Hypnosis for dental anxiety.

UNLABELLED: Dental anxiety can be a hindrance to treatment. It is prevalent, so helping patients to overcome it should not be regarded as the province of a specialist. Hypnosis can be effective but is underused. A comparison of the conscious, alert state and hypnosis/nitrous oxide sedation is shown by electroencephalogram examples. The benefits and drawbacks of the use of hypnosis are discussed and suggestions of ways of learning and using hypnosis outlined. CLINICAL RELEVANCE: This paper is an overview of the common problem of dental anxiety and a pragmatic approach to overcoming it using hypnotherapy.

Hipnosis como complemento en la cirugía oral del adulto mayor / Hypnosis as a complement to oral surgery in elderly persons

Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario Comandante Manuel Fajardo, en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 por ciento) y el menor en 70-79, (30 por ciento). El sexo femenino prevaleció con 70 por ciento. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 por ciento) y le siguió la diabetes tipo II en 2 (10 por ciento). En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 por ciento) seguido por los dientes parodontósicos con 4 (20 por ciento). El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor(AU)

Introduction: population aging is a worldwide phenomenon, and oral surgery is complex in elderly patients. Therefore, preoperative preparation is vital to their satisfactory evolution. The purpose of the present paper is to show the efficacy of hypnosis in elderly patients who fear oral surgery. Methods: a descriptive cross-sectional study was conducted with a sample of 20 patients aged 60 or over, cared for at the maxillofacial surgery service of Comandante Manuel Fajardo University Hospital in the year 2011. The variables analyzed were age, sex, number of hypnotic sessions, disease history, most frequent diagnoses and fear. Results: most patients fell into the 60-69 age group (70 percent). The remaining 30 percent were in the 70-79 age group. Female sex predominated with 70 percent. The highest number of sessions was 58 in the 60-69 age group, with an average of 4 per patient. The most frequent pathological antecedents were hypertension in 14 (70 percent), followed by type II diabetes in 2 (10 percent). The most common diagnoses were fourth degree caries in 10 (50 percent), followed by parodontic teeth in 4 (20 percent). Fear was measured with a dedicated scale on which patient scores of 10, 8 and 7 were reduced to 4 and 5. Conclusions: hypnotic therapy was shown to be effective to relieve fear of oral surgery in elderly persons(AU)

Hypnosis and dental anesthesia in children: a prospective controlled study.

The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

Effects of hypnotic focused analgesia on dental pain threshold.

The rate, intensity, and selectivity of hypnotic focused analgesia (HFA) were tested with dental pulp stimulation. Thirty-one healthy subjects were hypnotized, and hypnotic suggestions were given for anesthesia of the right mandibular arch. A posthypnotic suggestion of persisting analgesia was also given. The pain threshold of the first premolar was bilaterally measured before, during, and after hypnosis using a pulp tester. During hypnosis, the pain threshold increased significantly (p < .0001) for both sides. The posthypnotic right pain threshold was also significantly (p < .0015) higher than in the basal condition.

Cortical power spectrum analysis of hypnotic pain control in surgery.

Cortical power spectrum (CPS) of brain potentials was recorded from the scalp between prefrontal and parietal regions in both right hemisphere (RH) and left hemisphere (LH). A pattern of laterality shift in CPS occurred at different stages during an extensive oral surgery, performed under hypnosis, in a young female patient. Video and audio recordings as well as psychophysiological recordings were obtained through the following 6 stages: Baseline, Hypnosis, Surgery (1 hr, no cortical recording), Immediate Postsurgery Procedure, Hypnotic Re-experience, Hypnotic Rest, and Posthypnotic Baseline. Indications of anxiety and pain scores were reported in writing by the patient through verbal command by the hypnotist. In each stage, 10 min of CPS (10 spectrum/stage, 8 epochs/spectrum, 6 seconds/epoch) were analyzed by a PDP-11 computer. The results of CPS analysis demonstrated significant large total power reduction at different stages. There was significant correlation between both hemispheres at baseline, but dissociation of hemispheric power output occurred during hypnosis stages. LH was more dominant than RH during baseline and presurgery hypnosis, but both were leveled-off immediately following the surgery procedure. However, RH became more dominant during all postsurgery hypnosis stages. Interestingly, this pattern shifted back to the original relationship during the posthypnotic baseline stage. Specific changes of spectral power in theta and alpha of EEG activities in both hemispheres also occurred in conjunction with hypnosis.