Effect of Music Intervention on Anxiety in Patients Undergoing Periodontal Surgery: A Pilot Study| Stephy Publishers

 


Abstract

Objective: The effect of music listening on blood pressure (BP), heart rate (HR) and anxiety level (AL) was investigated for thirty patients undergoing periodontal surgery.

Methods: A total of sixty patients referred for periodontal surgery were randomized into two equal groups as i) without music (control), and ii) with music (test). Before and after the procedure, BP and HR were recorded. All patients responded to AL assessment using facial image scale (FIS) before and after surgery. After listening to music before and during the procedure BP, HR and AL were assessed for the test group.

Results: Systolic BP (SBP) in both groups increased but showed no statistically significant difference between the two groups (p>0.05). Diastolic BP (DBP) increased after treatment with no statistically significant difference (p>0.05) between test (4.70mmHg) and control (6.20mmHg) groups. HR decreased after the procedure in both test and control groups (8.40 vs. 9.03 beats per minute) with no statistically significant difference between the two groups (p>0.05). AL after the procedure decreased in both groups but with no statistically significant difference (p>0.05).

Conclusion: Only HR and AL decreased after music intervention.However, no differences in BP, HR and AL were found between groups with and without music.

This clinical trial was registered with TCTR (Thai Clinical Trials Registry) code TCTR20190411004.

Keywords

Music, Anxiety, Periodontal surgery, Blood pressure, Heart rate

Introduction

Anxiety when visiting the dentist for dental treatment is ranked the 5th highest among feared situations1 with only a small group of patients having no anxiety in the dental environment. Researchers in the Netherlands reported that almost 62% of patients suffer anxiety from dental treatment.2 Factors often linked to anxiety-related incidents include personal characteristics, fear about pain, previous dental experiences, the influence of a family member or co-worker expressing dental anxiety and hemophobia.2‒8 Physical responses of patients with dental anxiety include increased blood pressure (BP), heart rate (HR) and respiratory rate.9,10 A National Health Survey in 2012 by the Thai Ministry of Public Health reported the occurrence of periodontitis in the working age group at 15.6% and in the elderly at 32.1%.11 Treatment of severe periodontitis cases often requires periodontal surgery.12

Patients were requested to answer the Dental Anxiety Scale (DAS) questionnaire while waiting for treatment. Results showed that tooth extraction, periodontal surgery and scaling caused significant dental anxiety,13 while 12.1% of patients referred for periodontal treatment reported extreme anxiety. Main reasons were given as fear of pain and poor dental treatment experience. Patients with high anxiety before periodontal surgery have usually experienced more pain than those with low anxiety levels.14 Effective management of dental anxiety includes dentist-patient communication, relaxation therapy and conscious sedation (inhalation of nitrous oxide or anxiolytic agents such as diazepam). There are potential side effects of medications. Patients with extreme anxiety may require general anesthesia.15 Patients with dental anxiety often prefer other relaxation methods rather than taking medication to reduce any possible side effects.16

Music helps to relieve stress and anxiety by its calming effect on both the nervous system and the host immune system due to several underlying mechanisms which include 1) autonomic nervous responses by suppressive action on the sympathetic nervous system, leading to decreased adrenergic activity and neuromuscular arousal, and 2) by triggering the limbic system to release endorphins.17 The level of secretory immunoglobulin A (S-IgA) as a patient stress marker reduced while listening to music during dental treatment.18 Appropriate music rhythm for relaxation was determined as 70-80 beats per minute.19 Meyer LB reported that music used for relaxation which related to the culture of the listener had a greater effect than music that lacked familiarity.20 Using headphones to listen to music during medical treatment increased anxiety because the patient could not hear instructions or information from the treatment providers.21 Using relaxing music with a slow tempo, no lyrics and instrumentation using strings, woodwind and piano is recommended in dental practices.

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