Musicoterapia e controllo dell’ansia in ambito odontoiatrico

OBJECTIVES Among the anxiety disorders, den-tal anxiety (AD) – i.e., the abnormal fear of undergoing even minor dental treatments – represents a significant problem for oral health as such patients withdraw from adequate care and as the setting is deteriorated by the state of tension of the patient, which can hinder the normal execution of the proce-dures. Therefore, many more or less invasive methods have been proposed to remedy this problem, from intravenous sedation to con-scious sedation using nitrous ox-ide, hypnosis, or diazepines. This literature review aims to dis-cuss the current evidence on the efficacy of music therapy for con-trolling dental anxiety in adults. MATERIALS AND METHODS Medline, PubMed, Embase, Sco-pus, and Cochrane were searched. In addition, randomized controlled trials and quasi-experi-mental studies of adult outpatient participants from 1960 to 2020 were included in the review. The intervention considered was re-ceptive music therapy using headphones as a single interven-tion, experimented with a place-bo, relaxation, and pharmacologi-cal techniques. Outcomes were measured with various self-ad-ministered questionnaires and rating scales. RESULTS Sixteen articles were extracted from the initial pool of 471 studies. The results can be summarized as follows:-listening to music in head-phones (EMT) before and during dental procedures is as effective as a short pre-surgery relaxation session in AD control;-the use of EMT significantly re-duces the level of stress com-pared to other interventions;-the use of EMT with songs pre-ferred by the patient decreases intra-operative anxiety concern-ing the level of pre-operative anxiety, and there are decreased levels of heart rate, blood pres-sure, and respiratory rate;-the EMT with soothing piano music and volume control sig-nificantly reduces AD levels;-the EMT stabilizes pre-and in-tra-operative physiological pa-rameters and suppresses pre-and intra-operative anxiety-re-lated sympathetic activity;-432 Hz music seems to offer an extra edge over 440 Hz music. DISCUSSION There is extensive literature on the efficacy of a musical intervention in controlling anxiety in various medical conditions. The studies considered suggest the effective-ness of music in controlling dental anxiety, using headphones rather than loudspeakers, and allowing the patient to adjust the volume. No conclusive results emerged re-garding the preferability of a play-list chosen by the operator rather than the patient. What appears essential is the structured administration of the treatment and the collection of data that objectivize the results al-so in the eyes of the patient. The hypotheses on the effective-ness of EMT on AD are that: 1) mu-sic has a distracting effect, dis-tracting the patient from the ongo-ing experience; 2) music, especial-ly with noise-canceling head-phones, tends to eliminate all those noises experienced as threatening that are related to a dental session. CONCLUSIONS Music administered in the form of structured receptive music thera-py can be a helpful additional non-pharmacological intervention in the control of dental anxiety when administered in a structured manner and possibly modeled on the specific needs and tastes of the patient. However, further experimental re-search will be necessary to fully exploit this natural method’s mo-dalities, which can be readily available in all dental surgeries. CLINICAL SIGNIFICANCE Receptive music therapy applied structured during dental treat-ments significantly reduces anxi-ety in adults and represents a cheap, non-invasive, and easily applicable alternative in dental surgeries compared to current in-terventions