Effectiveness of music interventions on dental anxiety in paediatric and adult patients: a systematic review.

Abstract

BACKGROUND Dental anxiety has been identified as a significant and common problem in both children and adults and is considered an obstacle for dental care providers in the delivery of quality oral care. Patients with dental anxiety tend to avoid professional dental care which poses a problem for dentists and patients alike.There are various treatment options for reducing dental anxiety. Music has been used in different medical fields to meet physiological, psychological, and spiritual needs of patients. Music interventions can either be passive (music listening) or active music (therapy).There was a significant gap in the literature on the effectiveness of music therapy and music listening in reducing dental anxiety in patients undergoing various dental treatments/procedures. This systematic review specifically examined the effectiveness of music interventions in reducing dental anxiety in both paediatric and adult patients. OBJECTIVE The objective of this systematic review was to critically appraise, synthesise and present the best available evidence related to the effectiveness of music interventions on dental anxiety in paediatric and adult patients. DATA SOURCES A comprehensive search was undertaken on major electronic databases from their inception to October 2010. The search was restricted to English language and other languages where a translation was available from colleagues (for e.g. Chinese, Japanese, and Italian). REVIEW METHODS Randomised controlled trials, quasi-randomised controlled trials and quasi-experimental studies were included in the review. Critical appraisal and data extraction were undertaken using the Joanna Briggs Institute critical appraisal instrument and the standard data extraction form for evidence of effectiveness. RESULTS Seven studies with a combined total of 598 patients were included. Two out of the seven studies were RCTs, four quasi-randomised and one quasi-experimental study. There were 513 adult patients as participants from five studies and 85 paediatric patients from two studies. The results were classified into two categories.Two studies had paediatric patients as population group. One study found that music listening did not result in any reduction of anxiety during dental procedures on young patients; therefore the authors concluded that music alone is ineffective as a distraction during dental procedures. However, another study found that music reduced anxiety to some extent, although it was not significant.Five studies included in this review had adult patients as population group. Two studies concluded that relaxation when compared to music is an effective method of reducing patient's anxiety. One study concluded that music listening significantly lowered levels of anxiety and stress of females during dental procedures. Authors of the study concluded that there was a strong physiological (increased secretory immunoglobulins level) response to music by females. Two other studies provided conclusive evidence on effectiveness of music in reducing dental anxiety in this population group. CONCLUSIONS This systematic review concluded that there was enough evidence to suggest that adult patients may benefit from a procedural music-listening program. There was inconclusive evidence on the effectiveness of music in reducing dental anxiety in children. IMPLICATIONS FOR PRACTICE It is recommended that pre-recorded music be offered through headphones during the dental procedure to adult patients to reduce their dental anxiety. The evidence on the effectiveness of music in reducing dental anxiety in children is inconclusive. IMPLICATIONS FOR RESEARCH More research needs to be performed before it is possible to show, with a higher degree of certainty, that music listening does have a significant effect on the reduction of dental anxiety. Future studies, most likely randomised controlled trials should evaluate music therapy as an intervention for managing dental anxiety.