Music therapy and aromatherapy on dental anxiety and fear: A randomized controlled trial

The effectiveness of combining interactive media based cognitive behaviour therapy with art and music therapies for ameliorating the generalised anxiety disorder of children exposed to abduction

The researchers examined the efficacy of integrating interactive media-based cognitive behaviour in conjunction with art and music therapy for treating generalised anxiety disorder (GAD) in children abducted in Nigeria. A randomised control trial was carried out using three randomly selected secondary schools in Northern part of Nigeria. The study sample comprised 450 students randomly divided into a control group of (n = 225) and an experimental group of (n = 225). The treatment group was randomly selected into (n = 56) each for cognitive behaviour, art, and music therapy. While CBT + art and music had (n = 57) participants. This study's finding shows that cognitive behaviour therapy combined with art and music delivered through interactive media may be superior for treating paediatric GAD, than using only either CBT, art or music therapy. Participants who were assigned to a combined therapy that involved integrating CBT, music and art therapies reported a lower level of GAD, compared to those who were assigned to either CBT, art, or music alone. However, a cost benefit analysis points to the adopting of CBT in treating the GAD of children kidnapped. This study concluded with some implication for theory and health promotion.

Effect of music intervention on dental anxiety and fear: A bibliometric analysis of RCTs from 2004 to 2024

BACKGROUND

Dental treatments, especially invasive procedures, often induce anxiety and fear, impacting future treatment adherence. Music intervention, a non-pharmacological approach, has shown promise in reducing anxiety and enhancing well-being, but further research is needed to explore its application in dental settings and the influence of factors like music type, duration, and volume.

OBJECTIVE

To assess the effects of music interventions on dental anxiety and fear, analyze research trends, and identify knowledge gaps through a bibliometric analysis of randomized controlled trials.

METHODS

Data from eligible studies were extracted through a comprehensive search. Descriptive bibliometrics, citation analysis, and keyword analysis were performed to assess research outputs, distribution, hotspots, and trends. Different human development indices (HDI) were used to analyze variations in publication year, sex distribution, and interventions across countries.

RESULTS

This study included 46 randomized controlled trials (RCTs) from 2004 to 2024, with a mean annual growth rate of 5.95 %. India, Japan, and Turkey led the research output and citations. Approximately 4112 participants, with 45.68 % males were enrolled. Most RCTs focused on adults (65.22 %) and used passive music interventions (73.91 %). The most common treatment was dental extraction (39.13 %), with classical music being the predominant intervention (60.87 %). The control group were often blank (80.43 %). Various indicators of anxiety and fear have been reported. Significant differences were found in the sex distribution among the different HDI ranks (p < 0.001).

CONCLUSIONS

This study outlined the research profile of music interventions for reducing anxiety and fear during dental treatments, with India, Japan, and Turkey leading in terms of output. The most frequently studied intervention is classical music, which is typically used preoperatively. Notable sex distribution differences were observed across HDI groups. Future research trends should include more extensive trials, personalized interventions, standardized guidelines, and enhanced collaboration to optimize patient engagement and emotional regulation.

Effect of music therapy on relieving the pain and distress of children undergoing venipuncture: A systematic review and meta-analysis

BACKGROUND

Venipuncture is a routine procedure in pediatrics that often elicits pain and triggers adverse emotional responses. The stress, both psychological and physiological, that accompanies this procedure can significantly impair pediatric patients' compliance with medical regimens. To mitigate these effects, music therapy as a non-pharmacological approach known for its safety has been increasingly employed in pediatric settings. There is empirical evidence supporting the efficacy of music therapy in reducing procedural pain and in easing negative emotions experienced by pediatric patients.

OBJECTIVE

This study aimed to evaluate the effectiveness of music therapy in managing pain, anxiety and distress in pediatric patients undergoing venipuncture procedures.

METHODS

A comprehensive search was conducted on PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, EBSCO and FMRS databases for articles published up to December 20, 2024. Two reviewers independently selected studies and extracted articles that met strict inclusion and exclusion criteria. Quality assessments of the included studies were performed according to the Cochrane risk assessment tool, data analysis was performed using RevMan 5.3 software.

RESULTS

A total of 16 studies including 657 participants in the intervention group and 707 participants in the control group were selected for the final analysis. The results demonstrated a significant difference between the music groups and control groups for children's self-reported pain (standard mean difference SMD = -0.42, 95 % CI -0.58 to -0.27, P < 0.05), observer-reported pain (SMD = -0.52, 95 % CI -0.87 to -0.17, P < 0.05) and distress (SMD = -0.70, 95 % CI -1.27 to -0.13, P = 0.02). However, no significant difference was observed in anxiety (SMD = -0.10, 95 % CI -0.32 to 0.13, P = 0.41).

CONCLUSIONS

Pediatric patients undergoing venipuncture procedures would benefit from music interventions for pain and distress relief. However, no statistically significant effect was found on anxiety.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42024509600.

The effect of audio distraction in reducing signs of stress and anxiety during pediatric dental treatment: a systematic review and meta-analysis

AIM

To perform a systematic review to investigate if the use of audio distraction reduces signs of stress and anxiety in paediatric patients undergoing dental treatment.

MATERIALS AND METHODS

Search was made in electronic databases (MEDLINE, Scopus, Embase, Web of Science, Scielo, BVS, Springer Link, Science Direct, Cochrane Library, and grey literature) until March 11th, 2024. The eligibility criteria were: paediatric patients under dental treatment; use of audio as a distraction method; comparison between groups with and without use of audio distraction; Clinical trials. The outcomes measured were alterations in the anxiety, fear and/or stress levels. Evaluation of the risk of bias and assessment of the certainty of the evidence (GRADE) were performed. Meta-analysis was conducted for four outcomes, considering 95% confidence interval (CI), random effects and heterogeneity from Tau².

RESULTS

From 5,495 results, 25 studies composed the narrative sample and 12 composed the meta-analysis. High risk of bias was generally observed. Three results from the meta-analysis showed high heterogeneity and some outcomes presented a statistical association: systolic blood pressure reduction (p = 0.52; CI= -6.05 [-7.50 to -4.60]), pulse rate (p < 0.00001; CI= -4.95 [-9.95 to -3.52]), Venham's test scores (p < 0.00001; CI= -1.24 [-1.79 to -0.68]), and oxygen saturation (p < 0.00001; CI = 0.14 [-0.04 to 0.33]). The outcomes presented "very low" and "low" certainty of evidence.

CONCLUSION

Although a low certainty of evidence was observed, our study suggests that audio may be an effective alternative for reducing stress and anxiety and pain perception during non-invasive treatments. Future well-designed studies are necessary.

CLINICAL RELEVANCE

Audio distraction presents a potential role as an efficient method to reduce stress in children undergoing dental treatment. More RCTs are necessary to improve the evidence level, considering the main variables related to audio distraction.

Comparative efficacy of non-pharmacological interventions for anxiety in adult intensive care unit patients: A systematic review and network meta-analysis

BACKGROUND

The primary goal of the intensive care unit is to the anxiety of conscious patients is often ignored in the care unit.

AIM

The purpose of this study was to assess the efficacy of various non-pharmacological therapies for anxiety disorders in adult patients in the intensive care unit, in order to enhance humanistic care in the intensive care unit and to promote the patients' physical and mental recovery together.

STUDY DESIGN

We conducted a systematic and comprehensive search of the literature in five databases (including the Cochrane Library, PubMed, EBSCO, Web of Science, and Embase) covering nearly a decade for randomized controlled trials of non-pharmacological therapies to reduce anxiety in adult intensive care unit patients. Two researchers independently assessed the quality of the literature, collected and condensed the data, and used STATA software to perform a network meta-analysis. The ranking probabilities for each intervention were calculated using the Surface under the Cumulative Ranking (SUCRA) method. The study protocol was registered with PROSPERO.

RESULTS

This study ultimately included 26 randomized controlled trials involving 2791 adult ICU patients. Non-pharmacological interventions for anxiety in adult ICU patients included music therapy, aromatherapy, ICU diary, virtual reality, massage therapy, monitoring room diary, and health education. when compared to the control group (usual care), aromatherapy + music therapy [MD = -2.65, 95% CI (-4.76, -0.54)] (P = 0.0137) and music therapy [MD = -1.77, 95% CI (-3.40, -0.13)] (P = 0.0338) were superior in reducing anxiety in adult ICU patients. The results of the network meta-analysis showed that aromatherapy combined with music therapy significantly alleviated anxiety in adult ICU patients (SUCRA: 99.8%).

CONCLUSIONS

Music therapy combined with aromatherapy has demonstrated superior effectiveness compared to other non-pharmacological interventions for reducing anxiety in awake adults in the ICU. However, the underlying mechanisms of this combined therapy require further exploration.

RELEVANCE TO CLINICAL PRACTICE

Future research on the use of music therapy combined with aromatherapy in the care unit may help reduce anxiety in patients while fostering their physical and mental healing; however, individual variances and unique clinical circumstances must be considered.

The Effect of Music Distraction on Dental Anxiety During Invasive Dental Procedures in Children and Adults: A Meta-Analysis

Background: Dental anxiety and odontophobia are common issues, leading to challenges with oral hygiene and dental health. Music distraction offers an effective and side effect-free solution to alleviate pain and increase the acceptability of dental treatments. Our meta-analysis aimed to assess the efficacy of music distraction in reducing patient anxiety during invasive dental procedures in children and adults. Methods: The PubMed, Web of Science, and Embase databases were searched for clinically controlled trials, using the keywords "music" and "dental anxiety". The main outcome measured was the anxiety score. A meta-analysis was conducted using a random-effects model to estimate the standardized mean differences (SMDs). The subgroup analyses were conducted based on age groups, music preferences, and music styles. The research protocol has been registered with PROSPERO (Registration ID: CRD42022357961). Results: A total of 24 controlled clinical trials involving 1830 participants met the inclusion criteria for the meta-analysis. Music distraction significantly reduced dental anxiety during invasive procedures under local anesthesia (SMD, -0.50; 95% CI, -0.80 to -0.21; p = 0.0009; I2 = 83%). Our subgroup analysis revealed that music distraction was more effective in adults (SMD, -0.51; p = 0.0007) than in children (SMD, -0.47; p = 0.13) in reducing dental anxiety. Regarding music selection, music chosen by the participant (SMD, -1.01; p = 0.008) demonstrated more anxiolytic effects than by the author (SMD, -0.24; p = 0.02). Regarding music styles, classical music (SMD, -0.69; p = 0.009) was associated with better anxiolytic effects in adults. Conclusions: Our meta-analysis supports the use of music to alleviate dental anxiety during invasive procedures. Listening to classical or customized music can serve as an effective adjunct to outpatient surgical care in dental clinics.

Non-pharmacological interventions for reducing dental anxiety in pediatric dentistry: a network meta-analysis

BACKGROUND

Child dental anxiety is a prevalent issue in the field of pediatric dentistry. At present, several non-pharmacological interventions are employed to mitigate anxiety during dental treatments for children. The objective of this study is to assess the effectiveness of diverse non-pharmacological interventions in reducing dental anxiety, as well as enhancing heart rate during pediatric dental treatments. To achieve this, we conducted a systematic review and a network meta-analysis (NMA) to compare the efficacy of various outcome indicators.

METHODS

A thorough search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, Scopus, APA PsycInfo, CINAHL, and AMED to identify all eligible randomized controlled trials (RCTs) from the beginning of the databases up to August 1, 2024. The quality assessment was carried out using the Cochrane Collaboration's bias risk tool. The two outcome measures under consideration were dental anxiety and heart rate. Network graphs, league tables and SUCRA were constructed using R 4.2.3 software and Stata 16 software. This study is registered in PROSPERO under the registration number CRD42023467610.

RESULTS

The study examined 12 different non-pharmacological approaches, drawing from a pool of 61 research studies involving 6,113 participants aged 4 to 16 years. The results of the network meta-analysis revealed that music (SUCRAs: 93.60%) proved to be the most effective measure in mitigating dental anxiety, followed by aromatherapy (SUCRAs: 78.58%) and game (SUCRAs: 70.99%). Moreover, hypnosis (SUCRAs: 98.80%), music (SUCRAs: 79.58%), and relaxation (SUCRAs: 72.41%) were identified as the top three interventions for decreasing heart rate.

CONCLUSION

In this NMA, when contemplating dental anxiety outcomes, music is recommended as a priority. For heart rate outcomes, hypnosis may be a preferred measure. However, owing to the limited number of articles, the conclusion of this study still requires additional confirmation or correction through more high-quality primary studies in the future.

Recent Developments in the Non-Pharmacological Management of Children's Behavior Based on Distraction Techniques: A Concise Review

Oral diseases and conditions affect children's oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological behavior management strategies, such as distraction techniques, are commonly adopted to manage children's behaviors. Distraction techniques have been developed rapidly in recent years and are widely accepted by both health professionals and parents due to their noninvasive and low-cost nature. This concise review aims to summarize current distraction techniques applied during dental treatments, especially for children. The most commonly reported techniques for children are audio distraction, audio-visual distraction, tactile distraction, olfactory distraction, and gustatory distraction. Audio distraction techniques involving music and storytelling help children relax. Audio-visual distraction techniques help to divert children's attention from the dental treatment. Tactile stimuli can reduce the transmission of pain signals. Olfactory stimuli can help children feel comfortable and relaxed. Gustatory distraction involving sweet substances can create a positive environment. These distraction techniques effectively reduce DFA in children and improve their satisfaction with dental procedures. As technology continues to develop, further research is needed to provide more robust, evidence-based guidance for dentists using distraction techniques.

Efficacy of music therapy on stress and anxiety prior to dental treatment: a systematic review and meta-analysis of randomized clinical trials

Introduction

Stress and anxiety are emotional states that often accompany patients who have to receive dental treatments, leading them to postpone or avoid treatments with the consequent deterioration of their oral health and, hence, their general condition. Music therapy has been shown to be an alternative to other treatments that are invasive and not without danger, such as anxiolytics or sedation. This systematic review and meta-analysis evaluated the effect of music therapy on anxiety and stress prior to dental treatments.

Methods

Studies published in PubMed (through Medline), Web of Science (WOS), Embase, and Cochrane Library databases were consulted up to October 2023. The inclusion criteria were established for intervention studies (randomized controlled trials, RCTs) according to the PICOS (population, intervention, comparison, outcomes, and study) strategy in subjects with dental stress and anxiety (participants) treated with music therapy (intervention) in comparison with patients without music therapy (control) and evaluating the response to treatment (outcomes).

Results

A total of 154 results were obtained, with 14 studies finally selected. The risk of bias and the methodological quality were assessed using the Cochrane Risk of Bias Tool and the Jadad scale, respectively. A random-effects meta-analysis was used to quantify the results of the pooled studies, while a fixed-effects meta-analysis was used for studies in the pediatric population. The meta-analysis of pooled studies found statistical significance in the subgroups of anxiety and anxiety-stress (p = 0.03 and p = 0.05, respectively), with an overall effect in favor of the intervention group (p = 0.005). Meta-analysis of the studies in the pediatric population showed considerable statistical significance for the experimental group (p < 0.00001).

Conclusion

Music therapy as a treatment for stress and anxiety, prior to dental treatment, proved to be effective in both children and adults although more well-designed randomized clinical studies are needed to validate its efficacy.

Systematic review registration

INPLASY, identifier 202312000.

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

AIM

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Assessment of Different Distraction Behavioral Methods in Pediatric Dental Clinic: A Systematic Review

Dental anxiety is one of the main problems dentists may face during the treatment of pediatric dental patients; therefore, clinicians tend to perform different behavior management techniques to reduce dental anxiety in children. This review aimed to systematically compare and evaluate the published literature regarding the effects of distraction techniques on anxiety, pain perception, and patient experience during dental practice. A detailed electronic search was conducted on 3 databases including PubMed, Google Scholar, and Cochrane Library. The databases were searched for articles published in the English language between 2015 and 2022. Among 102 studies, 27 studies fulfilled the criteria of eligibility and were included in this study to be analyzed. Numerous approaches have been proposed for the reduction of dental anxiety, out of which the use of audio-visual aids and instruments, active distraction such as tablets, smartphones, and virtual reality glasses showed governance in decreasing the children's anxiety followed by cognitive and behavioral methods.

Efficacy of Music Intervention for Dental Anxiety Disorders: A Systematic Review and Meta-Analysis

Objective To evaluate the effectiveness of music therapy for dental anxiety disorders. Methods In order to gather clinical randomized controlled trials comparing the effectiveness of music interventions to traditional oral manipulation in patients with dental anxiety disorders, computer searches of the electronic databases of Wanfang, CNKI, VIP, PubMed, Web of Science, ScienceDirect, Cochrane library, Scopus, and CINAHL were conducted. The search period covered from 23 December 2022, through to the development of the database. The Cochrane Handbook was used to assess the quality of the included literature, and two researchers independently conducted the literature screening and data extraction. Stata 17.0 and RevMan 5.3 were used to conduct the meta-analysis. Results The preoperative baseline levels of the music intervention group were similar to those of the control group (p > 0.05), according to the meta-analysis, and music intervention significantly decreased heart rate (I² = 81.2%, WMD (95% CI): -7.33 (-10.07, -4.58), p < 0.0001), systolic blood pressure fluctuations (I² = 85.6%, WMD (95% CI): -6.10(-9.25, 2.95), p < 0.0001), diastolic blood pressure (I² = 79.7%, WMD (95% CI): -4.29(-6.57, -2.02), p < 0.0001) fluctuations, anxiety scores (I² = 19.6%, WMD (95% CI): -9.04(-11.45, 6.63), p < 0.0001), and pain scores (I² = 32.7%, WMD (95% CI): -7.64(-9.43, -5.85), p < 0.0001), as well as significantly lowered anxiety and pain levels and raised patients' cooperation rates (I² = 0%, OR (95% CI): 3.03(1.24, 7.40), p = 0.02). Conclusions Music interventions are effective for dental anxiety disorders, but given the limitations of the study, more multicenter, large-sample, high-quality randomized controlled trials are needed to further validate the findings and obtain more objective and reliable clinical evidence.