AIM: This narrative aims to outline the use of hypnosis in managing dental anxiety in during dental treatment. The PICO used to answer the objectives are (P) dental patients, (I) hypnosis, (C) conventional behaviour management techniques & (O) reduced pain/anxiety. MATERIALS AND METHODS: An electronic search of three databases; PubMed, Scopus and EBSCOhost was conducted using the keywords "hypnosis or hypnotherapy" AND "dentistry or dental" between the year 2000 and 2020. A total of 19 studies were selected based on eligibility. Data extracted were study subject, design of study, parameters used to assess, type of hypnosis script used and the study outcome. RESULTS: The studies show that hypnosis is effective in pain management and dental anxiety. It can also be used for improving compliance in patients who are wearing orthodontic appliances (Trakyali et al, 2008) and reducing salivary flow during dental treatment (Satlz et al, 2014). CONCLUSION: Hypnosis has the potential to be a useful tool in the management of children and adults.

J Int Soc Prev Community Dent. 2021 Apr 15;11(2):115-124. doi: 10.4103/jispcd.JISPCD_320_20. eCollection 2021 Mar-Apr.

Stomatodynia is an oral dysesthesia with a psychosomatic component. Twelve consecutive patients with stomatodynia were offered hypnosis sessions. Measures of anxiety, depression, and pain were administered before the first and after the last hypnosis session. Pain severity was assessed with a Numeric Rating Scale (NRS). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). The data were collected retrospectively from medical records on the 12 patients. The difference between NRS pain ratings and HADS scores before and after hypnosis was significant (p < .05). Six patients reported receiving treatment for stomatodynia before hypnotherapy; 3 of them stopped treatment for stomatodynia before completion of the hypnosis intervention. Results provide support for potential positive effects of hypnosis intervention for stomatodynia and point to the need for additional research on this issue.

Int J Clin Exp Hypn. 2021 Jul-Sep;69(3):346-354. doi: 10.1080/00207144.2021.1912611. Epub 2021 May 6.

Full Title: Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.

AIMS: To conduct a systematic review and meta-analysis to evaluate the effectiveness of hypnosis/relaxation therapy compared to no/minimal treatment in patients with temporomandibular disorders (TMD). METHODS: Studies reviewed included randomized controlled trials (RCTs) where investigators randomized patients with TMD or an equivalent condition to an intervention arm receiving hypnosis, relaxation training, or hyporelaxation therapy, and a control group receiving no/minimal treatment. The systematic search was conducted without language restrictions, in Medline, EMBASE, CENTRAL, and PsycINFO, from inception to June 30, 2014. Studies were pooled using weighted mean differences and pooled risk ratios (RRs) for continuous outcomes and dichotomous outcomes, respectively, and their associated 95% confidence intervals (CI). RESULTS: Of 3,098 identified citations, 3 studies including 159 patients proved eligible, although none of these described their method of randomization. The results suggested limited or no benefit of hypnosis/relaxation therapy on pain (risk difference in important pain -0.06; 95% CI: -0.18 to 0.05; P = .28), or on pressure pain thresholds on the skin surface over the temporomandibular joint (TMJ) and masticatory muscles. Low-quality evidence suggested some benefit of hypnosis/relaxation therapy on maximal pain (mean difference on 100-mm scale = -28.33; 95% CI: -44.67 to -11.99; P =.007) and active maximal mouth opening (mean difference on 100-mm scale = -2.63 mm; 95% CI: -3.30 mm to -1.96 mm; P < .001) compared to no/minimal treatment. CONCLUSION: Three RCTs were eligible for the systematic review, but they were with high risk of bias and provided low-quality evidence, suggesting that hypnosis/relaxation therapy may have a beneficial effect on maximal pain and active maximal mouth opening but not on pain and pressure pain threshold. Larger RCTs with low risk of bias are required to confirm or refute these findings and to inform other important patient outcomes.

J Oral Facial Pain Headache. 2015 Spring;29(2):115-25. doi: 10.11607/ofph.1330. Zhang Y, Montoya L, Ebrahim S, Busse JW, Couban R, McCabe RE, Bieling P, Carrasco-Labra A, Guyatt GH.

OBJECTIVE: Empirical evidence concerning the efficacy of hypnosis to reduce anxiety in dental patients is limited. Hence we conducted a controlled trial in patients undergoing tooth removal. The study aims at assessing patient's attitude toward hypnosis and comparing the course of dental anxiety before, during and subsequent to tooth removal in patients with treatment as usual (TAU) and patients with treatment as usual and hypnosis (TAU+HYP). METHODS: 102 patients in a dental practice were assigned to TAU or TAU+HYP. Dental anxiety was assessed before, during and after treatment. All patients were asked about their experiences and attitudes toward hypnosis. RESULTS: More than 90% of patients had positive attitudes toward hypnosis. Dental anxiety was highest before treatment, and was decreasing across the three assessment points in both groups. The TAU+HYP group reported significantly lower levels of anxiety during treatment, but not after treatment compared with TAU group. CONCLUSION: Our findings confirm that hypnosis is beneficial as an adjunct intervention to reduce anxiety in patients undergoing tooth removal, particularly with regard to its no-invasive nature. PRACTICAL IMPLICATION: The findings underline that hypnosis is not only beneficial, but also highly accepted by the patients. Implementation of hypnosis in routine dental care should be forwarded. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Patient Educ Couns. 2015 May 24. pii: S0738-3991(15)00228-1. doi: 10.1016/j.pec.2015.05.007. Glaesmer H(1), Geupel H(2), Haak R(3). Author information: (1)Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany. Electronic address: Heide.Glaesmer@medizin.uni-leipzig.de. (2)Private dental practice, Gera, Germany. (3)Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.

Dental anxiety can be a hindrance to treatment. It is prevalent, so helping patients to overcome it should not be regarded as the province of a specialist. Hypnosis can be effective but is underused. A comparison of the conscious, alert state and hypnosis/nitrous oxide sedation is shown by electroencephalogram examples. The benefits and drawbacks of the use of hypnosis are discussed and suggestions of ways of learning and using hypnosis outlined.CLINICAL RELEVANCE: This paper is an overview of the common problem of dental anxiety and a pragmatic approach to overcoming it using hypnotherapy.

Dent Update. 2014 Jan-Feb;41(1):78-80, 83. Griffiths M.

Full title: The management of dental anxiety and impact of psychosomatic factors on dentistry: is recent scientific research translated into German dental practices? This study investigated the dentists' knowledge about psychosomatic medicine. Anxiolytic techniques, considerations about psychosomatic medicine, and referrals to psychotherapists were examined by a questionnaire. Overall, 65 percent felt negatively affected by patients with dental fear. Few dentists used relaxation techniques and hypnosis. The relationship between psychosomatic factors and pain perception was well known, but not their impact on wound healing. The frequency of continuing education courses correlated with a broader range of treatment techniques and less difficulties in treatment. Research evidence about the impact of psychological factors on dental treatment has not been translated into dental practice.

J Health Psychol. 2013 Dec;18(12):1519-28. Diercke K, Bürger GD, Bermejo JL, Lux CJ, Brunner M. University of Heidelberg, Germany.

Full title: Effect of hypnosis on induction of local anaesthesia, pain perception, control of haemorrhage and anxiety during extraction of third molars: a case-control study.

This study sought to determine the efficacy of hypnosis on dental patients who had the third molars removed under hypnosis versus using a local anesthetic. 24 female and male volunteers were involved in this study. The results showed that hypnosis can effectively reduce anxiety, bleeding, and pain. Hypnosis was induced by either using gaze fixation or Chiasson's techniques. No information was given regarding suggestions, which may have been given during the study.

J Craniomaxillofac Surg. 2013 Jun;41(4):310-5. doi: 10.1016/j.jcms.2012.10.009. Abdeshahi SK, Hashemipour MA, Mesgarzadeh V, Shahidi Payam A, Halaj Monfared A. Kerman Oral and Dental l Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Full title: The management of dental anxiety and impact of psychosomatic factors on dentistry. - Is recent scientific research translated into German dental practices?

This study investigated the dentists' knowledge about psychosomatic medicine. Anxiolytic techniques, considerations about psychosomatic medicine, and referrals to psychotherapists were examined by a questionnaire. Overall, 65 percent felt negatively affected by patients with dental fear. Few dentists used relaxation techniques and hypnosis. The relationship between psychosomatic factors and pain perception was well known, but not their impact on wound healing. The frequency of continuing education courses correlated with a broader range of treatment techniques and less difficulties in treatment. Research evidence about the impact of psychological factors on dental treatment has not been translated into dental practice.

J Health Psychol. 2012 Dec 6. Diercke K, Bürger GD, Bermejo JL, Lux CJ, Brunner M. University of Heidelberg, Germany.

BACKGROUND:

Bruxism may be described as a diurnal or nocturnal parafunction, characterised by clenching, bracing, gnashing or grinding of the teeth and jaws. The aim of the management of bruxism should be to control or reduce the level of activity where possible. A variety of treatment strategies have been employed to achieve this including hypnosis, occlusal equilibration, splint therapy, physiotherapy and acupuncture. A more recent approach is the use of biofeedback.

METHOD:

Nineteen consecutive patients were recruited from the temporomandibular joint dysfunction (TMD) clinic at Manchester Dental Hospital, all of whom were known bruxists. They were supplied with the Grindcare® device (Medotech) and instructed to wear it every night over the five-week observation period. By monitoring electromyographic (EMG) muscle activity, the device is able to emit low-voltage electrical impulses as it senses a clenching or grinding episode, bringing about muscle relaxation.

RESULTS:

Eleven of the nineteen patients (58%) reported a major reduction in the occurrence of headaches and discomfort of the masticatory muscles on waking. Female and younger subjects responded more favourably than male and older subjects respectively.

CONCLUSION:

The use of biofeedback could reduce the level of parafunctional activity and bring about meaningful symptomatic improvement. No adverse effects occurred throughout the study period.

Br Dent J. 2013 Jul;215(1):E1. doi: 10.1038/sj.bdj.2013.653. Needham R, Davies SJ. The Turner Dental Hospital, Higher Cambridge Street, Manchester, M15 6FH, UK. richard.needham@postgrad.manchester.ac.uk;

Assistant Professor, Department of Family Dentistry, The University of Iowa College of Dentistry, Iowa City, Iowa Private Practice of General Dentistry, Ankeny, Iowa Professor, Department of Pediatric Dentistry and Director of the Biostatistics Unit for the College of Dentistry Professor and Head, Department of Family Dentistry Biostatistician, Dows Institute for Dental Research, The University of Iowa College of Dentistry, Iowa City, Iowa Professor, Department of Internal Medicine, The University of Iowa College of Medicine, Iowa City, Iowa Associate Professor and Director of Dental Pharmacy, The University of Iowa College of Dentistry, Iowa City, Iowa.

This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population. More than three-quarters (76.1%) of the respondents reported using at least one CAM treatment in the past 12 months; 93.3% reported using at least one CAM treatment at some time in their lives. High rates of chiropractic use were found in this population. Tooth pain was the most frequently reported dental condition motivating CAM use. About 10% of dental school clinic patients use topical oral herbal and/or natural products to treat dental conditions, most frequently for preventive/oral health reasons or for tooth pain.

Spec Care Dentist. 2012 Sep;32(5):177-183. doi: 10.1111/j.1754-4505.2012.00273.x. Spector ML, Fischer M, Dawson DV, Holmes DC, Kummet C, Nisly NL, Baker KA.

Full title: Sedating the apprehensive debilitated patients for dental procedures by combining parenteral sedation and hypnosis with supplemental acupuncture therapy.

Treating apprehensive debilitated patients (i.e. geriatric patients, patients with cardiac, pulmonary, kidney, or liver diseases, and those with other severe systemic conditions) for dental procedures can cause unexpected medical complications such as cardiac arrest, stroke, asthma or shock, etc. Due to diminishing functional capacities of their organs, sedating those patients with sedative drugs in normal regular dosage could increase the risk of adverse events for this group of patients and can also increase the risk of liability for the clinician. The authors treated 34 apprehensive dental patients with a combination technique using parenteral sedation and hypnosis together with acupuncture. We used Bi-Digital O-Ring Test (BDORT) to select the compatible sedative drugs and to individualize the dosage suitable to the patient's medical condition. Oftentimes, BDORT predetermined dosage amounts to a fraction of regular dosage that is normally recommended by manufacturer for regular healthy patients. Such a reduced dosage, though benign to patient, may be insufficient to render a patient to the sedation level for dental treatment. Nevertheless, hypnosis with acupuncture can be applied to potentiate the therapeutic effect of parenteral sedation, thereby reducing the amount of sedative agents required to alleviate patient anxiety. The results indicated that hypnosis with acupuncture and BDORT could effectively allow the reduction of the sedative dosage and may beneficially provide a safe and comfortable situation for the debilitated patients to receive the necessary treatment.

Acupunct Electrother Res. 2012;37(1):49-62. Lu DP, Wu PS, Lu WI. University of Pennsylvania, USA.

Hypnodontics, or the use of hypnosis in dentistry, is not widely used throughout the dental profession. Many patients seeking to use this therapy to help them access dental treatment are forced to seek treatment from non-clinically trained hypnotherapists. This article aims to explore what hypnosis is, its applications in dentistry and provide a brief insight into how these hypnotic concepts may be put to use in day-to-day dental practice.

Br Dent J. 2012 Jun 8;212(11):549-51. doi: 10.1038/sj.bdj.2012.467. Holden A. Stag Dental Care, 107 Wickersley Road, Rotherham, S60 3PU.

Abstract The rate, intensity, and selectivity of hypnotic focused analgesia (HFA) were tested with dental pulp stimulation. Thirty-one healthy subjects were hypnotized, and hypnotic suggestions were given for anesthesia of the right mandibular arch. A posthypnotic suggestion of persisting analgesia was also given. The pain threshold of the first premolar was bilaterally measured before, during, and after hypnosis using a pulp tester. During hypnosis, the pain threshold increased significantly (p < .0001) for both sides. The posthypnotic right pain threshold was also significantly (p < .0015) higher than in the basal condition.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):454-68. Facco E, Casiglia E, Masiero S, Tikhonoff V, Giacomello M, Zanette G. a University of Padua , Italy.

Abstract The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

Int J Clin Exp Hypn. 2011 Oct-Dec;59(4):424-40. Huet A, Lucas-Polomeni MM, Robert JC, Sixou JL, Wodey E. a UFR d'Odontologie de l'Université de Rennes 1 , France.

BACKGROUND: Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children, such us: 'tell, show & do', positive reinforcement, modelling and hypnosis. The use of hypnosis is generally an overlooked area, hence the need for this review.

OBJECTIVES: This systematic review attempted to answer the question: What is the effectiveness of hypnosis (with or without sedation) for behaviour management of children who are receiving dental care in order to allow successful completion of treatment? Null hypothesis: Hypnosis has no effect on the outcome of dental treatment of children.

SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE (OVID), EMBASE (OVID), and PsycINFO. Electronic and manual searches were performed using controlled vocabulary and free text terms with no language restrictions. Date of last search: 11th June 2010.

SELECTION CRITERIA: All children and adolescents aged up to 16 years of age. Children having any dental treatment, such as: simple restorative treatment with or without local anaesthetic, simple extractions or management of dental trauma.

DATA COLLECTION AND ANALYSIS: Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors of trials were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The methodological quality of randomised controlled trials (RCTs) was assessed using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2.

MAIN RESULTS: Only three RCTs (with 69 participants) fulfilled the inclusion criteria. Statistical analysis and meta-analysis were not possible due to insufficient number of studies.

AUTHORS' CONCLUSIONS: Although there are a considerable number of anecdotal accounts indicating the benefits of using hypnosis in paediatric dentistry, on the basis of the three studies meeting the inclusion criteria for this review there is not yet enough evidence to suggest its beneficial effects.

Cochrane Database Syst Rev. 2010 Aug 4;8:CD007154. Al-Harasi S, Ashley PF, Moles DR, Parekh S, Walters V. Military Dental Centre, PO Box 454, PC 121, Seeb, Oman.

by Ron Schefdore, DDS

and

Jack Maggiore, DDS

Many health care professionals are turning to blood screening test kits to quickly and accurately screen current and potential patients to help improve their health and possibly save their lives. These tests can be used at home by the patient or can be administered by a health care professional using only 1-4 drops of blood. Within the dental community, these tests have proven to improve treatment acceptance and increase quality referrals of patients by health care professionals (1). This is an example of a major paradigm shift occurring in a health care profession not accustomed to serving a leading role in systemic disease detection, whereby the outcome is the improved overall health of patients. While many dental offices have seen their incomes decrease over the past two years, offices that have implemented in-office blood screenings and follow the Healthy Heart Dentistry® program have realized sustained growth in revenues, patient base, and referrals. We describe below two such strategies for achieving this level of success.

[More]

by V. Kim Kutsch, DMD., Carri Cady, RDH

Introduction
Medication-induced xerostomia (MIX disease, an acronym first introduced by Edwin Zinman) is becoming a more common problem for Americans. There are many potential causes of xerostomia, or dry mouth, and these causes include loss of saliva production as part of the natural aging process,¹ Sjogren's Syndrome,² radiation to the head and neck,³ and medication-induced xerostomia.⁴ There are now about 3000 prescription medications that list xerostomia as a possible side effect,⁵ but drug companies by-and-large have not included specific labeling to alert the consumer about xerostomia and its increased risk for dental caries.⁶ MIX disease affects people of all ages. The average person has no idea what xerostomia is, so the current drug labeling has little or no significance for them.

[More]

Dental fears and phobias trouble patients with and without special needs, and they are a problem for dentists, as well. This article reviews current research and literature related to methods used to alleviate dental fear and concludes that while some important psychological methods are available, much work is left to be done in this area. It is clear that there is an important role for psychological and behavioral input to the dentist-patient interaction. While dental phobia represents a class of special needs itself, patients with other important disabilities (e.g., physical or cognitive impairments) are sometimes comorbidly phobic, a condition often missed or misdiagnosed by treating practitioners. Office-based techniques that focus on relaxation, breathing, imagery, hypnosis, and effective use of operatory language are described. The methods advocated here can be used with patients having mild or moderate cognitive impairments. Readings are recommended for the dentist or auxiliary practitioner interested in learning these techniques.

Spec Care Dentist. 2009 Jan;29(1):51-7. Peltier B. University of the Pacific, San Francisco, California, USA. bpeltier@pacific.edu

BACKGROUND: With regard to the management of dental anxiety in general dental practice, it has been considered that general dental practitioners (GDPs) are well placed to treat adults with mild forms of dental anxiety. However, little is known about the specific anxiety management techniques being used by GDPs in the UK.Aim To determine the views and experiences of dental practitioners in their current use of anxiety management techniques, their undergraduate and post-graduation training in these techniques and future training needs. METHODS: A postal questionnaire was sent to a sample of GDPs working in the Midlands region (n = 750) in the UK. Dentists were randomly selected using lists provided by the primary care trusts for each locality. RESULTS: The response rate was 73% (n = 550). Of these, 90 were not included in the final analysis due to exclusion criteria set prior to questionnaire release. This left 460 questionnaires for analysis. Eighty-five percent of respondents agreed that dentists had a responsibility to help dentally anxious patients (n = 391). Dentists were asked their reasons for not using anxiety management techniques in practice. Psychological techniques, sedation (oral, inhalation, or intravenous) and hypnosis were reported as not having been used due to the paucity of time available in practice, a shortage of confidence in using these techniques and the lack of fees available under the NHS regulations. Also, 91% reported feeling stressed when treating anxious patients. When asked about the quality of teaching they had received (undergraduate and postgraduate), 65% considered that the teaching was less than adequate in the use of psychological methods, whereas 44% indicated that they would be interested in further training in psychological methods if financial support was available. CONCLUSION: The need for further training in managing the dentally anxious patient is supported by dentists' lack of confidence and inadequate training in treating such patients, as determined from the results of a postal questionnaire to UK GDPs.

Br Dent J. 2008 Apr 26;204(8):E13; discussion 442-3. Epub 2008 Apr 18. Hill KB, Hainsworth JM, Burke FJ, Fairbrother KJ. University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN. K.B.Hill@bham.ac.uk

BACKGROUND: With regard to the management of dental anxiety in general dental practice, it has been considered that general dental practitioners (GDPs) are well placed to treat adults with mild forms of dental anxiety. However, little is known about the specific anxiety management techniques being used by GDPs in the UK.Aim To determine the views and experiences of dental practitioners in their current use of anxiety management techniques, their undergraduate and post-graduation training in these techniques and future training needs. METHODS: A postal questionnaire was sent to a sample of GDPs working in the Midlands region (n = 750) in the UK. Dentists were randomly selected using lists provided by the primary care trusts for each locality. RESULTS: The response rate was 73% (n = 550). Of these, 90 were not included in the final analysis due to exclusion criteria set prior to questionnaire release. This left 460 questionnaires for analysis. Eighty-five percent of respondents agreed that dentists had a responsibility to help dentally anxious patients (n = 391). Dentists were asked their reasons for not using anxiety management techniques in practice. Psychological techniques, sedation (oral, inhalation, or intravenous) and hypnosis were reported as not having been used due to the paucity of time available in practice, a shortage of confidence in using these techniques and the lack of fees available under the NHS regulations. Also, 91% reported feeling stressed when treating anxious patients. When asked about the quality of teaching they had received (undergraduate and postgraduate), 65% considered that the teaching was less than adequate in the use of psychological methods, whereas 44% indicated that they would be interested in further training in psychological methods if financial support was available. CONCLUSION: The need for further training in managing the dentally anxious patient is supported by dentists' lack of confidence and inadequate training in treating such patients, as determined from the results of a postal questionnaire to UK GDPs.

Br Dent J. 2008 Apr 26;204(8):E13; discussion 442-3. Hill KB, Hainsworth JM, Burke FJ, Fairbrother KJ. University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN. K.B.Hill@bham.ac.uk

Temporomandibular disorders (TMDs) involve a heterogeneous group of clinical conditions affecting the stomatognathic system and its related structures. Because the etiology of these disorders is still unclear, a wide range of therapeutic solutions has been proposed in the literature, including occlusal appliances, physical therapies, drugs, and biobehavioral modalities. Biobehavioral therapy could have a beneficial effect in the treatment of TMDs because of the reportedly high prevalence of psychological dysfunction in TMD patients. The authors reviewed the biobehavioral modalities used to achieve pain relief in patients affected by such disorders, with the aim of synthesizing data on the effectiveness these therapeutic approaches. Literature data suggest that the inclusion of biobehavioral interventions in the management of TMDs may be reasonable, even if no conclusions can be drawn about their long-term effectiveness.

Behav Med. 2007 Fall;33(3):101-18. Orlando B, Manfredini D, Salvetti G, Bosco M. The Department of Neuroscience, Section of Prosthetic Dentistry, University of Pisa, Italy.

Complementary and alternative medicine in dentistry includes various treatment modalities. Many procedures are under scientific investigation to determine effectiveness. Dental patients request CAM therapy in an attempt to save money and to prevent invasive procedures. The Alternative Medical Systems are methods of alternative therapy different from Conventional/Western medicine. Mind-Body Interventions are methods of affecting body functions using prayer, meditation, mental imagery and creativity. Biologically-Based Therapy is the use of substances found in nature to promote healing and wellness. Manipulative and Body-Based Methods are based on the manipulation and/or movement of the body to treat for pain and wellness. Energy Therapy is based on manipulating energy fields of body. CAM procedures may eventually become standard practice after scientific verification of efficacy.

Dent Assist. 2007 Jul-Aug;76(4):34-6, 38, 40-3 Andrews EK.

The Department of Maxillofacial Surgery of the University Hospital Schleswig-Holstein/Campus Lübeck offers intraoperative hypnosis since 2002. Besides clinical evaluation by controlled studies, patients attitudes should be included in the judgement on such adjuvant procedure not established in general.70 patients of the department treated under combined local anaesthesia/hypnosis rated their individual postoperative patient satisfaction by standardised questionnaires. A control group of equal size and demographic/surgical features consisted of patients that were treated without hypnosis in the same interval.Results of the inquiry indicate that intraoperative hypnosis increases significantly postoperative satisfaction of oral and maxillofacial patients. Satisfaction is attributed decisively on the adjuvant procedure.

Mund Kiefer Gesichtschir. 2007 Oct 19 Hermes D, Trübger D, Hakim SG. Klinik für Kiefer- und Gesichtschirurgie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany, mail@dirkhermes.de.

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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. CLINICAL IMPLICATIONS: 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.

J Am Dent Assoc. 2007 Sep;138(9):1242-50.

Diclementi JD, Deffenbaugh J, Jackson D.

Fear of the dentist is a common phenomenon. There are many ways of dealing with anxious patients and this review aims to present the most common methods available to general dental practitioners. Clinical Relevance: An ability to deal with anxious patients successfully is undoubtedly a practice builder. Anxious patients can be stressful to manage but they often become the most vocal advocates of dentists that they trust.

School of Dentistry, Higher Cambridge Street, Manchester M15 6FH.

Dent Update. 2007 Mar;34(2):108-10, 113-4.

Surveys indicate that the adolescent, in particular, suffers from acute anxiety in relation to dentistry. This anxiety is promoted by the general opinion they form of dentists and dentistry through portrayal by their peers and the media.

[More]

"Hypnopuncture," a combination treatment of hypnosis and acupuncture, provides a therapeutic treatment plan for long-term therapy for patients with a distinctive gag reflex. The treatment is applied independently of the cause. In cases of emergency treatment in dentistry, the immediate compliance of a patient is of utmost importance. The long-term goal of any therapeutic measure is control of the gag reflex.

[More]

It was hypothesized that dental anxiety, which leads to neurophysiologic alterations in heart rate, respiratory rate and blood pressure prior, during and subsequent to dental treatment, can be influenced by medical hypnosis. We report the positive impact from non-invasive hypno-sedation during dental implant surgery on a 54-year-old female patient who experienced neurophysiologic reactions as a result of the psychosomatic process of dental anxiety (dental anxiety scale value = 13). The neurophysiologic changes during dental surgery performed with and without hypnosis were compared after the patient underwent the same surgical treatment protocol. This case report was part of a study designed to evaluate hypnosis as a non-invasive therapy for dental-anxious patients over six sessions using subjective experience and objective parameters, which included electroencephalogram, electrocardiogram, heart rate, blood pressure, oxygen saturation of the blood, respiration rate, salivary cortisol concentration and body temperature.

Department of Prosthodontics, Maxillofacial Surgery and Neurology and Psychiatry, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany. seitner@prothetik-erlangen.de

In this article, the nature of hypnosis will be discussed, together with its therapeutic/facilitator role in the control of the potential problems that occur in everyday dental practice. It is the vital relationship between a patient and therapist which produces the desired results of hypnotherapy. CLINICAL RELEVANCE: A holistic approach, in patient care, emphasizes the treatment of an individual who has a dental problem.