Hypnosis and nitrous oxide impact on the school aged patients’ anxiety and cooperation candidate for tooth extraction: A randomized clinical trial

• Published in: Heliyon Vol. 10; no. 15; p. e35223
• Main Authors: Motallebi, Afsoon, Fathi, Mehdi, Mazhari, Fatemeh, Hoseinzadeh, Melika, Parisay, Iman
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 15.08.2024; Elsevier
• Subjects: Anxiety; Conscious sedation; Cooperation; Hypnosis; Nitrous oxide; Pediatric dentistry; Tooth extraction; Conscious sedation; Cooperation; Tooth extraction; Anxiety; Hypnosis; Nitrous oxide; Pediatric dentistry
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e35223

This randomized clinical trial (RCT) investigated whether hypnosis would lead to favorable outcomes in reducing anxiety, enhancing cooperation, and improving physiological responses in school-aged children undergoing tooth extraction compared to nitrous oxide/oxygen (N2O/O2) and conventional behavior guidance (CBG). Sixty-six school-aged children (mean age: 7.87 ± 1.18 years) who needed one posterior primary tooth extraction were included. Children with low-to-moderate anxiety were randomly divided into three groups (n = 22 each): hypnosis, N2O/O2, and CBG. Anxiety levels during and after anesthetic injection and tooth extraction were assessed using the Venham Clinical Anxiety Scale (VCAS) and the Venham Picture Test (VPT). Changes in heart rate (HR) and oxygen saturation (SpO2) were monitored. Children's cooperation levels were measured using the Venham Clinical Cooperation Scale (VCCS). The VPT scores were significantly higher in the CBG group than in the N2O/O2 and hypnosis groups (p < 0.001). The VCAS scores in the N2O/O2 group were lower than those in the CBG group (p < 0.05) and were comparable to those in the hypnosis group. The VCCS scores were significantly higher in the CBG group than in the N2O/O2 and hypnosis groups (p < 0.05). HR changes in the N2O/O2 group were significantly lower than in the hypnosis and CBG groups (p < 0.05). No significant difference in pain was observed between the groups the day after the intervention. N2O/O2 inhalation and hypnosis are effective in reducing self-reported and observed anxiety and improving cooperation levels in pediatric patients during dental extraction. Moreover, the frequency of reported pain was lower in the hypnosis group compared to the other groups.