Effectiveness of binaural beats in alleviating anxiety during periodontal flap surgery: A randomized controlled trial

Dental anxiety is a prevalent concern, significantly impacting patient experience and treatment outcomes, particularly in periodontal flap surgery. Binaural beats, an auditory brainwave entrainment technique with demonstrated anxiolytic effects in medical contexts, have emerged as a promising nonpharmacological approach but remain underexplored in dental surgery. This study evaluates the efficacy of binaural beats in alleviating anxiety among patients undergoing periodontal flap surgery.

Fifty chronic periodontitis patients requiring periodontal flap surgery with moderate-to-high preoperative anxiety scores were randomly allocated to a test group (binaural beat exposure) or a control group (no auditory intervention). The test group listened to binaural beats for 30 min (10 min preoperatively + 20 min intraoperatively) using stereo headphones. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), and physiological stress markers such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded in both groups at the preoperative and postoperative stages.

Binaural beat exposure significantly reduced anxiety and physiological stress markers (P < 0.0001). Mean STAI scores decreased from 49 ± 6.93 to 38.7 ± 9.46. SBP and DBP declined from 132.0 ± 7.79 to 124.6 ± 8.40 mmHg and from 87.2 ± 4.61 to 79.8 ± 6.91 mmHg. HR reduced from 93.4 ± 8.17 to 83.2 ± 7.15 bpm, whereas the control group demonstrated postoperative elevations in anxiety and stress markers.

Binaural beats effectively reduced anxiety and physiological stress responses during periodontal flap surgery, offering a cost-effective, noninvasive alternative for anxiety management.