Impact of passive music intervention in subjects with self-reported moderate to high dental anxiety undergoing ultrasonic scaling procedure

Document Type : Original Article


1 Additional Professor, Department of Periodontology, Yenepoya Dental College, Yenepoya University, Deralakatte, Mangalore, India

2 BDS Intern, Yenepoya Dental College, Yenepoya University, Deralakatte, Mangalore, India

3 Professor, Department of Periodontology, Yenepoya Dental College, Yenepoya University, Deralakatte, Mangalore, India

4 Assistant Professor, Department of Statistics, Yenepoya University, Deralakatte, Mangalore, India



BACKGROUND AND AIM: The purpose of the present study was to evaluate the impact of passive music intervention in patients with moderate to high dental anxiety undergoing ultrasonic scaling procedure.
METHODS: Eighty healthy subjects with an anxiety score of 13-25 by Modified Dental Anxiety Scale (MDAS) in a randomised controlled trial (RCT) were recruited into study and control groups. Study group of forty subjects underwent ultrasonic scaling procedure with pre-recorded instrumental music intervention. Forty subjects in control group received the same dental treatment without music intervention. Physiologic parameters such as pulse rate (PR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded twice (before and at the end of procedure) for both groups. Dental anxiety experience was recorded using Visual Analogue Scale (VAS) for all the subjects at the end of study program. Repeated measure analysis of variance (ANOVA) was used to test the significant mean difference between pre- and post-measurements of all clinical parameters among study and control groups. Independent samples t-test was applied to analyze VAS inter-group significance.
RESULTS: The mean values of PR (pre and post) as well as SBP and DBP (pre and post) were statistically significant for study group as compared to control group. Mean values of PR (pre and post) and SBP and DBP (pre and post) showed statistically significant reduction in study group compared to control group. Post-therapy VAS score was significantly lower in the study group as compared to the control group. P-value was maintained at < 0.05.
CONCLUSION: Music intervention during ultrasonic procedure helps reduce dental anxiety in subjects with moderate to high dental anxiety levels.


Main Subjects

Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: Literature review. Clin Cosmet Investig Dent 2016; 8: 35-50.
Agras S, Sylvester D, Oliveau D. The epidemiology of common fears and phobia. Compr Psychiatry 1969; 10(2): 151-6.
Chandure J, Tamgadge S, Tamgadge A. Effect of music therapy on adult patients undergoing dental treatment procedures. Int Clin Pathol J 2017; 5(4): 270-4.
Brahm CO, Lundgren J, Carlsson SG, Nilsson P, Corbeil J, Hagglin C. Dentists' views on fearful patients. Problems and promises. Swed Dent J 2012; 36(2): 79-89.
Thoma MV, Zemp M, Kreienbuhl L, Hofer D, Schmidlin PR, Attin T, et al. Effects of music listening on pre-treatment anxiety and stress levels in a dental hygiene recall population. Int J Behav Med 2015; 22(4): 498-505.
Armfield JM, Heaton LJ. Management of fear and anxiety in the dental clinic: A review. Aust Dent J 2013; 58(4): 390-407.
Wide BU, Carlsson V, Westin M, Hakeberg M. Psychological treatment of dental anxiety among adults: A systematic review. Eur J Oral Sci 2013; 121(3 Pt 2): 225-34.
Gordon D, Heimberg RG, Tellez M, Ismail AI. A critical review of approaches to the treatment of dental anxiety in adults. J Anxiety Disord 2013; 27(4): 365-78.
Seinfeld S, Figueroa H, Ortiz-Gil J, Sanchez-Vives MV. Effects of music learning and piano practice on cognitive function, mood and quality of life in older adults. Front Psychol 2013; 4: 810.
10. Chu H, Yang CY, Lin Y, Ou KL, Lee TY, O'Brien AP, et al. The impact of group music therapy on depression and cognition in elderly persons with dementia: A randomized controlled study. Biol Res Nurs 2014; 16(2): 209-17.
11. Gold C, Heldal TO, Dahle T, Wigram T. Music therapy for schizophrenia or schizophrenia-like illnesses. Cochrane Database Syst Rev 2005; (2): CD004025.
12. Geretsegger M, Mossler KA, Bieleninik L, Chen XJ, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev 2017; 5: CD004025.
13. Kamioka H, Tsutani K, Yamada M, Park H, Okuizumi H, Tsuruoka K, et al. Effectiveness of music therapy: A summary of systematic reviews based on randomized controlled trials of music interventions. Patient Prefer Adherence 2014; 8: 727-54.
14. Bradt J, Teague A. Music interventions for dental anxiety. Oral Dis 2018; 24(3): 300-6.
15. Humphris GM, Morrison T, Lindsay SJ. The Modified Dental Anxiety Scale: Validation and United Kingdom norms. Community Dent Health 1995; 12(3): 143-50.
16. Appukuttan D, Vinayagavel M, Tadepalli A. Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice. J Oral Sci 2014; 56(2): 151-6.
17. Sinha E, Rekha R, Nagashree SR. Anxiety of dental treatment among patients visiting primary health centers. J Indian Assoc Public Health Dent 2019; 17(3): 235-45.
18. Iorgulescu G. Musictherapy in dental medicine. International Journal of Music and Performing Arts 2015; 3(2): 19-24.
19. Mejia-Rubalcava C, Alanis-Tavira J, Mendieta-Zeron H, Sanchez-Perez L. Changes induced by music therapy to physiologic parameters in patients with dental anxiety. Complement Ther Clin Pract 2015; 21(4): 282-6.
20. Olszewska I Zarow M. Does Music during a Dental Treatment Make a Difference? J Dental Res 2003; J Dent Res 2003; 82: B-351.
21. Kim YK, Kim SM, Myoung H. Musical intervention reduces patients' anxiety in surgical extraction of an impacted mandibular third molar. J Oral Maxillofac Surg 2011; 69(4): 1036-45.
22. Tran D, Edenfield SM, Coulton K, Adams D. Anxiolytic intervention preference of dental practitioners in the Savannah, Chatham County area: A pilot study. J Dent Hyg 2010; 84(3): 151-5.
23. Malagi S, Pattanshetti K, Bharmappa R, Reddy AS, Pai J, Joseph R. Assessment of subjective intensity of pain during ultrasonic supragingival calculus removal: A comparative study. J Indian Soc Periodontol 2014; 18(4): 472-7.
24. Lahmann C, Nickel M, Schuster T, Sauer N, Ronel J, Noll-Hussong M, et al. Functional relaxation and guided imagery as complementary therapy in asthma: A randomized controlled clinical trial. Psychother Psychosom 2009; 78(4): 233-9.
25. Corah NL. Dental anxiety. Assessment, reduction and increasing patient satisfaction. Dent Clin North Am 1988; 32(4): 779-90.
26. Townend E, Dimigen G, Fung D. A clinical study of child dental anxiety. Behav Res Ther 2000; 38(1): 31-46.