All of them stated that they understood the text, not suggesting changes.Īnother blinded researcher (PCA) in charge of the statistical data analysis performed simple random sampling, according to the sequence of numbers randomized by computer that was assigned to each patient upon entering the dental extraction service, to determine which group the patient belonged to, using the “RANDBETWEEN” function in Microsoft Excel ™ v.2016 (Microsoft Corp., Redmond, WA, USA). To evaluate, with local participants, the transcultural language change of the original scale, a facial validity analysis was performed on ten patients at the University’s dental clinic, directly consulting on the understanding and format of the instrument. To define a baseline state of anxiety, a researcher (CA) selected patients who presented a moderate or high score of anxiety at the CORAH-MDAS 20Ģ1 applied at the time of invitation. Patients who met the inclusion criteria were invited to voluntarily participate in the study and they accepted by signing an informed consent. According to these data, each group determined a minimum number of 12 subjects (algorithm “power one mean 1.3 0.5, sd(0.9)” Stata/MP v14.0. An alpha error of 5%, a beta error of 80% and a mean difference of 0.8☐.9 µg/dL were considered for study groups.
The sample size was calculated based on the results of the effect of music on salivary cortisol conducted by Mejía-Rubalcava, et al. Patients who had pericoronitis or acute infection of the tooth to be extracted at the time of the surgery or ten days prior were also excluded. Patients with systemic diseases that can directly affect the physiological variables associated with anxiety were excluded: diabetes, immunodepression, high blood pressure, thyroid pathology, cardiac diseases, alcoholism, heavy smoker (more than 10 cigarettes per day), those receiving permanent pharmacological treatment with tricyclic antidepressants, anticholinergics, benzodiazepines, antihypertensives, synthetic glucocorticoids (prednisone and prednisolone) or anticonvulsants as well as pregnant women and patients with hearing impairment. We included healthy patients who were ASA I, between 15 and 40 years of age, with indication of a simple dental extraction, treated in the oral surgery section of the Dental Clinic of the Universidad Austral de Chile between June and September 2018 in Valdivia, Chile. Considering that the measurement of salivary cortisol allows to identify the stress levels of patients undergoing dental extractions, 18ġ9 this study aimed to evaluate the effect of music at 432 Hz and 440 Hz, versus no music, on anxiety levels according to the CORAH Modified Dental Anxiety Scale (CORAH-MDAS), 20Ģ1 and the salivary cortisol levels of patients requiring a simple dental extraction. To date, there have been no reports comparing the effect of a type of music with different frequencies to control anxiety in patients during dental treatment. However, it has been noted that the tones of the 440 Hz tuning frequency can be uncomfortable, irritating and disagreeable, whereas the intervals and tones obtained from the 432 Hz tuning frequency are peaceful, pleasant and more harmonious, 16 suggesting that the A note should be optimally tuned to 432 Hz because it exerts less pressure on the singers’ voices and has greater musical qualities. 11ġ4 According to the International Organization for Standardization (ISO) 15, the pitch standard established for the musical note A is 440 Hz. 10 In this regard, it has been described that music is effective in controlling anxiety. 13 Studies have shown that music significantly reduces saliva cortisol levels during simulated dental care situations, such as showing the patient the carpule syringe needle and exposure to a high-speed dental handpiece sound. 12 One of the most objective and simple ways to measure stress and anxiety is through salivary cortisol. In dentistry, the use of music has proven to reduce the physiological parameters of anxiety in patients during dental cleaning, 8 extractions, 9ġ0 endodontic treatments, 11 and pediatric care.
1Ģ Music therapy has been used as a non-pharmacological method to control anxiety 3Ĥ due to its suppressive action on the sympathetic nervous system, leading to a reduction in both adrenergic activity and neuromuscular activation, 5 Dental care is considered one of the five most commonly feared situations and one of the main reasons for missing dental appointments.
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