Cardiovascular Changes Due to Dental Anxiety During Local Anesthesia Injection for Extraction
Dr. Nimish Agarwal
Abstract
Aim of the Study The present study evaluated the cardio-vascular changes related to anxiety of the patient under-going local anesthesia injection for extraction in Indian population.
Methodology In total, 100 Indian male patients were enrolled in the prospective study. Anxiety was measured at 15 min before local anesthetic delivery using Corah’s Dental Anxiety Scale (DAS). Cardiovascular response data including blood pressure, heart rate, oxygen saturation and electrocardiographic changes were measured at five time points from 5 min before to 15 min after the administration of anesthetic.
Nimish Agarwal nimish.agarwal9@gmail.com
1 Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
2 Jag Prakash Hospital, New Delhi, India
3 Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
4 Department of Prosthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
Results The mean anxiety scale score before administra-tion of anesthetic was 8.24 (±3.55) with a range from 4 to 20. Younger age was associated with a higher anxiety scale score. Severe preoperative anxiety (DAS > 12) was asso-ciated with significantly increased heart rate and blood pressure during administration of anesthetic. Significant ECG change was present at the time and 5 min after local anesthesia administration. Pain on injection was also associated with increased heart rate and blood pressure during anesthetic administration.
Conclusion The present study shows that significant car-diovascular changes do occur due to dental anxiety at the time of local anesthesia administration for tooth extraction in Indian population.
Introduction
Anxiety or fear during dental treatment has been a concern to dentist from time immemorial. Approximately 6-15% of the population suffers from dental fear and anxiety which leads to avoidance of dental treatment worldwide [1]. Although every procedure that is performed in the dental office is capable of being viewed as frightening, by the patient, anxiety related to injection of an anesthetic is probably one of the most important psychological respon-ses. The anticipation of the anesthesia injection produces more fear than the actual injection itself [2]. Anxiety related to local anesthesia injection has a significant effect on patient’s cardiovascular status. Many patients have been reported of having cardiac attack and vasovagal syncope