Acupuncture May Ease Dental Anxiety

By Todd Neale, Staff Writer, MedPage Today Published: March 30, 2010 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Patients who resisted dental procedures because of anxiety successfully received treatment after five minutes of acupuncture, a small case series showed. The median level of anxiety among 20 patients was significantly reduced after acupuncture and completion of their respective procedures (P<0.001), Palle Rosted, MD, of Weston Park Hospital in Sheffield, England, and colleagues reported online inAcupuncture in Medicine. Individually, 12 of the patients had significant reductions in anxiety from baseline to postprocedure, as measured with the Beck Anxiety Inventory. The findings suggest acupuncture can help combat moderate-to-severe anxiety associated with going to the dentist, along with distraction techniques, sedatives, antidepressants, and beta blockers, Rosted said. Action Points   Explain to interested patients that this was an observational study without a control group and that the results should be confirmed in a randomized controlled trial. "It's not [a miracle cure]," he said in an interview. "But what we can say is that dentists have an extra tool in the toolbox." Rosted said acupuncture for dental anxiety is inexpensive, relatively free of adverse events, and quick and easy to learn. He cautioned, however, that acupuncture in this setting needs to be evaluated in a larger, randomized trial. It is estimated that severe dental anxiety affects about 5% of individuals in Western countries, with another 20% to 30% reporting moderate anxiety. Sedatives have been shown to be effective, but their safety is controversial, Rosted and his colleagues wrote in their paper. Psychotherapeutic techniques, although showing some benefit, are time consuming and require specialized education and skills, they added. Anecdotal reports have suggested acupuncture may relieve dental anxiety, but its use had not been well studied. To explore the issue, Rosted and his colleagues looked at 20 case reports from eight dentists who were seeking a diploma from the British Dental Acupuncture Society. The mean age of the patients was 40.3. All had a history of severe dental anxiety lasting from two to 30 years. The anxiety had made treatment difficult or impossible. Fourteen of the patients had cancelled a previous scheduled procedure. In the other six, treatment was begun but not completed. Seven of the patients had agreed to return for minor dental procedures, such as cleaning, and 13 had returned for a dental examination. When they arrived for the new appointments, their dentists offered them acupuncture to relieve anxiety. Five minutes before the procedure, needles were applied to two points on the top of the head believed to be effective for relieving stress and anxiety -- GV20 and EX6. The needles remained in place throughout the procedure. At baseline, the median anxiety score on the Beck scale was 26.5 out of a possible 63. Scores of 26 and higher indicate severe anxiety. The median postprocedure anxiety score was 11.5, falling in the mild range. Dentist-rated anxiety was also significantly reduced from a score of 4 to 2 on a five-point scale (P<0.001). Although only 12 of the patients had significant reductions in anxiety, the planned dental treatment was performed in all 20. "Some of [the anxiety reduction] might be attributed to the fact that the dental treatment had been completed, and the patients' responses might be biased by the presence of their dentist," Rosted and his colleagues wrote. "However, it seems likely that acupuncture contributed." The researchers noted that the patients did not know they would be offered acupuncture when they arrived at the dentist's office, another indication that the treatment was responsible for the relaxing effect. Rosted said a randomized controlled trial to explore the benefits of acupuncture for dental anxiety is being planned. The study had no external funding. The authors reported no conflicts of interest.

Primary source: Acupuncture in Medicine Source reference: Rosted P, et al "Acupuncture in the management of anxiety related to dental treatment: a case series" Acupunct Med 2010; DOI: 10.1136/aim.2009.001933. Source- MedPage Today