Harnessing the power of gate control: interventions for procedural pain and anxiety

Medical and dental procedures present a minefield of opportunities for pain and anxiety. Many procedures for diagnosis, treatment, and palliation are performed either without comfort measures at all or with sedation/anesthesia. Yet, there are many ways of decreasing patients’ procedural pain and anxiety and of increasing physical and psychological comfort. Gate control theory explains how we can close the gate on pain transmission (and minimize opening the gate) through non-pharmacological means. An exploration of several bottom-up and top-down interventions will be discussed including breathing, mindfulness, gradual exposure, non-pain stimuli, distraction, touch, and postoperative communications. Interventions will be illustrated with pictures and short videos in the dental setting.