Effect of deep pressure input on parasympathetic system in patients with wisdom tooth surgery

Hsin-Yung Chen; Hsiang Yang; Ling-Fu Meng; Pei-Ying Sarah Chan; Chia-Yen Yang; Hsin-Ming Chen

doi:10.1016/j.jfma.2016.07.008

Effect of deep pressure input on parasympathetic system in patients with wisdom tooth surgery

J Formos Med Assoc. 2016 Oct;115(10):853-859. doi: 10.1016/j.jfma.2016.07.008. Epub 2016 Aug 24.

Authors

Hsin-Yung Chen¹, Hsiang Yang², Ling-Fu Meng³, Pei-Ying Sarah Chan⁴, Chia-Yen Yang⁵, Hsin-Ming Chen⁶

Affiliations

¹ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology and Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
² Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁴ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁵ Department of Biomedical Engineering, Ming-Chuan University, Taoyuan, Taiwan.
⁶ Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan. Electronic address: hmchen51@ntuh.gov.tw.

PMID: 27568389
DOI: 10.1016/j.jfma.2016.07.008

Abstract

Background/purpose: Deep pressure input is used to normalize physiological arousal due to stress. Wisdom tooth surgery is an invasive dental procedure with high stress levels, and an alleviation strategy is rarely applied during extraction. In this study, we investigated the effects of deep pressure input on autonomic responses to wisdom tooth extraction in healthy adults.

Methods: A randomized, controlled, crossover design was used for dental patients who were allocated to experimental and control groups that received treatment with or without deep pressure input, respectively. Autonomic indicators, namely the heart rate (HR), percentage of low-frequency (LF) HR variability (LF-HRV), percentage of high-frequency (HF) HRV (HF-HRV), and LF/HF HRV ratio (LF/HF-HRV), were assessed at the baseline, during wisdom tooth extraction, and in the posttreatment phase.

Results: Wisdom tooth extraction caused significant autonomic parameter changes in both groups; however, differential response patterns were observed between the two groups. In particular, deep pressure input in the experimental group was associated with higher HF-HRV and lower LF/HF-HRV during extraction compared with those in the control group.

Conclusion: LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The results suggest that the application of deep pressure alters the response of HF-HRV and facilitates maintaining sympathovagal balance during wisdom tooth extraction.

Keywords: anxiety; dental fear; stress; supportive care.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Anxiety / therapy
Cross-Over Studies
Dental Anxiety / therapy*
Female
Humans
Male
Molar, Third / surgery*
Parasympathetic Nervous System / physiology*
Pressure*
Single-Blind Method
Stress, Psychological
Taiwan
Young Adult