Cochrane · intervention · CD007154
Hypnosis for children undergoing dental treatment
Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
13
current version
GRADE rated
0
No studies
4
Included studies
3
as reported
No studies 4 · 30.8%Ungraded 9 · 69.2%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | All children and adolescents up to 16 years of age (age bands: under 5 years; 6 to 12 years; more than 12 up to 16 years), having any dental treatment such as simple restorative treatment with or without local anaesthetic, simple extractions, management of dental trauma, or orthodontic treatment; included regardless of baseline anxiety | 69 participants (34 male, 35 female), age range 4.5 to 15 years; health status ASA I and II (n=69) |
| Intervention | Any hypnotic technique with or without any sedative agent (sedation could be inhalation, oral or intravenous) | Hypnosis, informal with breathing and relaxation techniques (Gokli 1994, n=29); hypnorelaxation with oxygen (Braithwaite 2005, n=10); conscious hypnosis (Trakyali 2008, n=15) |
| Comparison | No hypnotic intervention or sedative agent alone | No hypnosis (Gokli 1994, n=29); inhalation sedation with nitrous oxide and oxygen plus standardised behaviour management (Braithwaite 2005, n=10); verbal motivation by orthodontist (Trakyali 2008, n=15) |
| Outcomes | Completion of treatment (yes/no); Measures of behaviour between test and control groups; Difference in post-operative anxiety between test and control groups; Adverse events | Measures of behaviour during local anaesthesia (n=39); Physiological measures, pulse rate and oxygen saturation (n=29); Orthodontic appliance wearing time and co-operation (n=30); Anxiety control and overall response during extraction (n=10); Patient preference/acceptance (n=10); Treatment time (n=10); Adverse events, none reported (n=69); Completion of treatment, not reported (n=0); Post-operative anxiety, not reported (n=0) |
| Study designs | Both randomised and quasi-randomised controlled trials (case control studies were not included to avoid bias) | Three randomised controlled trials (two cross-over, one parallel); two at high risk of bias, one at moderate risk of bias (n=3) |
| Timing | Not specified | No patient follow-up in any study; Trakyali 2008 measured over 6 months |
Search date: 2010-06. Databases: The Cochrane Oral Health Group's Trials Register; The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OVID); EMBASE (OVID); PsycINFO (OVID)
Questions and results
Show all 2 versionsHypnosis vs No hypnosis (no hypnotic intervention)
Population: Children and adolescents up to 16 years of age undergoing dental treatment
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Completion of treatment (yes/no) | Completion of treatment was a protocol-planned primary outcome but was not reported as an outcome by any of the three included studies; statistical analysis and meta-analysis were not possible due to the insufficient… | NR | No studies |
Physiological measures during local anaesthesia (pulse rate and oxygen saturation) Population: Children aged 4 to 13 years with no previous dental experience undergoing restorative treatment with local anaesthesia (Gokli 1994) | With regard to oxygen saturation and pulse rate, only pulse rate was significantly lower in the hypnosis group (P = 0.005); oxygen saturation did not differ significantly. (Gokli 1994; cross-over, 29 children.) | 1 study · 29 participants | Ungraded |
Adverse events Population: Children undergoing dental and orthodontic treatment (Gokli 1994; Trakyali 2008) | None of the studies mentioned any adverse effects regarding hypnosis. (Gokli 1994; Trakyali 2008.) | 2 studies · 59 participants | Ungraded |
Difference in post-operative anxiety between test and control groups | Difference in post-operative anxiety was a protocol-planned outcome but was not measured or reported by any included study (no post-operative anxiety scale was reported). | NR | No studies |
Measures of behaviour during local anaesthesia administration (undesirable behaviours: crying, hand movement, physical resistance, leg movement) Population: Children aged 4 to 13 years with no previous dental experience undergoing restorative treatment with local anaesthesia (Gokli 1994) | Patients who were hypnotised demonstrated fewer undesirable behaviours (crying, hand movement, physical resistance and leg movement) than those who did not undergo hypnosis. Decreased crying with hypnosis was the only… | 1 study · 29 participants | Ungraded |
Orthodontic appliance (headgear) wearing time and patient co-operation 6 months Population: Children (mean age approximately 10 years) with skeletal Class II division 1 malocclusion undergoing orthodontic treatment with cervical headgear (Trakyali 2008) | A statistically significant decrease (P < 0.05) in headgear wear was observed in the control (verbal motivation) group from the first to the sixth month; the difference in the hypnosis group was not significant,… | 1 study · 30 participants | Ungraded |
Hypnosis combined with a sedative agent vs Sedation alone (sedative agent only)
Population: Children and adolescents up to 16 years of age undergoing dental treatment
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | No randomised or quasi-randomised trials comparing hypnosis combined with sedation versus sedation alone met the inclusion criteria; this planned comparison had no eligible studies. | 0 studies | No studies |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen
Population: Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Completion of treatment (yes/no) | Completion of treatment (yes/no) was a protocol-planned primary outcome but was not reported by the included study for this comparison (Braithwaite 2005); one participant in the sedation arm was withdrawn during… | NR | No studies |
Anxiety control and overall response to treatment during tooth extraction | Hypnosis did not provide sufficient anxiety control during tooth extraction, and overall response to treatment remained statistically lower than response to inhalation sedation with nitrous oxide and oxygen (i.e. the… | 1 study · 10 participants | Ungraded |
Total treatment time | No significant difference in total treatment time between inhalation sedation and hypnorelaxation; hypnorelaxation demanded little additional time to complete care. (Braithwaite 2005.) | 1 study · 10 participants | Ungraded |
Patient preference / acceptance of treatment | The majority of patients preferred inhalation sedation over hypnosis. (Braithwaite 2005; 10 patients.) | 1 study · 10 participants | Ungraded |
Adverse events | None of the studies mentioned any adverse effects regarding hypnosis. (Braithwaite 2005.) | 1 study · 10 participants | Ungraded |
Measures of behaviour / negative responses during local anaesthesia administration | Hypnosis can control some of the patient's negative responses to dental treatment, such as movement and behaviour, during administration of local anaesthesia. (Braithwaite 2005; single-blind cross-over, 10 patients… | 1 study · 10 participants | Ungraded |