Skip to main content
Top
Published in: Clinical Oral Investigations 11/2023

20-09-2023 | Anxiety | Review

Effect of music during endodontic treatment on patients’ anxiety: a systematic review of randomized clinical trials

Authors: Carolina Horn Troian-Michel, Lilian Tietz, Aline Teixeira Mendes, Pedro Henrique Marks Duarte, Theodoro Weissheimer, Ricardo Abreu da Rosa, Marcus Vinicius Reis Só

Published in: Clinical Oral Investigations | Issue 11/2023

Login to get access

Abstract

Objectives

Endodontic treatment is one of the most fearful procedures among dentistry, and the use of music during the procedure has been evaluated to control patients’ anxiety. This systematic review has been conducted to provide a synthesis of the state of knowledge in this field and aimed to answer the following question: “Can music therapy reduce patient’s state anxiety during endodontic treatment?”.

Methods

A search was performed in six electronic databases (PubMed, Cochrane Library, Scopus, Web of Science, EMBASE, and Open Gray) for articles published until April 2022. The eligibility criteria, based on the PICOS strategy, were as follows: (P) patients undergoing endodontic treatment; (I) exposure to music; (C) no music; (O) patients’ anxiety; (S) only randomized clinical trials. The risk of bias was analyzed according to the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2). The strength of evidence from the included studies was assessed using the Grading of Assessment, Development, and Assessment Recommendations (GRADE) tool.

Results

Five eligible studies were retrieved. A low to high risk of bias was verified. Descriptive analysis showed an effect in favor of music intervention, with differences among state anxiety, heart rate and blood pressure.

Conclusions

With a very low quality of evidence, dental care professionals may consider playing background music during endodontic treatment since it is a cost-effective and easy alternative to trying to reduce dental anxiety.

Clinical Relevance

Five studies were included in this systematic review and showed, with a very low quality of evidence, that music may reduce state anxiety levels on patients during root canal treatment.
Appendix
Available only for authorised users
Literature
1.
3.
go back to reference Arntz A, Van Eck M, Heijmans M (1990) Predictions of dental pain: the fear of any expected evil, is worse than the evil itself. Behav Res Therap 28:29–41CrossRef Arntz A, Van Eck M, Heijmans M (1990) Predictions of dental pain: the fear of any expected evil, is worse than the evil itself. Behav Res Therap 28:29–41CrossRef
4.
go back to reference Van Wijk AJ, Hoogstraten J (2006) Reducing fear of pain associated with endodontic therapy. Int End J 39:384–388CrossRef Van Wijk AJ, Hoogstraten J (2006) Reducing fear of pain associated with endodontic therapy. Int End J 39:384–388CrossRef
5.
go back to reference Zanette G et al (2013) Conscious sedation with diazepam and midazolam for dental patient: priority to diazepam. Minerva Stomatol 62:355–374PubMed Zanette G et al (2013) Conscious sedation with diazepam and midazolam for dental patient: priority to diazepam. Minerva Stomatol 62:355–374PubMed
6.
go back to reference Huh YK et al (2015) Assessment of patients’ awareness and factors influencing patients’ demands for sedation in endodontics. J Endod 41:182–189CrossRefPubMed Huh YK et al (2015) Assessment of patients’ awareness and factors influencing patients’ demands for sedation in endodontics. J Endod 41:182–189CrossRefPubMed
7.
go back to reference Weisfeld CC et al (2021) Dealing with anxious patients: a systematic review of the literature on nonpharmaceutical interventions to reduce anxiety in patients undergoing medical or dental procedures. J Altern Complement Med 27:717–726CrossRefPubMed Weisfeld CC et al (2021) Dealing with anxious patients: a systematic review of the literature on nonpharmaceutical interventions to reduce anxiety in patients undergoing medical or dental procedures. J Altern Complement Med 27:717–726CrossRefPubMed
8.
go back to reference Lai HL, Good M (2002) An overview of music therapy. J Nurs 49:80–84 Lai HL, Good M (2002) An overview of music therapy. J Nurs 49:80–84
9.
go back to reference Santiváñez-Acosta R, Tapia-López ELN, Santero M (2020) Music therapy in pain and anxiety management during labor: a systematic review and meta-analysis. Medicina (Kaunas) 56:526CrossRefPubMed Santiváñez-Acosta R, Tapia-López ELN, Santero M (2020) Music therapy in pain and anxiety management during labor: a systematic review and meta-analysis. Medicina (Kaunas) 56:526CrossRefPubMed
11.
go back to reference Nilsson U (2008) The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J 87:780–807CrossRefPubMed Nilsson U (2008) The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J 87:780–807CrossRefPubMed
13.
go back to reference Li J, Zhou L, Wang Y (2017) The effects of music intervention on burn patients during treatment procedures: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med 17:158CrossRefPubMedPubMedCentral Li J, Zhou L, Wang Y (2017) The effects of music intervention on burn patients during treatment procedures: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med 17:158CrossRefPubMedPubMedCentral
14.
go back to reference Garza-Villarreal EA et al (2017) Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis. Pain Physician 20:597–610CrossRefPubMed Garza-Villarreal EA et al (2017) Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis. Pain Physician 20:597–610CrossRefPubMed
15.
go back to reference Li Y et al (2020) The effectiveness of music therapy for patients with cancer: A systematic review and meta-analysis. J Acv Nurs 76:1111–1123 Li Y et al (2020) The effectiveness of music therapy for patients with cancer: A systematic review and meta-analysis. J Acv Nurs 76:1111–1123
16.
go back to reference Aravena PC, Almonacid C, Mancilla MI (2020) Effect of music at 432 Hz and 440 Hz on dental anxiety and salivary cortisol levels in patients undergoing tooth extraction: a randomized clinical trial. J Appl Oral Sci 28:e20190601CrossRefPubMedPubMedCentral Aravena PC, Almonacid C, Mancilla MI (2020) Effect of music at 432 Hz and 440 Hz on dental anxiety and salivary cortisol levels in patients undergoing tooth extraction: a randomized clinical trial. J Appl Oral Sci 28:e20190601CrossRefPubMedPubMedCentral
18.
go back to reference Lai HL et al (2008) Randomized controlled trial of music on state anxiety and physiological indices in patients undergoing root canal treatment. J Clin Nurs 17:2654–2660CrossRefPubMed Lai HL et al (2008) Randomized controlled trial of music on state anxiety and physiological indices in patients undergoing root canal treatment. J Clin Nurs 17:2654–2660CrossRefPubMed
19.
go back to reference Di Nasso L et al (2016) Influences of 432 Hz music on the perception of anxiety during endodontic treatment: a randomized controlled clinical trial. J Endod 42:1338–1343CrossRefPubMed Di Nasso L et al (2016) Influences of 432 Hz music on the perception of anxiety during endodontic treatment: a randomized controlled clinical trial. J Endod 42:1338–1343CrossRefPubMed
22.
go back to reference Nagendrababu V et al (2020) Glossary for systematic reviews and meta-analyses. Int End J 53:232–249CrossRef Nagendrababu V et al (2020) Glossary for systematic reviews and meta-analyses. Int End J 53:232–249CrossRef
24.
go back to reference Maia LC, Antonio AG (2012) Systematic reviews in dental research. A guideline. J Clin Pediatr Dent 37:117–124CrossRefPubMed Maia LC, Antonio AG (2012) Systematic reviews in dental research. A guideline. J Clin Pediatr Dent 37:117–124CrossRefPubMed
25.
go back to reference Moher D, Shamseer L, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1CrossRefPubMedPubMedCentral Moher D, Shamseer L, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1CrossRefPubMedPubMedCentral
26.
go back to reference Page MJ, Mckenzie JE, Bossuyt PM et al (2020) Mapping of reporting guidance for systematic reviews and meta-analyses generated a comprehensive item bank for future reporting guidelines. J Clin Epidemiol 118:60–68CrossRefPubMed Page MJ, Mckenzie JE, Bossuyt PM et al (2020) Mapping of reporting guidance for systematic reviews and meta-analyses generated a comprehensive item bank for future reporting guidelines. J Clin Epidemiol 118:60–68CrossRefPubMed
27.
go back to reference Sterne JAC et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:14898 Sterne JAC et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:14898
28.
go back to reference Guyatt G et al (2011a) GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394CrossRefPubMed Guyatt G et al (2011a) GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394CrossRefPubMed
29.
go back to reference Newton JT (2009) Music may reduce anxiety during invasive procedures in adolescents and adults. Evid Based Dent 10:15CrossRefPubMed Newton JT (2009) Music may reduce anxiety during invasive procedures in adolescents and adults. Evid Based Dent 10:15CrossRefPubMed
30.
go back to reference Ozkalayci O et al (2016) Effects of music on sedation depth and sedative use during pediatric dental procedures. J Clin Anesth 34:647–653CrossRefPubMed Ozkalayci O et al (2016) Effects of music on sedation depth and sedative use during pediatric dental procedures. J Clin Anesth 34:647–653CrossRefPubMed
31.
go back to reference Yi-Yueh L et al (2014) Comparative study of auxiliary effect on dental anxiety, pain and compliance during adult dental root canal treatment under therapeutic Chinese music or western classic music. Phys Med Rehabil Kurortmed 24:149–154 Yi-Yueh L et al (2014) Comparative study of auxiliary effect on dental anxiety, pain and compliance during adult dental root canal treatment under therapeutic Chinese music or western classic music. Phys Med Rehabil Kurortmed 24:149–154
32.
go back to reference Wazzan M et al (2022) The effect of music therapy in reducing dental anxiety and lowering physiological stressors. Acta Biomed 92:e2021393PubMedPubMedCentral Wazzan M et al (2022) The effect of music therapy in reducing dental anxiety and lowering physiological stressors. Acta Biomed 92:e2021393PubMedPubMedCentral
33.
go back to reference Mcguinness LA, Higgins JPT (2021) Risk-of-bias VISualization (robvis): an r package and shiny web app for visualizing risk-of-bias assessments. Res Synth Methods 12:55–61CrossRefPubMed Mcguinness LA, Higgins JPT (2021) Risk-of-bias VISualization (robvis): an r package and shiny web app for visualizing risk-of-bias assessments. Res Synth Methods 12:55–61CrossRefPubMed
34.
go back to reference Maggirias J, Locker D (2002) Five-year incidence of dental anxiety in an adult population. Community Dent Health 19:173–179PubMed Maggirias J, Locker D (2002) Five-year incidence of dental anxiety in an adult population. Community Dent Health 19:173–179PubMed
35.
go back to reference Ko YL, Lin PC (2012) The effect of using a relaxation tape on pulse, respiration, blood pressure and anxiety levels of surgical patients. J Clin Nurs 21:5–6CrossRef Ko YL, Lin PC (2012) The effect of using a relaxation tape on pulse, respiration, blood pressure and anxiety levels of surgical patients. J Clin Nurs 21:5–6CrossRef
36.
go back to reference Allen K et al (2001) Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosom Med 63:487–492CrossRefPubMed Allen K et al (2001) Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosom Med 63:487–492CrossRefPubMed
37.
go back to reference Miyata K et al (2016) Music before dental surgery suppresses sympathetic activity derived from preoperative anxiety: a randomized controlled trial. JDR Clin Trans Res 1:153–162PubMed Miyata K et al (2016) Music before dental surgery suppresses sympathetic activity derived from preoperative anxiety: a randomized controlled trial. JDR Clin Trans Res 1:153–162PubMed
38.
go back to reference Packyanathan JS, Lakshmanan R, Jayashri P (2019) Effect of music therapy on anxiety levels on patient undergoing dental extractions. J Family Med Prim Care 8:3854–3860CrossRefPubMedPubMedCentral Packyanathan JS, Lakshmanan R, Jayashri P (2019) Effect of music therapy on anxiety levels on patient undergoing dental extractions. J Family Med Prim Care 8:3854–3860CrossRefPubMedPubMedCentral
39.
go back to reference Mejía-Rubalcava C, Alanís-Tavira J, Mendieta-Zeron H, Sanchez-Perez L (2015) Changes induced by music therapy to physiologic parameters in patients with dental anxiety. Complement Ther Clin Pract 21:282–286CrossRefPubMed Mejía-Rubalcava C, Alanís-Tavira J, Mendieta-Zeron H, Sanchez-Perez L (2015) Changes induced by music therapy to physiologic parameters in patients with dental anxiety. Complement Ther Clin Pract 21:282–286CrossRefPubMed
40.
go back to reference Guyatt G, Oxman AD, Vist G et al (2011b) GRADE guidelines: 4. Rating the quality of evidence - study limitations (risk of bias). J Clin Epidemiol 64:1283–1293 Guyatt G, Oxman AD, Vist G et al (2011b) GRADE guidelines: 4. Rating the quality of evidence - study limitations (risk of bias). J Clin Epidemiol 64:1283–1293
41.
go back to reference Guyatt G, Oxman AD, Kunz R et al (2011c) GRADE guidelines: 7. Rating the quality of evidence ‐ inconsistency. J Clin Epidemiol 64:1294–1302 Guyatt G, Oxman AD, Kunz R et al (2011c) GRADE guidelines: 7. Rating the quality of evidence ‐ inconsistency. J Clin Epidemiol 64:1294–1302
42.
go back to reference Guyatt G, Oxman AD, Akl EA et al (2011d) GRADE guidelines: 8. Rating the quality of evidence ‐ indirectness. J Clin Epidemiol 64:1303–1310 Guyatt G, Oxman AD, Akl EA et al (2011d) GRADE guidelines: 8. Rating the quality of evidence ‐ indirectness. J Clin Epidemiol 64:1303–1310
43.
go back to reference Guyatt G, Oxman AD, Kunz R et al (2011e) GRADE guidelines: 6. Rating the quality of evidence - imprecision. J Clin Epidemiol 64:1283–1293 Guyatt G, Oxman AD, Kunz R et al (2011e) GRADE guidelines: 6. Rating the quality of evidence - imprecision. J Clin Epidemiol 64:1283–1293
44.
go back to reference Murad MH et al (2017) Rating the certainty in evidence in the absence of a single estimate of effect. Evid Based Med 22:85–87 Murad MH et al (2017) Rating the certainty in evidence in the absence of a single estimate of effect. Evid Based Med 22:85–87
45.
go back to reference Guyatt G, Oxman AD, Sultan S et al (2011f) GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol 64:1311–1316 Guyatt G, Oxman AD, Sultan S et al (2011f) GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol 64:1311–1316
47.
go back to reference Abi-Dargham A (2023) Candidate biomarkers in psychiatric disorders: state of the field. World Psychiatry 22:236–262 Abi-Dargham A (2023) Candidate biomarkers in psychiatric disorders: state of the field. World Psychiatry 22:236–262
Metadata
Title
Effect of music during endodontic treatment on patients’ anxiety: a systematic review of randomized clinical trials
Authors
Carolina Horn Troian-Michel
Lilian Tietz
Aline Teixeira Mendes
Pedro Henrique Marks Duarte
Theodoro Weissheimer
Ricardo Abreu da Rosa
Marcus Vinicius Reis Só
Publication date
20-09-2023
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 11/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-023-05247-0

Other articles of this Issue 11/2023

Clinical Oral Investigations 11/2023 Go to the issue