A candle scented with aromatic lavender. A
massaging pillow. A face mask of warm gel. Soothing music. These are the way to
help a patient through fears and anxieties surrounding an endodontic procedure
-- a tooth root canal. And researchers at the annual meeting of the American
Association of Endodontists reported Thursday that such considerations will
actually reduce tooth pain.
People have heard horror stories from years ago about root canal," said Andre
Mickel, director of the advanced specialty education program in endodontics at
Case Western Reserve University, Cleveland. "Or they come into the office
already in pain and that's the pain they remember. It's kind of a bad start."
"A root-canal procedure with today's technology is practically painless," said
Carl Newton, professor of endodontics at Indiana University School of Medicine,
Indianapolis. "But patients are anxious about the procedure and many have
painful teeth when they enter the endodontist's office." That's why a relaxing
atmosphere can relieve some of the anxiety and prevent panic in the patients,
Newton said.
The researchers were contacted by telephone in Honolulu where they were
attending the endodontists' meeting.
While many endodontists have been working to make their offices more relaxing,
Mickel said his study shows that those efforts have a physiological effect. In
his study, volunteers agreed to use an electronic tooth pulp stimulator that
passes a weak electrical current through the nerves of their teeth. The
volunteers, whose blood pressure and pulse was monitored, would report when they
began to feel pain. The 200 people in the study were divided into four groups.
One group did not receive any relaxation technique; the others would hear
soothing music or would rest on a massaging pillow or covered their eyes with a
warm, gel-filled mask.
Mickel reported that the massage and mask groups had lower blood pressure and
pulse rate and were able to go longer before reporting pain with the electrical
tooth stimulation than other groups. The people listening to music had lower
blood pressure than the control group, but had no advantages in pulse rate of
pain reporting.
Mickel had previously reported reductions with pain perception and anxiety when
subjects were presented pleasant aromas such as scented lavender.
"Although we have effective anesthesia techniques, other methods should be
considered to reduce tension," said Eugene Choi, a resident in endodontics at
Case Western Reserve who presented the study findings at the meeting. "When
patients are stressed, it increases our stress, and when you're relaxed, it's
more conducive to things going smoothly. We want our patients to be happy."
Newton said attempts to lessen anxiety and fear in patients seems to reduce pain
or pain perception. "It appears that just courtesy goes a long way." He said
he's seen patients come into his office with an exaggerated fear of the
procedure, but by the end of the treatment they are interested in actually
seeing what's going on in their mouths. He has an optical camera which can
display the procedure on a television screen. A root canal saves a severely
decayed tooth by removing the pulp -- the soft inner tissue containing nerves
and blood vessels. The endodontists cleans, fills and seals the canals and the
tooth is restored with a permanent filling. An estimated 17 million teeth are
saved with root-canal procedures each year.
Formerly, the procedures took two or more sessions to complete the therapy, but
Newton said that now it can all be done in one visit.
