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Effects of Music Listening on Pre-treatment Anxiety and Stress Levels in a Dental Hygiene Recall Population

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Abstract

Background

Waiting for a medical procedure can exert significant feelings of state anxiety in patients. Music listening has been shown to be effective in decreasing anxiety levels. No study so far examined the potential anxiety and stress-reducing effect of a music intervention on pre-treatment anxiety and stress in patients waiting for dental hygiene treatment. Knowing whether the anxiety-reducing effect of music would also be detectible in the context of preventive routine medical procedures in healthy individuals would widen the area of application of music from the hospital or clinical environment to medical offices in general.

Purpose

Waiting for a medical treatment can induce anxiety and may lead to the experience of stress. We set out to examine the effect of music on pre-treatment anxiety in a healthy patient sample waiting for a dental treatment.

Methods

In a randomized controlled clinical trial, 92 consecutive volunteer patients (mean age, 57 years) waiting for their scheduled dental hygiene treatment were randomly allocated to either an experimental (n = 46, listening to music for 10 min) or a control group (n = 46, waiting in silence). State and habitual anxiety, subjective stress, and mood measures were assessed before and after music listening or silence, respectively.

Results

State anxiety levels in the music group decreased significantly after intervention as compared to the control group (F(1/90) = 8.06; p = 0.006). Participants’ trait anxiety and dental anxiety were not found to moderate this effect.

Conclusions

Listening to music prior to dental hygiene treatment decreases anxiety levels to a greater extent than waiting in silence.

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Notes

  1. When not otherwise stated‚ anxiety refers to “state anxiety”.

References

  1. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing Company; 1984.

    Google Scholar 

  2. Pittman S, Kridli S. Music intervention and preoperative anxiety: an integrative review. Int Nurs Rev. 2011;58(2):157–63.

    Article  CAS  PubMed  Google Scholar 

  3. Gillen E, Biley F, Allen D. Effects of music listening on adult patients’ pre-procedural state anxiety in hospital. Int J Evid Based Healthc. 2008;6(1):24–49.

    PubMed  Google Scholar 

  4. Tripp DA, Neish NR, Sullivan MJ. What hurts during dental hygiene treatment. J Dent Hyg. 1998;72(4):25–30.

    CAS  PubMed  Google Scholar 

  5. Spielberger CD, Sydeman SJ. State-trait anxiety inventory and state-trait anger expression inventory. In: Maruish ME, editor. The use of psychological testing for treatment planning and outcome assessment. Hillsdale: Lawrence Erlbaum Associates; 1994. p. 292–321.

    Google Scholar 

  6. Jöhren P. Validation of a questionnaire for the detection of dental anxiety. ZWR Das Deut Zahnärzteblatt. 1999;108:104–14.

    Google Scholar 

  7. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171–9.

    Article  CAS  PubMed  Google Scholar 

  8. Schulkin J, McEwen BS, Gold PW. Allostasis, amygdala, and anticipatory angst. Neurosci Biobehav Rev. 1994;18:385–96.

    Article  CAS  PubMed  Google Scholar 

  9. Sternberg EM. Neural regulation of innate immunity: a coordinated nonspecific host response to pathogens. Nat Rev Immunol. 2006;6(4):318–28.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Sullivan MJ, Neish N. Catastrophic thinking and the experience of pain during dental procedures. J Indiana Dent Assoc. 2000;79(4):16–9.

    PubMed  Google Scholar 

  11. Katz J, Poleshuck EL, Andrus CH, Hogan LA, Jung BF, Kulick DI, et al. Risk factors for acute pain and its persistence following breast cancer surgery. Pain. 2005;119(1–3):16–25.

    Article  PubMed  Google Scholar 

  12. Ozalp G, Sarioglu R, Tuncel G, Aslan K, Kadiogullari N. Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiol Scand. 2003;47(1):26–9.

    Article  CAS  PubMed  Google Scholar 

  13. Vaughn F, Wichowski H, Bosworth G. Does preoperative anxiety level predict postoperative pain? AORN J. 2007;85(3):589–604.

    Article  PubMed  Google Scholar 

  14. Walker KJ, Smith AF. Premedication for anxiety in adult day surgery. Cochrane Database Syst Rev. 2009;4, CD002192.

    PubMed  Google Scholar 

  15. Nyklicek I, Thayer JF, Van Doornen LJP. Cardiorespiratory differentiation of musically induced emotions. J Psychophysiol. 1997;11(4):304–21.

    Google Scholar 

  16. Khalfa S, Bella SD, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci. 2003;999:374–6.

    Article  PubMed  Google Scholar 

  17. Nater UM, Abbruzzese E, Krebs M, Ehlert U. Sex differences in emotional and psychophysiological responses to musical stimuli. Int J Psychophysiol. 2006;62(2):300–8.

    Article  PubMed  Google Scholar 

  18. Burns JL, Labbé E, Williams K, McCall J. Perceived and physiological indicators of relaxation: as different as Mozart and Alice in Chains. Appl Psychophysiol Biofeedback. 1999;24(3):197–202.

    Article  CAS  PubMed  Google Scholar 

  19. Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci U S A. 2001;98(20):11818–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Juslin PN, Sloboda J. Handbook of music and emotion. USA: Oxford University Press; 2010.

    Google Scholar 

  21. Afzal H, Afzal S, Siddique SA, Naqvi SA. Measures used by medical students to reduce test anxiety. J Pak Med Assoc. 2012;62(9):982–6.

    PubMed  Google Scholar 

  22. Elliott D, Polman R, Taylor J. The effects of relaxing music for anxiety control on competitive sport anxiety. Eur J Sport Sci. 2014;14 Suppl 1:S296–301.

    Article  PubMed  Google Scholar 

  23. Good M, Anderson GC, Ahn S, Cong X, Stanton-Hicks M. Relaxation and music reduce pain following intestinal surgery. Res Nurs Health. 2005;28(3):240–51.

    Article  PubMed  Google Scholar 

  24. McCaffrey R, Locsin R. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery. Holist Nurs Pract. 2006;20(5):218–24. quiz 25–6.

    Article  PubMed  Google Scholar 

  25. Nilsson U, Rawal N, Unosson M. A comparison of intra-operative or postoperative exposure to music—a controlled trial of the effects on postoperative pain. Anaesthesia. 2003;58(7):699–703.

    Article  CAS  PubMed  Google Scholar 

  26. Nilsson U, Unosson M, Rawal N. Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial. Eur J Anaesthesiol. 2005;22(2):96–102.

    Article  CAS  PubMed  Google Scholar 

  27. Twiss E, Seaver J, McCaffrey R. The effect of music listening on older adults undergoing cardiovascular surgery. Nurs Crit Care. 2006;11(5):224–31.

    Article  PubMed  Google Scholar 

  28. Voss JA, Good M, Yates B, Baun MM, Thompson A, Hertzog M. Sedative music reduces anxiety and pain during chair rest after open-heart surgery. Pain. 2004;112(1–2):197–203.

    Article  PubMed  Google Scholar 

  29. MacDonald RAR, Mitchell LA, Dillon T, Serpell MG, Davies JB, Ashley EA. An empirical investigation of the anxiolytic and pain reducing effects of music. Psychol Music. 2003;31(2):187–203.

    Article  Google Scholar 

  30. Nilsson U. The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J. 2008;87(4):780–807.

    Article  PubMed  Google Scholar 

  31. Allen K, Golden LH, Izzo Jr JL, Ching MI, Forrest A, Niles CR, et al. Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosom Med. 2001;63(3):487–92.

    Article  CAS  PubMed  Google Scholar 

  32. Cooke M, Chaboyer W, Hiratos MA. Music and its effect on anxiety in short waiting periods: a critical appraisal. J Clin Nurs. 2005;14(2):145–55.

    Article  PubMed  Google Scholar 

  33. Wang SM, Kulkarni L, Dolev J, Kain ZN. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg. 2002;94(6):1489–94.

    PubMed  Google Scholar 

  34. Lee D, Henderson A, Shum D. The effect of music on preprocedure anxiety in Hong Kong Chinese day patients. J Clin Nurs. 2004;13(3):297–303.

    Article  PubMed  Google Scholar 

  35. Cooke M, Chaboyer W, Schluter P, Hiratos M. The effect of music on preoperative anxiety in day surgery. J Adv Nurs. 2005;52(1):47–55.

    Article  PubMed  Google Scholar 

  36. Hayes A, Buffum M, Lanier E, Rodahl E, Sasso C. A music intervention to reduce anxiety prior to gastrointestinal procedures. Gastroenterol Nurs. 2003;26(4):145–9.

    Article  PubMed  Google Scholar 

  37. El-Hassan H, McKeown K, Muller AF. Clinical trial: music reduces anxiety levels in patients attending for endoscopy. Aliment Pharmacol Ther. 2009;30(7):718–24.

    Article  CAS  PubMed  Google Scholar 

  38. Buffum MD, Sasso C, Sands LP, Lanier E, Yellen M, Hayes A. A music intervention to reduce anxiety before vascular angiography procedures. J Vasc Nurs. 2006;24(3):68–73. quiz 4.

    Article  PubMed  Google Scholar 

  39. Haun M, Mainous RO, Looney SW. Effect of music on anxiety of women awaiting breast biopsy. Behav Med. 2001;27(3):127–32.

    Article  CAS  PubMed  Google Scholar 

  40. Yung PM, Chui-Kam S, French P, Chan TM. A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate. J Adv Nurs. 2002;39(4):352–9.

    Article  PubMed  Google Scholar 

  41. Lee KC, Chao YH, Yiin JJ, Chiang PY, Chao YF. Effectiveness of different music-playing devices for reducing preoperative anxiety: a clinical control study. Int J Nurs Stud. 2011;48(10):1180–7.

    Article  PubMed  Google Scholar 

  42. Lee KC, Chao YH, Yiin JJ, Hsieh HY, Dai WJ, Chao YF. Evidence that music listening reduces preoperative patients’ anxiety. Biol Res Nurs. 2012;14(1):78–84.

    Article  PubMed  Google Scholar 

  43. Berbel P, Moix J, Quintana S. Music versus diazepam to reduce preoperative anxiety: a randomized controlled clinical trial. Rev Esp Anestesiol Reanim. 2007;54(6):355–8.

    CAS  PubMed  Google Scholar 

  44. Bringman H, Giesecke K, Thorne A, Bringman S. Relaxing music as pre-medication before surgery: a randomised controlled trial. Acta Anaesthesiol Scand. 2009;53(6):759–64.

    Article  CAS  PubMed  Google Scholar 

  45. Lahmann C, Schoen R, Henningsen P, Ronel J, Muehlbacher M, Loew T, et al. Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. J Am Dent Assoc. 2008;139(3):317–24.

    Article  PubMed  Google Scholar 

  46. Rayman S, Dincer E, Almas K. Managing dental fear and anxiety. N Y State Dent J. 2013;79(6):25–9.

    PubMed  Google Scholar 

  47. Gadbury-Amyot CC, Williams KB. Dental hygiene fear: gender and age differences. J Contemp Dent Pract. 2000;1(2):42–59.

    CAS  PubMed  Google Scholar 

  48. Thoma MV, La Marca R, Bronnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response. PLoS One. 2013;8(8):e70156.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Laux L, Glanzmann P, Schaffner P, Spielberger CD. Das State-Trait-Angstinventar. Theoretische Grundlagen und Handanweisungen. Weinheim: Beltz; 1981.

    Google Scholar 

  50. Steyer R, Schwenkmezger P, Notz P, Eid M. Der Mehrdimensionale Befindlichkeitsfragebogen (MDBF): Handanweisung. Göttingen: Hogrefe; 1997.

    Google Scholar 

  51. Vasey MW, Thayer JF. The continuing problem of false positives repeated measures ANOVA in psychophysiology: a multivariate solution. Psychophysiology. 1987;24:479–86.

    Article  CAS  PubMed  Google Scholar 

  52. Greenhouse JB, Junker BW. Exploratory statistical methods, with applications to psychiatric research. Psychoneuroendocrinology. 1992;17(5):423–41.

    Article  CAS  PubMed  Google Scholar 

  53. Kirk RE. Experimental design: procedures for the behavioral sciences. 3rd ed. Pacific Grove: Brooks/Cole; 1995.

    Google Scholar 

  54. Lee YY, Chan MF, Mok E. Effectiveness of music intervention on the quality of life of older people. J Adv Nurs. 2010;66(12):2677–87.

    Article  PubMed  Google Scholar 

  55. Robb S, Nichols R, Rutan R, Bishop B, Parker J. The effects of music-assisted relaxation on preoperative anxiety. J Music Ther. 1995;32(1):3–12.

    Article  Google Scholar 

  56. Levenson RW. The search for autonomic specifity. In: Ekman P, Davidson RJ, editors. The nature of emotion. New York: Oxford University Press; 1994. p. 252–7.

    Google Scholar 

  57. Bulfone T, Quattrin R, Zanotti R, Regattin L, Brusaferro S. Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. Holist Nurs Pract. 2009;23(4):238–42.

    Article  PubMed  Google Scholar 

  58. Mitchell LA, MacDonald RA, Brodie EE. A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain. Eur J Pain. 2006;10(4):343–51.

    Article  PubMed  Google Scholar 

  59. Pothoulaki M, MacDonald RAR, Flowers P, Stamataki E, Filiopoulos V, Stamatiadis D, et al. An investigation of the effects of music on anxiety and pain perception in patients undergoing haemodialysis treatment. J Health Psychol. 2008;13(7):912–20.

    Article  CAS  PubMed  Google Scholar 

  60. Davis WB, Thaut MH. The influence of preferred relaxing music on measures of state anxiety, relaxation, and physioloigcal responses. J Music Ther. 1989;26:168–87.

    Article  Google Scholar 

  61. Menon V, Levitin DJ. The rewards of music listening: response and physiological connectivity of the mesolimbic system. Neuroimage. 2005;28(1):175–84.

    Article  CAS  PubMed  Google Scholar 

  62. Juslin PN, Västfjäll D. Emotional responses to music: the need to consider underlying mechanisms. Behav Brain Sci. 2008;31:559–621.

    Article  PubMed  Google Scholar 

  63. Knight WE, Rickard NS. Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. J Music Ther. 2001;38(4):254–72.

    Article  CAS  PubMed  Google Scholar 

  64. Mok E, Wong KY. Effects of music on patient anxiety. Aorn J. 2003;77(2):396–7. 401–6, 9–10.

    Article  PubMed  Google Scholar 

  65. Allen K, Blascovich J. Effects of music on cardiovascular reactivity among surgeons. JAMA. 1994;272(11):882–4.

    Article  CAS  PubMed  Google Scholar 

  66. Mitchell LA, MacDonald RA. An experimental investigation of the effects of preferred and relaxing music listening on pain perception. J Music Ther. 2006;43(4):295–316.

    Article  PubMed  Google Scholar 

  67. Kim YK, Kim SM, Myoung H. Musical intervention reduces patients’ anxiety in surgical extraction of an impacted mandibular third molar. J Oral Maxillofac Surg. 2011;69(4):1036–45.

    Article  PubMed  Google Scholar 

  68. Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L. Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized controlled trials. Ambul Pediatr. 2008;8(2):117–28.

    Article  PubMed  Google Scholar 

  69. Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav. 2005;86(1–2):92–5.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from the Young Investigator Grant of the University of Zurich, grant no. 56233208 (MVT). We thank the survey respondents and acknowledge the assistance of Adriana Giaquinto and Regula Bättig in organizing the patient interviews. UMN acknowledges funding by the Volkswagen Foundation.

Conflict of Interest

Myriam V. Thoma, Martina Zemp, Lea Kreienbühl, Deborah Hofer, Patrick R. Schmidlin, Thomas Attin, Ulrike Ehlert, and Urs M. Nater declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Correspondence to Urs M. Nater.

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Thoma, M.V., Zemp, M., Kreienbühl, L. et al. Effects of Music Listening on Pre-treatment Anxiety and Stress Levels in a Dental Hygiene Recall Population. Int.J. Behav. Med. 22, 498–505 (2015). https://doi.org/10.1007/s12529-014-9439-x

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