Study comparing midazolam and nitrous oxide in dental anxiety control
Darklilson Pereira-Santos1, Marcus Antônio Brêda-Júnior, Emanuela Prado Ferraz
1From the Oral and Maxillofacial Surgery and Periodontology Department, Ribeirão Preto Dental School, São Paulo University, São Paulo, Brazil.
The Journal of Craniofacial Surgery
|September 17, 2013
Summary
Midazolam sedation effectively reduced anxiety during lower third molar extractions, as shown by decreased salivary cortisol levels. This study highlights midazolam as a superior method for managing dental anxiety in patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Anesthesiology
- Endocrinology
Background:
- Dental anxiety significantly impacts patient experience and treatment outcomes.
- Sedation is crucial for managing anxiety during invasive procedures like lower third molar extractions.
- Objective biomarkers of anxiety, such as salivary cortisol, offer valuable insights.
Purpose of the Study:
- To compare the anxiolytic effects of midazolam versus nitrous oxide with oxygen during lower third molar extractions.
- To assess changes in anxiety levels using salivary cortisol levels and the Corah Dental Anxiety Scale.
- To determine the most effective sedation method for reducing physiological stress markers.
Main Methods:
- Twenty-eight male patients undergoing lower third molar extraction were included.
- Sedation was administered using either midazolam or nitrous oxide with oxygen.
- Salivary cortisol levels and Corah Dental Anxiety Scale scores were measured pre- and post-sedation.
Main Results:
- A statistically significant reduction in salivary cortisol levels was observed 40 minutes after midazolam administration compared to baseline.
- Midazolam demonstrated a greater efficacy in lowering salivary cortisol levels than nitrous oxide.
- Both objective (salivary cortisol) and subjective (anxiety scale) measures indicated reduced anxiety with midazolam.
Conclusions:
- Midazolam is a highly effective agent for reducing anxiety and physiological stress during lower third molar extractions.
- Salivary cortisol serves as a reliable objective indicator of anxiety in dental patients.
- Midazolam sedation offers a significant advantage in managing patient anxiety in oral surgery.
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