Dental anxiety, cardiovascular changes and patient preconceptions toward implants and root canal treatments: An observational study.

Background: There is little information about dental anxiety and the patient's vital signs during dental procedures. This study evaluates and compare patient anxiety levels and cardiovascular changes before and during root canal treatment (RCT) and single-tooth implant procedures. Material and Methods: Preoperative data and pre-treatment considerations were recorded. HR and SpO2 were monitored during treatment procedures at five points. Data were analyzed accordingly using Mann Whitney or X2 tests. 80 patients met the inclusion criteria. Results: Anxiety and fear scores were strongly correlated (p< 0.001). Both treatments resulted in low levels of dental anxiety and fear. Patients with a prior dental bad experience presented higher anxiety scores in the implant treatment group (p< 0.05). Implant treatment was considered a more time-consuming and more painful procedure than root canal treatment (p< 0.05). No significant relation was found between the level of anxiety with HR and SpO2. Conclusions: No significant relation was found between the level of dental anxiety with HR and SpO2. Single-implant treatment was pre-considered to be a more time-consuming and more painful procedure when compared with a RCT. HR was higher at the initial stages and decreased as both procedures finished. Key words:Dental anxiety, endodontics, dental implants, oximetry, heart rate.

General Anxiety in Dental Staff and Hemodynamic Changes over Endodontists' Workday during the Coronavirus Disease 2019 Pandemic: A Prospective Longitudinal Study.

INTRODUCTION: The aim of this study was to assess general anxiety levels in endodontists and dental assistants related to different conditions during the pandemic and lockdown and to evaluate hemodynamic changes in endodontists' heart rate (HR), blood pressure, and blood oxygenation during their workday. METHODS: Anxiety levels in endodontists and dental assistants were recorded weekly during the state of alarm declared because of the coronavirus disease 2019 pandemic. Hemodynamic parameters were monitored using a sphygmomanometer for HR and blood pressure and a pulse oximeter for oxygen saturation. Measurements were taken before and after each root canal treatment as well as on arrival at the clinic and at the end of the working day. Rest data, recorded every Saturday, served as a control. Data analysis was performed using chi-square, paired t, Mann-Whitney, and analysis of variance tests (P < .05). RESULTS: General anxiety decreased over the weeks, with significant differences between weeks 1 and 4 (P < .05). Endodontists perceived higher anxiety levels of anxiety during anesthesia inoculation and dental assistants during the dental unit's disinfection and equipment material (P < .05). There was a significant increase in the cardiovascular response in all endodontists in the clinic registrations compared with rest data (P < .05). Values were higher in the strict confinement period and significant for HR when arriving at the clinic (P < .05). CONCLUSIONS: Levels of general anxiety were higher during the first weeks. The chief perceived factors related to anxiety in endodontists and dental assistants were the risk of contagion and protection measures. Higher HR and blood pressure levels were registered during the workday, especially when arriving at the clinic.

Dental Anxiety, Fear, and Root Canal Treatment Monitoring of Heart Rate and Oxygen Saturation in Patients Treated during the Coronavirus Disease 2019 Pandemic: An Observational Clinical Study.

INTRODUCTION: The present study aimed to evaluate anxiety in patients and to monitor their heart rate (HR) and blood oxygenation (SpO2) before, during, and after a root canal treatment (RCT) during the state of alarm in 2 different periods of strict and partial confinement. METHODS: The patients who required a primary RCT were selected. Demographic, preoperative, and postoperative variables were registered, including perceived dental anxiety, fear, HR, and SpO2. Spearman correlation, chi-square, Mann-Whitney, and Kruskal-Wallis tests were used for frequency distribution and variable interaction, and Wilcoxon and Mann-Whitney tests were used to compare HR and SpO2 between groups and different treatment points. RESULTS: Ninety-six patients were included. The median Modified Dental Anxiety Scale scores were 8 (interquartile range [IQR], 6-9.25) and 6 (IQR, 5.5-8) in patients treated during the strict and partial confinement periods. The median fear scores were 2 (IQR, 0-5) and 3 (IQR, 1-5), respectively. Having a previous dental bad experience resulted in higher dental anxiety and fear (P < .05). HR was increased in patients with higher MDAS and fear scores and in those treated during the strict confinement (P < .05). In treatment time points T6 (x-ray taking), and T7 (post-treatment), HR decreased compared with the other evaluated treatment time points (P < .05). No clinical differences were found regarding SpO2. CONCLUSIONS: Self-perception on dental anxiety and fear was similar to other studies in a nonpandemic context. Patients with higher levels of dental anxiety and those treated in the strict confinement period presented an elevated HR. However, it can be stated that RCT performed by endodontists does not result in a significant alteration in patients.