International Hypnosis Research Institute - Dentistry

Role of Hypnosis in Dental Treatment: A Narrative Review.

Sun, 18 Jul 2021 16:08:00 -0500

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.

Hypnosis in Treatment of Stomatodynia: Preliminary Retrospective Study of 12 Cases.

Mon, 12 Jul 2021 16:03:00 -0500

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.

Hypnosis/Relaxation therapy for temporomandibular disorders...

Tue, 01 Jun 2021 11:52:00 -0500

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.

A controlled trial on the effect of hypnosis on dental anxiety in tooth removal patients.

Tue, 01 Jun 2021 11:45:00 -0500

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.

Hypnosis for dental anxiety.

Thu, 24 Jul 2014 18:48:00 -0500

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.

The management of dental anxiety and impact of psychosomatic factors on dentistry...

Thu, 20 Feb 2014 18:19:00 -0500

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.

Effect of hypnosis on induction of local anaesthesia, pain perception, ...

Thu, 05 Sep 2013 16:43:00 -0500

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.

The management of dental anxiety and impact of psychosomatic factors on dentistry.

Tue, 26 Feb 2013 14:53:00 -0500

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.

Use of the Grindcare® device in the management of nocturnal bruxism: a pilot study.

Mon, 14 Jan 2013 16:20:00 -0500

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;

Complementary and alternative medicine usage by patients of a dental school clinic.

Sun, 30 Dec 2012 17:48:00 -0500

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.

Sedating the apprehensive debilitated patients for dental procedures...

Mon, 26 Nov 2012 04:14:00 -0500

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.

The art of suggestion: the use of hypnosis in dentistry.

Tue, 12 Jun 2012 05:47:00 -0500

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.

Effects of hypnotic focused analgesia on dental pain threshold.

Mon, 21 Nov 2011 18:29:00 -0500

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.

Hypnosis and dental anesthesia in children: a prospective controlled study.

Fri, 18 Nov 2011 18:29:00 -0500

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.

Hypnosis for children undergoing dental treatment.

Wed, 27 Oct 2010 13:33:00 -0500

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.