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REVIEW ARTICLE

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HYPNODONTICS - AN OVERVIEW

Dr. S. Lakshmi Priya, Dr. R. Jayaprakash, Dr.M.Kameshwaran, Dr.K.Shubashini

Department of Pediatric and Preventive Dentistry

Tagore Dental College and Hospital, Chennai, Tamilnadu, India

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ABSTRACT

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Children of different age group have different levels

of fear which leads to lack of cooperation from the

patient during dental treatment thereby affecting

the prognosis of the treatment on a long-term basis.

Various behaviour shaping techniques including

pharmacological and non- pharmacological methods

have been practiced by dentists to gain maximum

patient compliance. Hypnodontics is defined as the

art and science of using hypnosis to induce comfort

Address for Correspondence:

and reduce pain. Uncooperative patients or those who

have fear and anxiety during dental treatment can be

Dr. S. Lakshmi Priya MDS

benefited from hypnotherapy.

Senior Lecturer, Department of Pediatric

and Preventive Dentistry

KEYWORDS: Pediatric dentistry, Hypnosis, Dental,

Tagore Dental College and Hospital

Behaviour.

Near Vandalur, Melakkottaiyur Post,

Rathinamangalam,

Tamil Nadu 600127

e-mail id: drlakshmipedo@gmail.com

Received

: 05.08.2019

Accepted

: 03.09.2019

Published

: 27.09.2019

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JIDAM/Volume:6/Issue:3/Pages 23 - 26/July-September 2019

Lakshmi et al: Hypnodontics in pediatric dentistry

INTRODUCTION:

however, that, even in the deepest levels of hypnosis,

patients can still open their eyes, talk, walk and carry

One of the main reasons that make pediatric

out tasks as normal. Deep hypnosis takes time to

patients avoid their visit to the dentist is fear and

achieve and would not be suitable for routine dental

anxiety. Children of different age groups have different

practice; however, it is required for analgesia and to

levels of fear which leads to lack of cooperation

modify behaviours. Reaching a light state is easier

from the patient during dental treatment and affects

and quicker to achieve, and is more commonly used

the prognosis of the treatment on a long-term basis.

in hypnodontia on a day-to-day basis; for example, to

Sometimes, patients are not afraid of the pain that

relax an anxious patient.⁶Light hypnosis is sufficient

dental treatment brings, but of the procedure itself.¹

to relax the patient and influence the frightened

Various behaviour shaping techniques including

dental patient whose pain threshold has been lowered

pharmacological and non- pharmacological methods

by negative emotions, which is said to be effective in

have been practiced by dentists to gain maximum

up to 80% of the population. When using hypnosis

patient compliance. Almost all the behaviour shaping

for analgesia, the patient must reach deep hypnosis,

techniques aim at keeping the patient relaxed and

which takes time, and have an environment free from

making them cooperate with the dentist during

distractions and interruptions.⁷

treatment. Abdeshahi et al suggest that hypnosis

enhances control over stress, pain, muscle tension,

PATIENT MANAGEMENT:

perception, memories, emotions and feelings.²

According to the American Society of Clinical

HYPNOSIS IN DENTISTRY:

Hypnosis, hypnotic therapy can be used in patients

with tongue thrust, reverse-swallowing, TMJ

Hypnodontics is defined as the art and science

dysfunction, bruxism.⁸In every hypnosis session, it

of using hypnosis to dental practice and dental issues.

is vital that the hypnotist obtains informed consent

There are techniques which dentists use to relax their

and reduces patient expectations. The session begins

patient (including waking hypnosis) and minimize

with simple induction exercises and it is made

pain, blood loss, during and after procedures.

clear to the patient that he/she can emerge from the

Uncooperative patients or those who have fear and

hypnotic state at any time. At the end of the session,

anxiety during dental treatment can be benefitted

the hypnotic state must be reversed and the patient

from hypnotherapy. One can easily alleviate the

must be reassured that he can carry on with his day

tension, nervousness and unreasonable fear of pain

to day routine without any discomfort. A relevant

often exhibited by these patients with the help of

advantage of hypnosis is the capability of reaching

hypnosis. It provides an effective sedation whilst

full relaxation, deep sedation and, sometimes,

maintaining patient cooperation, but it also may help

amnesia, while maintaining patient co-operation.³A

patients recovering from dental anxiety and phobia as

disadvantage is the environmental needs; even room

well as those with a severe gag reflex.⁴Hypnosis may

temperature can have an impact on induction n.²The

be used independently or as an additional option with

dangers of hypnosis are negligible when employed

other forms of treatment for best results. During this

by a trained professional within the context of a

state, the mind is focused on the suggestions given for

structured therapeutic programme.⁷In a qualitative

comfort and ease. The subconscious mind can much

study exploring general dental practitioner attitudes

more easily accept these suggestions now that the

towards hypnosis, the majority stated that they would

conscious guarded mind is more relaxed. Also, the

not use hypnotic techniques due to time constraints,

subconscious mind, where fears reside, is accessed in

lack of confidence with the techniques and feeling

this relaxed trance state. A qualified hypnotherapist

stressed while treating anxious patients⁹ In a

can facilitate the release of those fears while instilling

research conducted in 2011,¹⁰ researchers from the

the patient with new beneficial behaviours and

university of Rennes used hypnosis to help children

thought patterns which will aid in controlling anxiety.⁵

overcome the fear of needles used for anaesthesia.

The effects depend on the level of hypnosis and the

In a comparative study among adults and children,

hypnotist’s suggestions; hypnotists can induce light

19% of children (and 10% of adults) fear of needles

and deep hypnotic trances. It is important to stress,

during procedures requiring anaesthesia was the

cause of uncooperative behaviour.¹¹Results of the

102

JIDAM/Volume:6/Issue:3/Pages 23 - 26/July-September 2019

Lakshmi et al: Hypnodontics in pediatric dentistry

study, that compared a group of children who were

perception, control of haemorrhage and anxiety

exposed to hypnosis with a control group, show that

during extraction of third molars: a case-control

hypnosis heightened pain threshold, reducing the

study. J Craniomaxillofac Surg 2013;41: 310 -15.

pain intensity and increasing the number of patients

Facco E, Zanette G, Casiglia E The role of

who did not feel anything.¹¹The results of many

hypnotherapy in dentistry. SAAD Dig.

2014

studies state that hypnosis can be useful to dentists

Jan;30:3-6.

especially when treating sensitive subjects, such as

Hill K B, Hainsworth J M, Burke F J, Fairbrother

patients who have an intense gag reflex,^12,13 patients

K J. Evaluation of dentists perceived needs

with dental phobia, previously traumatized patients,

regarding treatment of the anxious patient. Br

or with children.^14,15 Suggestibility describes the

Dent J 2008; 204: E13

susceptibility of an individual to hypnosis, and was

Fross G. Handbook of hypnotic techniques

defined by Peretz et al¹⁶ as the degree to which an

with special reference to dentistry. Revised and

individual is inclined toward the uncritical acceptance

updated. Carter B.

1988 Free Press; Tampa,

of ideas and propositions. Intelligent, highly

Florida.

motivated individuals are good hypnotic subjects due

Nicola Allison. Hypnosis in modern dentistry:

to their ability to concentrate. Patients with lower IQ

Challenging misconceptions. Faculty Dental

and those who find it difficult to focus, are harder

Journal October

2015: Volume

6. Issue

to hypnotise. Individuals with psychopathologies are

more prone to the dissociative effects of hypnosis,

Al-Harasi S, Ashley PF, Moles DR, Parekh S,

it may complicate or worsen their mental state.

Walters V. Hypnosis for children undergoing

Other contraindications include drugs/alcohol and

dental treatment. The Cochrane database of

systematic reviews 2010: CD007154.

uncooperative or sceptical patients.

Binkley C J, Beacham A, Neace W, Gregg R

CONCLUSION:

G, Liem E B, Sessler D I. Genetic variations

associated with red hair color and fear of dental

Hypnosis has multiple uses in dentistry,

pain, anxiety regarding dental care and avoidance

of dental care. J Am Dent Assoc 2009;140:896-

ranging from mild relaxation of the anxious patient to

905.

total analgesia for surgery. With proper knowledge,

training and patient selection, it can be a very vital

Diercke K, Burger GD, Bermejo JL, Lux CJ,

tool to manage children and even anxious adults

Brunner M. The management of dental anxiety

and impact of psychosomatic factors in dentistry:

in the dental operatory therefore making dental

is recent scientific research translated into German

treatment successful in a very simple yet convenient

dental practices? J Health Psychol 2013;18:1519-

way.

28.

FINANCIAL SUPPORT AND

10. Hammarstrand G, U Berggren and M Hakeberg.

Psychophysiological therapy vs hypnotherapy in

SPONSORSHIP:

the treatment of patients with dental phobia. Eur

J Oral Sci 1995; 103(6):399-404.

Nil

11. Huet A et al. Hypnosis and dental anesthesia in

CONFLICTS OF INTEREST:

children: a prospective controlled study. Int J

Clin Exp Hypn 2011;59(4):424-40.

There are no conflicts of interest.

12. Barsby M.J. The use of hypnosis in the

management of gagging and intolerance to

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