Review of the Month: Is your child scared of the dentist? Can hypnosis help?

pocket-watchThis week is Face Your Fears week. Many children are scared of going to the dentist, studies have shown a world-wide variation in the prevalence of dental anxiety with estimates ranging between 3% and 43% (Folayan, 2004). Our review of the month aimed to find out whether hypnosis can help children to cope with dental treatment.  The advantage of hypnosis is that it requires no specialist equipment, the patient remains conscious, and there are no side effects of the kind you may see with sedation or drug interventions.

What was the research?

A systematic review of the evidence to find out the effectiveness of hypnosis for behaviour management of children who are receiving dental care.

Who conducted the research?

The research was conducted by a team led by Sharifa Al-Harasi from the Military Dental Centre in Oman, on behalf of the Cochrane Oral Health Group. Paul F. Ashley, David R. Moles, Susan Parekh and Val Walters were also on the team.

What evidence was included in the review?

Data was extracted from 3 randomised controlled trials. A total of 69 children participated in the trials, and were randomly assigned to hypnosis or non-hypnosis groups. The children in the hypnosis groups could also be having some form of sedation in addition to the hypnosis. The children in the control groups either had sedation or nothing. The participants were all under the age of 16, and could be having any form of dental treatment.

What did the evidence say?

Very few studies on hypnosis for children undergoing dental treatment have been carried out, and only 3 trials were found that met the inclusion criteria. Two studies found that hypnosis had some beneficial effects during the administration of local anaesthetic, but it was not as effective during the removal of teeth. The majority of the children in one of the studies preferred sedation to hypnosis. One study found that hypnosis could make children undergoing orthodontic treatment more co-operative.

How good was the evidence?

Two of the studies were at high risk of bias, and one study at moderate risk of bias. Reporting of methods was generally poor. Only one of the studies was double-blind.

What are the implications for dentists and the general public?

There is some anecdotal evidence of the benefits of hypnosis for children undergoing dental treatment, when they are showing signs of anxiety. However, on the basis of these three studies there is not enough evidence to recommend it as a practice.

What should researchers look at in the future?

There is a need for well-conducted randomized controlled trials on this topic. Future research should follow-up patients to find out if the effect of hypnosis has modified the patient’s perception towards having dental treatment. Study design should be parallel and how the sample size was calculated should be reported.

Link

Al-Harasi S, Ashley PF, Moles DR, Parekh S, Walters V. Hypnosis for children undergoing dental treatment. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD007154. DOI: 10.1002/14651858.CD007154.pub2.

Reference

Folayan MO, Idehen EE, Ojom OO. The modulating effect of culture on the expression of dental anxiety in children: a literature review. International Journal of Paediatric Dentistry, 2004, 14(4): 241-5