Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: A randomized controlled clinical trial

Mehdi Jafarzadeh, Soroor Arman, Fatemeh Farahbakhsh Pour, Mehdi Jafarzadeh, Soroor Arman, Fatemeh Farahbakhsh Pour

Abstract

Background: Essential oils have been used as an alternative and complementary treatment in medicine. Citrus fragrance has been used by aromatherapists for the treatment of anxiety symptoms. Based on this claim, the aim of present study was to investigate the effect of aromatherapy with essential oil of orange on child anxiety during dental treatment.

Materials and methods: Thirty children (10 boys, 20 girls) aged 6-9 years participated in a crossover intervention study, according to the inclusion criteria, among patients who attended the pediatric department of Isfahan Dental School in 2011. Every child underwent two dental treatment appointments including dental prophylaxis and fissure-sealant therapy under orange aroma in one session (intervention) and without any aroma (control) in another one. Child anxiety level was measured using salivary cortisol and pulse rate before and after treatment in each visit. The data were analyzed using t-test by SPSS software version 18.

Results: The mean ± SD and mean difference of salivary cortisol levels and pulse rate were calculated in each group before and completion of treatment in each visit. The difference in means of salivary cortisol and pulse rate between treatment under orange odor and treatment without aroma was 1.047 ± 2.198 nmol/l and 6.73 ± 12.3 (in minutes), which was statistically significant using paired t-test (P = 0.014, P = 0.005, respectively).

Conclusion: It seems that the use of aromatherapy with natural essential oil of orange could reduce salivary cortisol and pulse rate due to child anxiety state.

Keywords: Aromatherapy; children; dental anxiety; orange essential oil; salivary cortisol.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Patients who entered the study were divided into the study groups and analyzed

References

    1. Bare LC, Dundes L. Strategies for combating dental anxiety. J Dent Educ. 2004;68:1172–7.
    1. Meng X, Heft MW, Bradley MM, Lang PJ. Effect of fear on dental utilization behaviors and oral health outcome. Commun Dent Oral Epidemiol. 2007;35:292–301.
    1. Walsh LJ. Anxiety prevention: Implementing the 4 S principle in conservative dentistry. Auxiliary. 2007;17:24–6.
    1. Taani DQ, El-Qaderi SS, Abu Alhaija ES. Dental anxiety in children and its relationship to dental caries and gingival condition. Int J Dent Hyg. 2005;3:83–7.
    1. 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;139:317–24.
    1. Loggia ML, Schweinhardt P, Villemure C, Bushnell MC. Effects of psychological state on pain perception in the dental environment. J Can Dent Assoc. 2008;74:651–6.
    1. Cohen S, Fiske J, Newton J. Behavioural dentistry: The impact of dental anxiety on daily living. Br Dent J. 2000;189:385–90.
    1. Locker D. Psychosocial consequences of dental fear and anxiety. Commun Dent Oral Epidemiol. 2003;31:144–51.
    1. Oosterink F, De Jongh A, Aartman IH. What are people afraid of during dental treatment? Anxiety-provoking capacity of 67 stimuli characteristic of the dental setting. Eur J Oral Sci. 2008;116:44–51.
    1. Millot JL, Brand G, Morand N. Effects of ambient odors on reaction time in humans. Neurosci Lett. 2002;322:79–82.
    1. Goel N, Grasso DJ. Olfactory discrimination and transient mood change in young men and women: Variation by season, mood state, and time of day. Chronobiol Int. 2004;21:691–719.
    1. Millot J, Brand G. Effects of pleasant and unpleasant ambient odors on human voice pitch. Neurosci Lett. 2001;297:61–3.
    1. Aggleton JP, Mishkin M. The amygdala: Sensory gateway to the emotions. Emotion. 1986;3:281–99.
    1. Kleinknecht R, Klepac R, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc. 1973;86:842.
    1. Hakeberg M, Berggren U. Dimensions of the Dental Fear Survey among patients with dental phobia. Acta Odontologica. 1997;55:314–8.
    1. Hainsworth J, Moss H, Fairbrother K. Relaxation and complementary therapies: An alternative approach to managing dental anxiety in clinical practice. Dent Update. 2005;32:90.
    1. Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: A cluster randomised-controlled trial. Commun Dent Oral Epidemiol. 2010;38:83–7.
    1. Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav. 2000;71:83–6.
    1. 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;86:92–5.
    1. Evandri M, Battinelli L, Daniele C, Mastrangelo S, Bolle P, Mazzanti G. The antimutagenic activity of Lavandula angustifolia (lavender) essential oil in the bacterial reverse mutation assay. Food Chem Toxicol. 2005;43:1381–7.
    1. Lee SY. [The effect of lavender aromatherapy on cognitive function, emotion, and aggressive behavior of elderly with dementia] Taehan Kanho Hakhoe Chi. 2005;35:303.
    1. Ndao DH, Ladas EJ, Cheng B, Sands SA, Snyder KT, Garvin JH, Jr, et al. Inhalation aromatherapy in children and adolescents undergoing stem cell infusion: Results of a placebo-controlled double-blind trial. Psychooncology. 2012;21:247–54.
    1. Nord DA, Belew J. Effectiveness of the essential oils lavender and ginger in promoting children's comfort in a perianesthesia setting. J Peri Anesth Nurs. 2009;24:307–12.
    1. Schnaubelt K. Rochester, Vermont: Healing Arts Press; 1998. Advanced aromatherapy: The science of essential oil therapy.
    1. Dobetsberger C, Buchbauer G. Actions of essential oils on the central nervous system: An updated review. Flavour Fragr J. 2011;26:300–16.
    1. Faturi CB, Leite JR, Alves PB, Canton AC, Teixeira-Silva F. Anxiolytic-like effect of sweet orange aroma in Wistar rats. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34:605–9.
    1. Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preprocedural anxiety: A controlled prospective study. Gastroenterol Nurs. 2006;29:466.
    1. Toet A, Smeets MA, van Dijk E, Dijkstra D, van den Reijen L. Effects of pleasant ambient fragrances on dental fear: Comparing apples and oranges. Chemosens Percept. 2010;3:182–9.
    1. Fitzgerald M, Culbert T, Finkelstein M, Green M, Johnson A, Chen S. The effect of gender and ethnicity on children's attitudes and preferences for essential oils: A pilot study. Explore. 2007;3:378–85.
    1. King SL, Hegadoren KM. Stress hormones: How do they measure up? Biol Res Nurs. 2002;4:92–103.
    1. Gozansky W, Lynn J, Laudenslager M, Kohrt W. Salivary cortisol determined by enzyme immunoassay is preferable to serum total cortisol for assessment of dynamic hypothalamic-pituitary-adrenal axis activity. Clin Endocrinol. 2005;63:336–41.
    1. Westra AE, Zegers MP, Sukhai RN, Kaptein AA, Holscher HC, Ballieux BE, et al. Discomfort in children undergoing unsedated MRI. Eur J Pediatr. 2011;170:771–7.
    1. Baier K, Milgrom P, Russell S, Mancl L, Yoshida T. Children's fear and behavior in private pediatric dentistry practices. Pediatric Dent. 2004;26:316–21.
    1. Maddocks-Jennings W, Wilkinson JM. Aromatherapy practice in nursing: Literature review. J Adv Nurs. 2004;48:93–103.
    1. Buck LB. Smell and taste: The chemical senses. Princ Neural Sci. 2000;4:625–47.
    1. Sam M, Vora S, Malnic B, Ma W, Novotny MV, Buck LB. Neuropharmacology: Odorants may arouse instinctive behaviours. Nature. 2001;412:142.
    1. Atsumi T, Tonosaki K. Smelling lavender and rosemary increases free radical scavenging activity and decreases cortisol level in saliva. Psychiatry Res. 2007;150:89–96.
    1. Kanegane K, Penha SS, Munhoz CD, Rocha RG. Dental anxiety and salivary cortisol levels before urgent dental care. J Oral Sci. 2009;51:515–20.
    1. Toda M, Morimoto K. Effect of lavender aroma on salivary endocrinological stress markers. Arch Oral Biol. 2008;53:964–8.
    1. Chang KM, Shen CW. Aromatherapy benefits autonomic nervous system regulation for elementary school faculty in Taiwan. Evid Based Complement Alternat Med 2011. 2011 946537.
    1. Holm L, Fitzmaurice L. Emergency department waiting room stress: Can music or aromatherapy improve anxiety scores? Pediatr Emerg Care. 2008;24:836–8.
    1. Peretz B, Nazarian Y, Bimstein E. Dental anxiety in a students’ paediatric dental clinic: Children, parents and students. Int J Paediatr Dent. 2004;14:192–8.

Source: PubMed

3
Prenumerera