Patient\u2019s pre-operative dental anxiety is related to diastolic blood pressure and the need for post-surgical analgesia

Javier Fernandez-Aguilar,Isabel Guillén,Mar Jovani-Sancho,María T Sanz

doi:10.1038/s41598-020-66068-9

Javier Fernandez-Aguilar, Isabel Guillén + Show 2 more

Open Access

https://doi.org/10.1038/s41598-020-66068-9

Copy DOI

Abstract

In order to study the relationship of the patient’s anxiety level from Corah’s Dental Anxiety Scale (DAS) vs different physiological parameters: pre and post-operative blood pressure, and pre and post-operative heart rates, and subsequently, relate the results to the patient’s post-operative anti-inflammatory analgesic need, 185 patients requiring a simple dental extraction were recruited. They filled out the DAS in the waiting room prior to their procedure and once in the examination room, their preoperative blood pressure and heart rate was measured. Once the dental extraction had been completed, their blood pressure and heart rate were measured again. Before leaving the clinic, the patient was given an analgesic form in which they had to indicate whether or not they had required analgesia after the procedure. Diastolic blood pressure (DBP) showed statistically significant differences between pre-operative and post-operative (P = 0.001). DAS was related with pre-operative diastolic blood pressure (pre-DBP) (P = 0.001) and post-operative diastolic blood pressure (post-DBP) as well as pre-operative heart rate (pre-HR) (P = 0.027) and post-operative heart rate (post-HR) (P = 0.013). Patients with high levels of DAS tend to take more Ibuprofen 400 mg (P = 0.038). The different levels of anxiety will determine what type of anti-inflammatory analgesia the patient will take, if necessary.

Highlights

In order to study the relationship of the patient’s anxiety level from Corah’s Dental Anxiety Scale (DAS) vs different physiological parameters: pre and post-operative blood pressure, and pre and post-operative heart rates, and subsequently, relate the results to the patient’s post-operative antiinflammatory analgesic need, 185 patients requiring a simple dental extraction were recruited
The patient may experience different negative reactions when facing dental treatment, such as anxiety, in which an imagined future threat is perceived, which leads to an increased activation of the sympathetic nervous system; fear, as a response to a real action which is perceived as imminent[4]; or even dental phobia, which is included within phobias related to “blood-injections-fear” and defined in the classification of “Diagnostic and Statistical Manual of Mental Disorders” (DSM IV) as a pronounced, persistent, excessive and irrational fear caused by the presence of a specific object or situation[5]
The patients who experienced at least one feature of dental anxiety established via the DAS made up a total of 111 patients from the sample (60%) in contrast to those for whom the DAS did not detect any level of anxiety (40%)