Hypnosis in controlling anxiety during third molar extraction: a critical review

The use of hypnosis as an alternative for controlling stress and anxiety in patients undergoing surgical treatment has been discussed in recent years. The aim of this study was to critically review Randomized Clinical Trials (RCTs) on the clinical efficacy of hypnosis in controlling anxiety related to third molar extraction. The PICO strategy was adopted: Population (Patients undergoing third molar extraction), Intervention (Hypnosis), Comparator (Other therapies to control anxiety) and Outcome (Reduced anxiety). The descriptors "Hypnosis," "Anxiety," "Dental treatment," "Third Molar" and "Oral Surgical Procedures" were used, combined or not, in the following databases: Medline (via PubMed), Scopus, Web of Science, Cochrane and Embase. Of the 255 articles found, only 1 met the inclusion criteria. Therefore, the first 100 articles from the Gray Literature (Google Scholar) were consulted, from which 2 studies were included. Although the three articles evaluated were RCTs, they were all classified as level III evidence with a high risk of bias. In two studies, the group that received hypnosis had a lower anxiety index, a statistically significant result (p < .05), according to the Spielberger Anxiety Inventory. These data show that, despite the advantages of hypnosis in controlling anxiety in patients undergoing third molar extraction, the literature is still limited. There is therefore a need for more RCTs, using a rigorous methodology that can support reliable clinical results.