Comparative evaluation of oxygen saturation levels using pulse oxymeter during nonsurgical and surgical periodontal therapy in chronic periodontitis patients

Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study

Background

Managing a child's anxiety is most critical for the success of treatment in the pediatric dental setup. Present trend advocates the use of non-aversive behavior management techniques.

Aim and objective

To compare and evaluate the efficacy of aromatherapy using orange essential oil with that of music distraction in the management of anxious pediatric dental patients.

Design

One hundred and fifty children of the age 6–8 years were divided into three groups of 50 each and performed restorative treatment under aromatherapy, with music distraction, without aromatherapy, or music distraction, respectively. Venham's picture test and facial image scale (FIS), pulse rate, respiratory rate, and oxygen saturation were recorded before and after the procedure.

Results

Compared with controls, both the aromatherapy group and music distraction group showed significant posttreatment change in anxiety levels with respect to Venham's picture test and FIS, along with the reduction in pulse rate and respiratory rate. When compared between music distraction and aromatherapy, it did not yield statistical significance, though music distraction showed better results compared to aromatherapy.

Conclusion

Both music distraction and aromatherapy using orange essential oil are effective in anxiety management of which music distraction presents a comparatively better result. Either these non-invasive techniques alone or a combination of both may be employed in the dental setup of pediatric dentists for molding cooperative patients.

How to cite this article

James J, Retnakumari N, Vadakkepurayil K, et al. Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study. Int J Clin Pediatr Dent 2021;14(2):249–253.

Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients

Background

To determine the influence of dental anxiety and the vasoconstrictor used in local anesthesia upon different hemodynamic parameters - systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and peripheral oxygen saturation (SatO2) - during dental extraction and oral hygiene. The safety of local anesthesia with vasoconstrictor in patients with medically controlled hypertension was also assessed.

Material and Methods

A total of 159 patients were divided into two groups according to the dental treatment received: tooth extraction (n = 106) and oral hygiene (n = 53). The hemodynamic parameters (SBP, DBP, HR and SatO2) were recorded throughout dental treatment. Patient anxiety was assessed using the Beck Anxiety Inventory (BAI), the Modified Corah’s Dental Anxiety Scale (MDAS) and the Hamilton test.

Results

The HR increased after anesthetic infiltration with vasoconstrictor and decreased after the tooth extraction. However, HR remained stable in the oral hygiene group, in both hypertensive and non-hypertensive patients. The SatO2 values decreased after anesthetic infiltration with vasoconstrictor. These slight changes associated with the vasoconstrictor agent were observed in patients without anxiety, but not in patients with mild or moderate anxiety. Both SBP and DBP remained constant after local anesthetic infiltration with vasoconstrictor, regardless of whether the patients presented hypertension or moderate anxiety.

Conclusions

The vasoconstrictor used in local anesthesia may induce a very subtle increase in HR, with no significant increase in patients who experience anxiety.

Key words:Tooth extraction, dental anesthesia, vasoconstrictor agents, dental anxiety, hypertension.

Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

CONTEXT

Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia.

AIM

The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA) during lengthy periodontal surgical procedures.

SETTINGS AND DESIGN

This was a randomized, split-mouth, cross-over study.

MATERIALS AND METHODS

A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS) was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures.

STATISTICAL ANALYSIS USED

Paired t-test and repeated measure ANOVA.

RESULTS

The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation.

CONCLUSION

Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response

Introduction:

Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children.

Aims:

The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure.

Settings and Design:

Total, 60 children of age 6–8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety – colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure.

Statistical Analysis Used:

Shapiro–Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal–Wallis test, Mann–Whitney test were applied in the study.

Results:

The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between “no anxiety” and “some anxiety” as quantified by Kruskal–Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure.

Conclusions:

The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.