Hypnosis as a method to alleviate Dental Anxiety, Fear and Phobia in Endodontic Treatment.

Abstract

Endodontic treatment is a commonly used dental procedure that involves using various instrumentation that some patients may find frightening. Sounds, smells, and sights associated with visits to dental surgeries can also contribute to patients perceiving these interventions as threatening, uncomfortable, and confusing. Some of the most common reactions to endodontic procedures involve dental anxiety, fear, and phobia. These feelings may often encourage patients not to maintain proper oral hygiene and adhere to prescribed therapy plans and regular check-ups which can increase the risk of oral disease. There are several treatment options available for people with dental anxiety and fear including psychological approaches, pain management procedures, regular check-ups and early diagnosis, prophylactic use of non-steroidal anti-inflammatory medication therapy, and different operative techniques. The literature has reported that using hypnosis in treating dental phobia can be an effective way to reduce pain and anxiety. This analysis of the literature has reviewed peer-reviewed articles to determine the effect size of hypnosis interventions in patients diagnosed with general, dental, medical and performance anxiety. The results suggest that hypnosis can be used successfully both as a stand-alone procedure and when combined with other psychological interventions. However, there is a considerable gap in the literature about the effects of self-hypnosis on alleviating patients with anxiety.

I.Introduction

Endodontic treatment is a procedure used in patients with irreversible inflammation of dental pulp tissue (pulpitis). Depending on the diagnosis, the treatment is to be completed in one or multiple sessions. Endodontic treatment requires the use of various instrumentation, including instruments to start the procedure and prepare the access cavity, needles, syringes, and drills, as well as more specific equipment to prepare, clean and obturate root canals (Blicher et al., 2016). As the extirpation of nervous tissue from root canals can be unpleasant, patients undergoing endodontic treatment are usually given a local anesthetic. However, there is still a number of people who feel pain during or after the procedure and may potentially finding the whole experience distressful. Additionally, sounds, smells, and sights associated with the visits to dental surgeries make that most of the dental procedures are generally perceived as a threatening, uncomfortable, and confusing experience (Burghardt, 2018).
In a recent study that examined patients’ understanding and awareness of sedation in endodontic procedures, the authors stated that 35% of the sample reported the fear of pain as the most common concern related to dental procedures. While 16% of patients were afraid of needles, 10% failed to be numbed following the application of the local anesthetic. The same study reported that 7% of participants experienced symptoms of anxiety associated with endodontic treatment (Huh, 2015). A distressful dental visit can, therefore, make people anxious and fearful of any future dental appointments and procedures.
Anxiety is a common reaction to a stressful situation that causes somatic reactions aimed at preparing the body to react to a worrying or potentially threatening situation caused by an event with an uncertain outcome. More accurately, anxiety is defined as an emotional reaction characterized by physical changes like the rise in blood pressure (activation of the sympathetic nervous system), and psychological responses such as having worrying thoughts and tension. Fear, on the other hand, is a physical and psychological response to an immediate threat or danger (Khan, 2016).
Anxiety and fear can affirm patients to postpone future visits to the dental office or encourage them not to adhere to prescribed therapy plans (Dou, 2018). Delays in seeking dental treatment can have detrimental effects on

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