Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent).

Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.

Health diplomacy in Africa-opportunities post-COVID-19.

For the last seventy years, Africa has suffered a disease burden that is steadily growing in scale and complexity. Despite that, health development in the continent has continued to rely on donors´ packages since decolonization. The last decade, however, has marked some health-related achievements on the continent such as the development of the Africa Health Strategy 2016-2030, the establishment of Africa Centres for Disease Control and Prevention (Africa CDC), the launch of The African Continental Free Trade Area (AfCFTA) and most recently the African Medicines Agency (AMA). These developments and the response to the COVID-19 pandemic have highlighted the importance and the opportunities of practicing Global Health Diplomacy on the continent. Home to 27% of the world´s countries, Africa has a tremendous global voting power which makes global health diplomacy an unequivocally effective soft power tool to achieve "The Africa we want". In this paper, we will expand on the importance of Global Health Diplomacy (GHD) practice in Africa as a soft power tool, illustrate the COVID-19 response in the continent championed by the Africa Centres for Disease Control and Prevention (Africa CDC) as a case study, and offer some recommendations to sustain and strengthen GHD´s role in the continent.