Article
The aim of this study was to examine the negative psychosocial impacts of dental anxiety in a sample of dentally fearful and anxious individuals recruited from the general population. The associations between psychosocial impacts, dental anxiety scale (DAS) scores and other severe fears were explored. One hundred and thirty-five subjects who were anxious or fearful about dental treatment were divided into low and high general fear groups based on the number of other severe fears they reported. Negative psychosocial impacts were assessed using a modified form of the scale developed by Kent et al. (1996). This consisted of three dimensions: psychological reactions, social relationships and avoidance/inhibition. Other measures included self-ratings of oral, general and emotional health and scales to assess self-esteem and morale. Overall, 93.1% of subjects reported one or more impacts. Those in the high-fear group had higher psychosocial impact scores than those in the low-fear group (means of 4.19 vs. 2.85; P < 0.05). Differences were most marked with respect to psychological consequences and avoidance/inhibition. The high-fear group had scores indicative of lower self-esteem and lower morale. Forward stepwise linear and logistic regression analyses indicated that both dental anxiety and general fearfulness contributed to these negative outcomes. However, the latter was a more consistent predictor in that it entered six of seven models generated while the former entered only four. The study indicated that dental fear and anxiety have pervasive psychosocial consequences, and that these are more marked among subjects with high levels of general fearfulness. It also provided evidence of the validity of a modified form of the psychosocial impact scale developed by Kent et al. (1996).
Article
The relationship between stress, salivary flow rate and oral volatile sulfur-containing compounds (VSCs) is not clearly established. Two stressful situations were studied: psychological stress caused by a biochemistry examination (Study I) and psychophysiological stress caused by premenstrual syndrome (PMS) (Study II). Seventy-one undergraduate dental students took part in Study I and VSCs were measured 1 wk before the examination, on the day of examination and 1 wk after. In Study II, 50 women were selected (23 with and 27 without PMS) and the measurements were made during non-menstrual, premenstrual and menstrual stages. Unstimulated salivary flow was determined in the subjects of both studies. On the day of the biochemistry examination, VSCs significantly increased and salivary flow decreased compared with baseline values. Women with PMS showed higher VSC concentrations during the premenstrual stage than those without PMS (P < 0.05), but the salivary flow was not statistically different. A change in VSCs was observed during different stages of the menstrual cycle for the groups of women, but the salivary flow did not change. The results suggest that a stressful situation can be a predisposing factor for the increase of VSCs in the mouth air, but the mechanism cannot be simply explained by reduction of the salivary flow.
Article
Folk wisdom has long suggested that stressful events take a toll on health. The field of psychoneuroimmunology (PNI) is now providing key mechanistic evidence about the ways in which stressors--and the negative emotions that they generate--can be translated into physiological changes. PNI researchers have used animal and human models to learn how the immune system communicates bidirectionally with the central nervous and endocrine systems and how these interactions impact on health.
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The purpose of the study was to investigate the effects of music therapy on women's physiologic measures, level of anxiety, and satisfaction during cesarean delivery. Sixty-four women who were planning to have a cesarean delivery were randomly divided into an experimental and a control group. The experimental group received routine care and music therapy, whereas the control group received routine care only. Our results indicated that compared to the control group the experimental group had significantly lower anxiety and a higher level of satisfaction regarding the cesarean experience. No significant differences were found between the two groups in any of the physiological indexes. This controlled study provides evidence that music therapy can reduce anxiety and create a more satisfying experience for women undergoing cesarean delivery.
Article
This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio-economic, oral health, insurance and service usage variables. A telephone interview survey of a random sample of 7312 Australian residents, aged five years and over, from all states and territories. The prevalence of high dental fear in the entire sample was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40-64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socioeconomic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between individuals with HF and LF in terms of socioeconomic, socio-demographic and self-reported oral health status characteristics.
Article
Pronounced dental anxiety could lead to avoidance strategies to evade dental visits. The aim of the present epidemiological study was to investigate the prevalence and related oral disease patterns of dental anxiety in young adult male soldiers. Therefore, the intensity and frequency of dental anxiety are presented and the correlation with oral clinical findings are evaluated. Three hundred seventy-four soldiers who underwent a compulsory dental check-up were randomly assigned to this study. Psychological parameters were collected based on a protocol integrating the Dental Anxiety Scale (DAS) and the Gatchell Fear Scale (GaFS). Patient-based measures included D3,4MF-scores for dental status and the Community Periodontal Index of Treatment Need (CPITN) for periodontal status. Thirty-two individuals (8.6%) showed DAS-scores of 13 or 14 (anxious), while 4.6% had a DAS-score > or = 15 (highly anxious/phobic). Highest DAS-values were measured among patients' aged 19-29 (n = 262). DMFS-values of anxious and less anxious patients showed only minor differences. However, anxious patients had significantly more carious lesions (P < 0.001). CPITN periodontal values showed no significant differences between both groups. 89.2% of less anxious individuals and 79.6% of anxious patients went for regular dental check-ups. Thus, every tenth patient was considered to have high dental anxiety. Anxiety results in avoidance behaviour, which can only be discovered upon compulsory examinations and which is associated with higher caries morbidity and need for oral rehabilitation. As anxiety has a direct influence on oral health, it should be detected and accounted for in a treatment concept integrating dental and cognitive-behavioural therapeutic approaches.
Article
The authors conducted two pilot studies that investigated the roles of hypnotizability, absorption (defined as the ability to maintain focused attention on a task or stimulus) and state versus trait anxiety as predictors of dental anxiety. One of the studies also examined the effectiveness of hypnosis in managing dental anxiety. Participants in study 1 completed measures of hypnotizability and anxiety, viewed a video of a dental procedure either under hypnosis or not, and completed dental anxiety questionnaires. Participants in study 2 were told either that the video showed major dental work or a routine polishing. All subjects watched the video and then completed measures assessing their perceptions of the video and their anxiety. The authors found a positive relationship between hypnotizability and scores on the Dental Anxiety Scale (DAS) (F(1,290) = 3.45, P = .06), as well as an interaction between hypnotizability and hypnosis (F(1,290) = 6.55, P = .01). An analysis of covariance found a relationship between trait and dental anxiety (F(1,290) = 11.50; P = .001). A two-way analysis of variance found a main effect for hypnosis (F(1,290) = 3.20, P = .07). The authors found an effect for group on the DAS (F(1,228) = 3.67, P = .057), such that subjects in the negative-cognition group scored higher on the DAS. The authors found an interaction between absorption and cognition in perceptions of pain experienced by the patient in the video (F(1,228) = 3.70, P = .05) and in ratings of one's own pain level if in the same situation (F(1,228) = 4.38, P < .05). Hypnotizability or absorption, pre-existing anxiety and cognitions about dental procedures predict dental anxiety, and hypnosis may be helpful for some, but not all, patients. Characteristics such as hypnotizability, trait anxiety and negative cognitions predict which people develop dental anxiety and who will be more responsive to hypnosis. The authors provide suggestions for dentists treating anxious patients.
Article
1. In searching for biological evidence that essential hypertension is caused by chronic mental stress, a disputed proposition, parallels are noted with panic disorder, which provides an explicit clinical model of recurring stress responses. 2. There is clinical comorbidity; panic disorder prevalence is increased threefold in essential hypertension. Plasma cortisol is elevated in both. 3. In panic disorder and essential hypertension, but not in health, single sympathetic nerve fibres commonly fire repeatedly within an individual cardiac cycle; this appears to be a signature of stress exposure. For both conditions, adrenaline cotransmission is present in sympathetic nerves. 4. Tissue nerve growth factor is increased in both (nerve growth factor is a stress reactant). There is induction of the adrenaline synthesizing enzyme, phenylethanolamine-N-methyltransferase, in sympathetic nerves, an explicit indicator of mental stress exposure. 5. The question of whether chronic mental stress causes high blood pressure, still hotly debated, has been reviewed by an Australian Government body, the Specialist Medical Review Council. Despite the challenging medicolegal implications, the Council determined that stress is one proven cause of hypertension, this ruling being published in the 27 March 2002 Australian Government Gazette. This judgement was reached after consideration of the epidemiological evidence, but in particular after review of the specific elements of the neural pathophysiology of essential hypertension, described above.
  • C Mejía-Rubalcava
C. Mejía-Rubalcava et al. / Complementary Therapies in Clinical Practice 21 (2015) 282e286