Dental patient anxiety: Possible deal with Lavender fragrance

Effect of Lavender Oral Drops in Reducing Dental Anxiety Among Patients Requiring Endodontic Treatment: A Randomised Clinical Trial

OBJECTIVE

Patients requiring endodontic treatment often experience high levels of anxiety. The aim of this research is to investigate the effect of oral administration of lavender on the anxiety score of these patients.

METHODS

In this double-blinded randomized clinical trial conducted in 2021, 64 patients with symptomatic irreversible pulpitis were recruited using a simple random sampling technique. Blinding was achieved for both the patients and the evaluators. The samples were split into intervention and control groups using a table of random integers to randomize them. An hour before the commencement of the procedure, the patients filled out the dental anxiety questionnaire. Twenty drops of water in 250 ml of water were given to the control group, whereas 20 drops of lavender extract added to 250 ml of water were given to the intervention group. Two groups completed the anxiety questionnaire 60 minutes after ingesting the remedies. To analyse the data, paired and independent t-tests, and multiple regression analysis were used.

RESULTS

64 patients were randomized and analyzed. Thirty-two of them who were in the control group experienced a substantially smaller decrease in their dental anxiety score compared to those 32 patients who were in the control group (p=0.001). This difference persisted even after grouping individuals by age, sex, and weight.

CONCLUSION

The administration of oral lavender extract drops to individuals requiring endodontic treatment appeared to significantly reduce their dental anxiety scores. The research registration number in the Iranian Registry of Clinical Trials is IRCT20120908010773N2, which is available at https: //irct.behdasht.gov.ir/. (EEJ-2024-03-50).

Neurofeedback Technology Reduces Cortisol Levels in Bruxismitle Patients: Assessment of Cerebral Activity and Anxiolytic Effects of Origanum majorana Essential Oil

Cerebral activities were measured during 21 essions in NeurOptimal (NO)-trained patients with bruxism. Salivary cortisol levels were quantified for each six training sessions (session 1, 6, 12, 18, 21) in 12 patients with bruxism after performing their pre- and post-NeurOptimal sessions. Their cortisol levels were compared with controls (without stress). We evaluated whether NO overtraining could reduce stress in bruxism after 21 repeated sessions with/without Origanum majorana inhalation by using nasal impregned filters with this essential oil (n = 12). This study enrolled 89 participants (590 salivary samples for cortisol assessment by ELISA ng/mL). Salivary samples were collected at several NO learning sessions (session 1, 6, 12, 18, and 21). In the present study, we assessed whether Origanum majorana essential oil exposure during 21 NO training sessions can promote anxiolytic effects by reducing cortisol levels in Bruxismitle patients or modulate their brain activities. The experimental design also included control subjects without NO training (n = 30) and unstressed participants without bruxism, as well as trained NeurOptimal (n = 5) participants during the 21 sessions, also including control subjects without stress. In our study, NeurOptimal post-training decreased cortisol levels in Bruxismitle patients, reducing stress scores on the Hamilton II scale after 21 NO sessions; finally, Origanum majorana essential oil exposure during NO training could enhance anxiolytic effects of repeated NO in Bruxismitle patients. The parameter divergence as an index of cerebral activity evaluates the reached difference between cerebral activity at pre-learning (PRE) minus post-training (POST) values in Bruxismitle participants with/without Origanum majorana odor exposure during each NO training sessions. As a consequence of NO overtraining, these cerebral activities fluctuate reaching a calm state while anxious states are associated with high divergences. The reduction in divergences when they are close to zero by habituation means a final calm state is reached by NO overtraining, while higher divergences mean anxiogenic states. Collectively, Origanum majorana essential oil inhalation during NO training could decrease salivary cortisol levels after 21 NO training sessions in Bruxismitle.

Evaluation of lavender and rose aromatherapies on the success of inferior alveolar nerve block in symptomatic irreversible pulpitis: A randomized clinical trial

Trial design

This is a prospective, block-randomized, blinded, multiple arm and parallel-group superiority clinical trial.

Methods

Seventy-eight patients satisfying the recruitment standards, were randomly allocated into three groups as follows: Group I (n = 26) - Inferior alveolar nerve block (IANB) devoid of aromatherapy (AT); Group II (n = 26) - IANB with lavender AT and Group III - IANB with rose AT (n = 26) with the help of the ultrasonic aroma diffuser (with respective oils)for 20 min/2 h in operatories 1,2 and 3 respectively. For AT, 3-4 drops of lavender and rose-conditioned oils were added from a 100 ml solution containing 100 mg of these medicinal plants. The pre-operative (PRO) and access opening (AO) pain as well as the anxiety of patients were recorded using the Visual Analog Scale (VAS) and Modified Dental Anxiety Scale (MDAS) respectively. Data thus obtained was entered into the Excel sheet and subjected to statistical tests (analysis of variance and paired t-test). The p-value less than 0.05 was considered statistically significant.

Results

Group I showed non-significant disparity between PRO and AO for both VAS as well as MDAS (p = 0.62, p = 0.71). However, group II (p = 0.04, p = 0.02) and group III (p = 0.03, p = 0.01) revealed significant differences between PO - AO VAS and MDAS. MDAS and VAS intergroup comparison revealed a significant difference among groups I and II (p = 0.03, p = 0.04), and groups I and III (p = 0.02, p = 0.03). However non-significant disparity was observed among groups II and III (p = 0.85, 0.34). Moreover, there was a statistically significant reduction in anxiety levels in females compared to males after rose AT (p = 0.02). Nevertheless, groups I and II did not show any gender predilection for anxiety as well as pain.

Conclusion

Alleviation of dental anxiety as well as reduction in pain during AO of teeth with SIP can be achieved using Lavender and rose AT. In female patients, rose AT can be preferred over lavender AT.

Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials

This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.

Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent)

Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

TRIAL REGISTRATION

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

Comparative Evaluation between Lavender Essential Oil and Patchouli Essential Oil in Aromatherapy and Its Effect on Dental Anxiety in Children

Introduction

Dental fear and anxiety is the most common distressing problem for children. Management of dental anxiety in children is one of the most difficult tasks in dentistry. Recently, alternative and contemporary medical approaches such as aromatherapy have received much attention. The potential effects of essential oils such as lavender and patchouli have been found to reduce anxiety, improve mood, and increase sedation. Thus, the study was conducted to compare the evaluation of lavender and patchouli essential oils used in aromatherapy and their effect on dental anxiety in children.

Aim

To compare the efficacy of lavender and patchouli essential oils in aromatherapy and its effect on dental anxiety in children.

Materials and methods

A total of 60 children between 6 and 12 years were randomly allocated to either an experimental or control group that received lavender and patchouli before dental treatment. Child anxiety was measured by using the Chotta Bheem-Chutki scale. A pulse oximeter was used to record the pulse rate. Data was tabulated and analyzed by Statistical Package for the Social Sciences (SPSS) software.

Results

There was a significant reduction in anxiety score and pulse rate between the intervals. Statistical differences were observed in the lavender group compared to patchouli oil.

Conclusion

The positive effects of both lavender and patchouli oil on children can be used to reduce anxiety in children. In our study, lavender oil showed slightly better results than patchouli oil.

How to cite this article

Tripathy S, Kohli A, Sharma K, et al. Comparative Evaluation between Lavender Essential Oil and Patchouli Essential Oil in Aromatherapy and Its Effect on Dental Anxiety in Children. Int J Clin Pediatr Dent 2023;16(5):681-685.

Revisiting the Therapeutic Effects of Essential Oils on the Oral Microbiome

The extensive use of antibiotics has resulted in the development of drug-resistant bacteria, leading to a decline in the efficacy of traditional antibiotic treatments. Essential oils (EOs) are phytopharmaceuticals, or plant-derived compounds, that possess beneficial properties such as anti-inflammatory, antibacterial, antimicrobial, antiviral, bacteriostatic, and bactericidal effects. In this review, we present scientific findings on the activity of EOs as an alternative therapy for common oral diseases. This narrative review provides a deeper understanding of the medicinal properties of EOs and their application in dentistry. It not only evaluates the effectiveness of these oils as antibacterial agents against common oral bacteria but also covers general information such as composition, methods of extraction, and potential toxicity. Further nonclinical and clinical studies must be conducted to determine their potential use and safety for treating oral diseases.

The Menstrual Cycle Phase and Effect of Aromatherapy on Orthodontic Debonding Pain

Objectives: The aim of this prospective clinical study was to evaluate the effects of the menstrual cycle phases and aromatherapy on women's perception of orthodontic debonding pain. Materials and Methods: The materials of our study were consisted of randomly selected 48 female patients (mean age:19.00±3.40). Four different study groups were performed. LA+; the patients in the luteal phase and received aromatherapy(n=12), LA-; the patients in the luteal phase and did not receive aromatherapy(n=13), FA+; the patients in the follicular phase and received aromatherapy(n=11), FA-; the patients in the follicular phase and did not receive aromatherapy(n=12). Debonding was performed and the pain experience for each tooth was scored by the patient on a visual analogue scale (VAS). Also, participants' general responses to pain were assessed with the Pain Catastrophizing Scale (PCS). The aromatherapy protocol was to inhale lavender oil from approximately 30 cm for 3 minutes, 3 minutes before debonding. Results: It was found that the mean VAS scores were higher in the luteal phase than in the follicular phase, however this difference was not statistically significant. There was no statistically significant difference between the groups with and without aromatherapy in terms of VAS scores(P>0.05). The correlation between total PCS scores and total VAS scores was statistically significant (r=0.310, P

Impact of Lavender on Pain and Anxiety Levels Associated With Spine Procedures

Background: To reduce pain and anxiety associated with interventional pain procedures, sedation is often used, with benzodiazepines, opioids, and propofol the most commonly used classes of drugs for sedation. However, patient coherence and ability to communicate procedural pain and abnormal sensations help prevent adverse outcomes. Therefore, discovering alternative therapies to mitigate the anxiety and pain associated with these procedures and to minimize risk is important. The aim of our study was to investigate whether lavender has an effect on pain and anxiety associated with lumbar epidural steroid injections and lumbar medial branch blocks.

Methods: In this randomized controlled study, 54 subjects were randomly assigned to 1 of 3 intervention groups, and 46 patients were included in the final analysis: experimental lavender group (n=17), control almond oil group (n=15), and placebo sterile water group (n=14). Patients wore a mask infused with either lavender, almond oil, or water for 5 minutes prior to and during their procedure. Patients rated their anxiety using the State-Trait Anxiety Inventory prior to and after the procedure based on how they felt during the procedure. Patients rated their pain according to the numerical rating scale. Outcome measures were a comparison of pain among the 3 groups and a comparison of the change in anxiety before and after the procedure among the 3 groups.

Results: The lavender group demonstrated the highest mean change in anxiety scores (9.9) compared to almond oil (5.3) and water (3.6) preprocedurally vs postprocedurally. The lavender group also reported the lowest mean pain level (3.8) compared to almond oil (5.6) and water (5.6). However, none of the differences between groups showed statistical significance at the P<0.05 level.

Conclusion: Lavender may have a clinically beneficial effect on anxiety levels and pain reduction.

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

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

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

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

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

Effects of Lavender on Anxiety, Depression, and Physiological Parameters: Systematic Review and Meta-Analysis

PURPOSE

The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics.

METHODS

A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression, or physiological parameters in humans. We assessed the risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias-corrected standardized mean difference as effect size metric, Hedges' ĝ for all outcomes.

RESULTS

Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' ĝ = -0.72, 95% confidence interval [CI] -0.90 to -0.55, p value <.001), depression (Hedges' ĝ = -0.43, 95% CI, -0.59 to -0.27, p value <.001), and systolic blood pressure (Hedges' ĝ = -0.23, 95% CI, -0.41to -0.05, p value = .01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p value = .187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p value = .055), and participants' health state accounted 8.9% (p value = .131) for the variance in anxiolytic effects.

CONCLUSION

Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on the effect of lavender on depression were scarce. Future trials on depression and physiological parameters are recommended, and increasing the sessions of administration is recommended.

Role of Essential Oil-Based Mouthwashes in Controlling Gingivitis in Patients Undergoing Fixed Orthodontic Treatment. A Review of Clinical Trials

Essential oil (EO)-based mouthwashes have been used for oral health maintenance due to their antimicrobial and anti-inflammatory properties. The aim was to review clinical trials that assessed the role of EO-based mouthwashes in controlling gingivitis in patients undergoing fixed orthodontic treatment (OT). The Patients, Interventions, Control and Outcome (PICO) format was based on the following: (a) P: Patients undergoing fixed OT (b) Intervention: EO-based mouth-wash; Control: Mouthwashes that did not contain EOs or no mouthwash (d) Outcome: Control of gingivitis measured by clinical indices. Databases were searched manually and electronically up to and including May 2021 using different medical subject subheadings. Data screening and extraction were performed. The risk of bias within randomized controlled trials was assessed using the revised Cochrane Collaboration’s risk of bias tool (RoB 2). The Risk of Bias In Non-randomized Studies—of Interventions (ROBINS-I) tool was used for non-randomized controlled trials. Disagreements related to literature search and RoB evaluations were resolved via discussion. Six clinical studies were included. Four studies showed that Listerine^® is effective in controlling gingivitis in patients undergoing fixed OT. One study reported that the use of 5% Fructus mume mouthwash resulted in a significant reduction in gingival bleeding. Two mouthwashes that contained 1% Matricaria chamomilla L. and 0.5% Zingiber officinale were also found to be efficient in controlling gingival bleeding. Four, one and one studies had a low, moderate and high RoB, respectively. In conclusion, EO-based mouthwashes seem to be effective for the management of gingivitis among patients undergoing fixed OT. Further well-designed and power-adjusted clinical trials are needed.

Is aromatherapy associated with patient's dental anxiety levels? A systematic review and meta-analysis

The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited evidence regarding its efficacy. The present meta-analysis is an attempt to assess the association between the use of aromatherapy and anxiety levels among dental patients. A comprehensive search was conducted across Medline, Scopus, Web of Science, EBSCO host, Cochrane databases, and Google Scholar for studies evaluating aromatherapy and anxiety level among dental patients. PRISMA guidelines were followed for the meta-analysis. Randomized and cluster-randomized trials comparing aromatherapy with controls were included. The random-effects model was used to assess the mean differences in anxiety levels of patients visiting dental OPD. The significance value was set at P < 0.05. Six studies were identified that met the requirements for inclusion. Aromatherapy was significantly associated with reduction in patient anxiety levels during dental treatment (pooled mean difference: −3.36 [95% CI, −3.77 – −2.95, P = 0.00001). Low heterogeneity was noted between studies (I² = 1%, P = 0.41) analyzed in the meta-analysis. High certainty of the evidence was obtained from the association between the use of aromatherapy and dental anxiety. This meta-analysis suggests that aromatherapy is effective in reducing dental anxiety. When used judiciously, the results of this work should encourage the use of aromatherapy to reduce patient anxiety levels during dental procedures

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

OBJECTIVES

To evaluate the efficacy of aromatherapy on dental anxiety.

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND AND PURPOSE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

The Effect of Lavender Aroma on Anxiety of Patients Having Bone Marrow Biopsy

Introduction:

Bone marrow biopsy is a common procedure for the diagnosis and treatment of hematologic diseases and tumors, which are associated with anxiety. The purpose of this study was to examine the effect of lavender aroma on anxiety of patients having bone marrow biopsy.

Materials and Methods:

This study was performed on 80 patients referred to Vali-e-Asr Hospital for bone marrow biopsy. Samples were selected by convenience method and were assigned into intervention and control groups using randomized blocks of 4. Random sequence was generated by RAS software. Several drops of distilled water on a cotton ball was used in the control group and same amount of lavender essential oil on a cotton ball was used in the intervention group. Then, participants in both groups were asked to smell the cotton ball for 15 minutes and then, their anxiety level was measured immediately. The results were analyzed by SPSS software version 25 using covariance analysis and rank regression.

Results:

The results showed that, the mean scores of anxiety in the control and intervention groups were 6.3 ± 1.92 and 3.75 ± 1.05, respectively. There was a significant difference (p <0.05) between the two groups in terms of anxiety score.The results showed that there was a significant difference in anxiety score between two groups in terms of variables such as age, gender, physician experience, biopsy history and biopsy site (P <0.05). The results also showed no significant difference between the (p >0.05).

Conclusion:

The results of this study showed that bone marrow biopsy is associated with anxiety, and smelling of lavender aroma is effective in reducing anxiety in patients undergoing this procedure. This fragrance can be used by treatment team in hematology and oncology clinics to reduce anxiety caused by bone marrow biopsy.

Effect of Aromatherapy on Dental Anxiety Among Orthodontic Patients: A Randomized Controlled Trial

Introduction: Dental anxiety is a distressing challenge faced by both the patients and the dental care provider, particularly in the Department of Orthodontics. The goal of this study was to assess the effect of aromatherapy (oils) on dental anxiety level among orthodontic patients and to compare the effect on anxiety levels between lavender oil, rose oil, and a placebo.

Materials and methods: A total of 72 patients (36 men and 36 women) who reported to the Department of Orthodontics were selected and randomly allocated into three groups: lavender oil, rose oil, and placebo. The ambient odor of those oils or placebo was maintained with a candle warmer, and the patients were made to wait in their respective rooms for 15 minutes. Participants' heart rate and blood pressure, being reliable and objective indicators of anxiety, were measured using pulse oximeter and sphygmomanometer, respectively. Additionally, a questionnaire, comprising demographic data and questions representing a modified Dental Anxiety Scale, was given to the patients to measure subjective anxiety levels before and after aromatic therapy. Paired t-test, analysis of variance, and the Wilcoxon signed-rank test were used for both subjective and objective analyses.

Results: Lavender oil and rose oil produced a significant reduction of dental anxiety level among orthodontic patients in both objective and subjective method (P ≤ .05); lavender oil demonstrated a greater significance in reducing the anxiety level when compared to rose oil.

Conclusion: Our findings indicate that aromatherapy offers promising effect against dental anxiety among orthodontic patients. Aromatherapy can be recommended as an easy alternative to reduce anxiety in patients before orthodontic treatment.

Origanum majorana Essential Oil Inhalation during Neurofeedback Training Reduces Saliva Myeloperoxidase Activity at Session-1 in Bruxistic Patients

Introduction: Bruxism affects teeth and provokes sleep alterations. We evaluated whether saliva Myeloperoxidase (MPO) activity could be reduced after 21 neurofeedback training (NO) sessions in Origanum majorana (AE) bruxistic-treated patients (n = 12 patients, 120 saliva samples). The term divergence evaluates cerebral activity, which was compared between bruxistic patients with/without this essential oil exposure during 21 NO training sessions (n = 12, n = 120 saliva samples). The nasal filter used allow us to vehiculizate this Origanum majorana essential oil in patients. MPO activity was measured in six training NO sessions (Session S1, 6, 12, 18, 21). We included a total of 104 patients and 500 saliva samples. Results: there was a fast reduction in MPO activity after NO session-1 in bruxistic patients; divergence (an index of NO training brain efficacy) is the difference in cerebral activity found between pre-training and post-training levels. Thus, Divergence can fluctuate during NO training before reaching a final calm state after many sessions (21). Repeated NO training lead to habituation in so far as cerebral activity as well as MPO activity after 21 training sessions. Origanum majorana essential oil modulates cerebral activity at certain training sessions in bruxistic patients. Stress levels were reduced on the perceived stress scores (PSS: Cohen Scale) after 21 NO sessions than for those bruxistic without NO training sessions. Conclusions: MPO activity could predict stress level in bruxistic patients and repeated NO reduced their stress level; Origanum majorana essential oil enhanced these anxiolytic effects.

The Efficacy of Lavender Aromatherapy in Reducing Preoperative Anxiety in Ambulatory Surgery Patients Undergoing Procedures in General Otolaryngology

Background

Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low-risk and cost-effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology.

Methods

A prospective and controlled pilot study was conducted with 100 patients who were admitted to New York-Presbyterian/Weill Cornell Medical Center for ambulatory surgery from January of 2015 to August of 2015. The subjects were allocated to two groups; the experimental group received inhalation lavender aromatherapy in the preoperative waiting area while the control group received standard nursing care. Both groups reported their anxiety with a visual analog scale (VAS) upon arriving to the preoperative waiting area and upon departure to the operating room.

Results

According to a Welch's two sample t-test, the mean reduction in anxiety was statistically greater in the experimental group than the control group (p = 0.001).

Conclusion

Lavender aromatherapy reduced preoperative anxiety in ambulatory surgery patients. This effect was modest and possibly statistically significant. Future research is needed to confirm the clinical efficacy of lavender aromatherapy.

Level of Evidence

2b.

Television-based health promotion in general practice waiting rooms in London: a cross-sectional study evaluating patients' knowledge and intentions to access dental services

BACKGROUND

This study aimed to evaluate whether television-based dental health promotion initiatives in General Practice waiting rooms would increase patients' knowledge of and intentions to seek dental services.

METHODS

This cross-sectional survey of 2,345 patients attending 49 General Practices in Brent, northwest London, evaluated the 'Life Channel' - a series of six brief health promotion advertisements, including one dental health promotion advertisement, displayed over ten minutes on television in General Practice waiting rooms. Primary outcome measures were a self-reported gain in the knowledge to contact a National Health Service (NHS) and emergency dentist, and an intention to seek dental services, attributed to viewing the Life Channel.

RESULTS

Among the 1,088 patients who did not know how to contact an NHS dentist prior to the survey, and the 1,247 patients who did not know how to contact an emergency dentist prior to the survey, 48.0 % (95 % CI 45.0-51.0 %) and 35.1 % (95 % CI 32.4-37.8 %) attributed the Life Channel to educating them how to do so, respectively. Among the 1,605 patients who did not have any intention to contact a dentist prior to the survey, 15.2 % (95 % CI 13.4-17.0 %) attributed the Life Channel to creating such an intention. We report adjusted odds ratios on sociodemographic disparities in this evaluation.

CONCLUSIONS

Television-based dental health promotion may significantly increase knowledge of and intention to seek dental services in this sample in London. Television-based dental health promotion may appeal more to certain population groups. More research is needed to identify longer term outcomes of television-based health promotion.