Mindfulness meditation (MM) can be an effective sedative technique for dental implant operation conducted under local anaesthesia.
Dental implant surgery lasts for 1-2 hours. Patients nearly always feel anxious during the procedure which leads to psychological stress and increased sympathetic activities such as heightened alertness, raised blood pressure, sweating, rapid heartbeat etc. Intravenous sedation would be helpful in managing this situation however it has limitations in dental context.
| What is Mindfulness meditation (MM)? Mindfulness meditation (MM) is nonjudgmental attention to experiences in the present moment. The MM practice involves focussing attention on present experiences of thoughts, emotions, and body sensations. One simply observes them nonjudgmentally as they arise and pass away. Mindfulness meditation is practiced for achieving enduring happiness. |
In mental illnesses and stress related situations, mindfulness meditation (MM) is known to produce beneficial effects however it is not clear if it is effective in managing patient anxiety in dental context. Hence, in a recent clinical trial, researchers investigated if sympathetic hyperactivity encountered during dental implant procedure can be managed non-pharmacologically by using mindfulness meditation (MM). The results are encouraging, it showed that MM can be an effective sedative technique for dental implant surgery conducted under local anesthesia.
The randomised clinical trial (RCT) had two treatment groups – Mindfulness Group and Conventional Group.
The patients in the experimental, Mindfulness Group, received mindfulness meditation training from a periodontist for 20 min daily for 3 days before dental implant surgery as per the protocol given below:
| Session 1 | The patient sat in a chair and was instructed to close eyes and relax and to focus on the flow of breath. If a random thought arose, the patient was told to passively notice and acknowledge that thought and to simply let ‘‘it’’ go, by bringing attention back to the sensations of the breath. The last 7 min of day 1 were held in silence, so that the participant could effectively practice mindfulness meditation. |
| Session 2 | The patients were instructed to focus on the ‘‘full breath,’’ (sensations in the nostrils and abdomen). The last 7 min of the session 2 were held in silence. |
| Session 3 | It was an extension of sessions 1 and 2. As a manipulation check, each subject was asked ‘‘if they felt that they were truly meditating’’ after each meditation session. |
The conventional control group did not receive any training in mindfulness meditation.
Psychological, physiological and biochemical parameters were examined through State-Trait Anxiety Inventory (STAI-S), bispectral index (BIS), cortisol levels (CL), systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and saturation (SpO2) parameters.
HR, SBP, DBP, SpO2, BIS score and CLs were compared at the baseline, immediately before surgery, during surgery, and immediately after surgery between the study and control groups.
The study group comprising of patients who received mindfulness meditation training showed significant decrease in BIS score (which is an indicator of awareness, an awake patient has BIS score of 90 to 100; values less than 40 represent a hypnotic state). HR, SBP and DBP were decreased and SPO2 was increased thus hemodynamic parameters improved. Cortisol levels (CL) was deceased while psychological parameter STAI-S scores improved.
The results of the RCT study show that mindfulness meditation training for 20 min daily for 3 days before the procedure significantly reduce anxiety of patients during dental implant surgery. This suggests that mindful meditation (MM) could be a reliable strategy for managing stress and anxiety of patients during dental implant operation.
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References:
- Turer, O.U., Ozcan, M., Alkaya, B. et al. The effect of mindfulness meditation on dental anxiety during implant surgery: a randomized controlled clinical trial. Sci Rep 13, 21686 (2023). https://doi.org/10.1038/s41598-023-49092-3
- CilinicalTrial.gov. The Effect of Mindfulness Meditation During Dental Implant Surgery. ClinicalTrials.gov ID NCT05748223. Available at https://clinicaltrials.gov/study/NCT05748223
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