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Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial

Abstract

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).

Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.

Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)

What is Known:
Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.
Aromatherapy with essential oils can be used to relieve children.
What is New:
Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.
During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

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Abbreviations

ANOVA:

Analysis of variance

FIS:

Face image scale

FLACC:

Face, Legs, Activity, Cry, Consolability

SPSS:

Statistical Package for the Social Sciences

WBS:

Wong-Baker pain rating scale

References

  1. ten Berge M, Veerkamp JS, Hoogstraten J, Prins PJ (2002) Childhood dental fear in the Netherlands: prevalence and normative data. Community Dent Oral Epidemiol 30:101–107

    PubMed  Google Scholar 

  2. Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM (2004) Psychological aspects of persistent pain: current state of the science. J Pain 5:195–211

    PubMed  Google Scholar 

  3. Locker D, Thomson WM, Poulton R (2001) Psychological disorder, conditioning experiences, and the onset of dental anxiety in early adulthood. J Dent Res 80:1588–1592

    CAS  PubMed  Google Scholar 

  4. Thomson WM, Locker D, Poulton R (2000) Incidence of dental anxiety in young adults in relation to dental treatment experience. Community Dent Oral Epidemiol 28:289–294

    CAS  PubMed  Google Scholar 

  5. Bikmoradi A, Khaleghverdi M, Seddighi I, Moradkhani S, Soltanian A, Cheraghi F (2017) Effect of inhalation aromatherapy with lavender essence on pain associated with intravenous catheter insertion in preschool children: a quasi-experimental study. Complement Ther Clin Pract 28:85–91

    PubMed  Google Scholar 

  6. Zhang C, Qin D, Shen L, Ji P, Wang J (2019) Does audiovisual distraction reduce dental anxiety in children under local anesthesia? A systematic review and meta-analysis. Oral Dis 25:416–424

    CAS  PubMed  Google Scholar 

  7. Messieha Z (2009) Risks of general anesthesia for the special needs dental patient. Spec Care Dentist 29:21–25 quiz 67-8

    PubMed  Google Scholar 

  8. Kritsidima M, Newton T, Asimakopoulou K (2010) The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial. Community Dent Oral Epidemiol 38:83–87

    PubMed  Google Scholar 

  9. Smallwood J, Brown R, Coulter F, Irvine E, Copland C (2001) Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial. Int J Geriatr Psychiatry 16:1010–1013

    CAS  PubMed  Google Scholar 

  10. Evandri MG, Battinelli L, Daniele C, Mastrangelo S, Bolle P, Mazzanti G (2005) The antimutagenic activity of Lavandula angustifolia (lavender) essential oil in the bacterial reverse mutation assay. Food Chem Toxicol 43:1381–1387

    CAS  PubMed  Google Scholar 

  11. Hajhashemi V, Ghannadi A, Sharif B (2003) Anti-inflammatory and analgesic properties of the leaf extracts and essential oil of Lavandula angustifolia mill. J Ethnopharmacol 89:67–71

    PubMed  Google Scholar 

  12. Tanida M, Niijima A, Shen J, Nakamura T, Nagai K (2006) Olfactory stimulation with scent of lavender oil affects autonomic neurotransmission and blood pressure in rats. Neurosci Lett 398:155–160

    CAS  PubMed  Google Scholar 

  13. Bradley BF, Starkey NJ, Brown SL, Lea RW (2007) Anxiolytic effects of Lavandula angustifolia odour on the Mongolian gerbil elevated plus maze. J Ethnopharmacol 111:517–525

    CAS  PubMed  Google Scholar 

  14. Holmes C, Ballard C (2004) Aromatherapy in dementia. Adv Psychiatr Treat 10:296–300

    Google Scholar 

  15. Umezu T (2000) Behavioral effects of plant-derived essential oils in the Geller type conflict test in mice. Jpn J Pharmacol 83:150–153

    CAS  PubMed  Google Scholar 

  16. Chioca LR, Ferro MM, Baretta IP, Oliveira SM, Silva CR, Ferreira J et al (2013) Anxiolytic-like effect of lavender essential oil inhalation in mice: participation of serotonergic but not GABAA/benzodiazepine neurotransmission. J Ethnopharmacol 147:412–418

    CAS  PubMed  Google Scholar 

  17. Karan NB (2019) Influence of lavender oil inhalation on vital signs and anxiety: a randomized clinical trial. Physiol Behav 211:112676

    CAS  PubMed  Google Scholar 

  18. Babaev O, Piletti Chatain C, Krueger-Burg D (2018) Inhibition in the amygdala anxiety circuitry. Exp Mol Med 50:18

    PubMed  PubMed Central  Google Scholar 

  19. Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L (2005) Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav 86:92–95

    CAS  PubMed  Google Scholar 

  20. Frankl S, Shiere FR, Fogels HR (1962) Should the parent remain with the child in the dental operatory? J Dent Child 29:150–163

    Google Scholar 

  21. Buchanan H, Niven N (2002) Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent 12:47–52

    CAS  PubMed  Google Scholar 

  22. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 23:293–297

    CAS  PubMed  Google Scholar 

  23. von Baeyer CL, Spagrud LJ (2007) Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years. Pain 127:140–150

    Google Scholar 

  24. Malviya S, Voepel-Lewis T, Burke C, Merkel S, Tait AR (2006) The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment. Paediatr Anaesth 16:258–265

    PubMed  Google Scholar 

  25. Voepel-Lewis T, Merkel S, Tait AR, Trzcinka A, Malviya S (2002) The reliability and validity of the face, legs, activity, cry, Consolability observational tool as a measure of pain in children with cognitive impairment. Anesth Analg 95:1224–1229

    PubMed  Google Scholar 

  26. Drendel AL, Kelly BT, Ali S (2011) Pain assessment for children: overcoming challenges and optimizing care. Pediatr Emerg Care 27:773–781

    PubMed  Google Scholar 

  27. Wong DL, Baker CM (1988) Pain in children: comparison of assessment scales. Pediatr Nurs 14:9–17

    CAS  PubMed  Google Scholar 

  28. McRae ME, Rourke DA, Imperial-Perez FA, Eisenring CM, Ueda JN (1997) Development of a research-based standard for assessment, intervention, and evaluation of pain after neonatal and pediatric cardiac surgery. Pediatr Nurs 23:263–271

    CAS  PubMed  Google Scholar 

  29. Aromatherapy With Essential Oils (PDQ(R)) (2002) Health professional version. PDQ Cancer Information Summaries, Bethesda (MD)

    Google Scholar 

  30. Goddard AW (2016) Cortical and subcortical gamma amino acid butyric acid deficits in anxiety and stress disorders: clinical implications. World J Psychiatry 6:43–53

    PubMed  PubMed Central  Google Scholar 

  31. King SL, Hegadoren KM (2002) Stress hormones: how do they measure up? Biol Res Nurs 4:92–103

    PubMed  Google Scholar 

  32. Jafarzadeh M, Arman S, Pour FF (2013) Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: a randomized controlled clinical trial. Adv Biomed Res 2:10

    PubMed  PubMed Central  Google Scholar 

  33. Seifi Z, Beikmoradi A, Oshvandi K, Poorolajal J, Araghchian M, Safiaryan R (2014) The effect of lavender essential oil on anxiety level in patients undergoing coronary artery bypass graft surgery: a double-blinded randomized clinical trial. Iran J Nurs Midwifery Res 19:574–580

    PubMed  PubMed Central  Google Scholar 

  34. Woolgrove J (1983) Pain perception and patient management. Br Dent J 154:243–246

    CAS  PubMed  Google Scholar 

  35. van Wijk AJ, Hoogstraten J (2005) Experience with dental pain and fear of dental pain. J Dent Res 84:947–950

    PubMed  Google Scholar 

  36. Garra G, Singer AJ, Domingo A, Thode HC Jr (2013) The Wong-Baker pain FACES scale measures pain, not fear. Pediatr Emerg Care 29:17–20

    PubMed  Google Scholar 

  37. Elbay US, Elbay M, Kaya E, Cilasun U (2016) Intraligamentary and supraperiosteal anesthesia efficacy using a computer controlled delivery system in mandibular molars. J Clin Pediatr Dent 40:193–199

    PubMed  Google Scholar 

  38. Hegde KM, Neeraja R, Srinivasan I, D RM, Melwani A, Radhakrishna S (2019) Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: a crossover split-mouth study. J Dent Anesth Pain Med 19:143–149

    PubMed  PubMed Central  Google Scholar 

  39. Elbay US, Elbay M, Kaya E, Yildirim S (2016) Effects of two different anesthetic solutions on injection pain, efficacy, and duration of soft-tissue anesthesia with inferior alveolar nerve block for primary molars. J Clin Pediatr Dent 40:456–463

    PubMed  Google Scholar 

  40. Mary Elizabeth O'Brien. Spirituality in nursing: standing on holy ground. 2002

    Google Scholar 

  41. Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D (2000) The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 90:706–712

    CAS  PubMed  Google Scholar 

  42. Hekmatpou D, Pourandish Y, Farahani PV, Parvizrad R (2017) The effect of aromatherapy with the essential oil of orange on pain and vital signs of patients with fractured limbs admitted to the emergency ward: a randomized clinical trial. Indian J Palliat Care 23:431–436

    PubMed  PubMed Central  Google Scholar 

  43. Perry R, Terry R, Watson LK, Ernst E (2012) Is lavender an anxiolytic drug? A systematic review of randomised clinical trials. Phytomedicine 19:825–835

    CAS  PubMed  Google Scholar 

  44. Goes TC, Antunes FD, Alves PB, Teixeira-Silva F (2012) Effect of sweet orange aroma on experimental anxiety in humans. J Altern Complement Med 18:798–804

    PubMed  Google Scholar 

  45. Marofi M, Sirousfard M, Moeini M, Ghanadi A (2015) Evaluation of the effect of aromatherapy with Rosa damascena mill. On postoperative pain intensity in hospitalized children in selected hospitals affiliated to Isfahan University of Medical Sciences in 2013: a randomized clinical trial. Iran J Nurs Midwifery Res 20:247–254

    PubMed  PubMed Central  Google Scholar 

  46. Kim JT, Ren CJ, Fielding GA, Pitti A, Kasumi T, Wajda M, Lebovits A, Bekker A (2007) Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obes Surg 17:920–925

    PubMed  Google Scholar 

  47. Kim JT, Wajda M, Cuff G, Serota D, Schlame M, Axelrod DM et al (2006) Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Pract 6:273–277

    PubMed  Google Scholar 

  48. Sessa F, Anna V, Messina G, Cibelli G, Monda V, Marsala G, Ruberto M, Biondi A, Cascio O, Bertozzi G, Pisanelli D, Maglietta F, Messina A, Mollica MP, Salerno M (2018) Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY) 10:166–177

    Google Scholar 

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Funding

This study was funded by researchers.

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Authors and Affiliations

Authors

Contributions

IA, SA, NBK designed the research. IA and SA collected the data, IA analyzed the data. IA, SA, NBK wrote and edited the paper. All authors approved the final version

Corresponding author

Correspondence to Ipek Arslan.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from guardians of all individual participants included in the study.

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Communicated by Peter de Winter

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Arslan, I., Aydinoglu, S. & Karan, N.B. Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial. Eur J Pediatr 179, 985–992 (2020). https://doi.org/10.1007/s00431-020-03595-7

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  • DOI: https://doi.org/10.1007/s00431-020-03595-7

Keywords

  • Anxiety
  • Clinical trial
  • Inhalation
  • Lavender
  • Pediatric dentistry