Yogic relaxation better than Alprazolam before RCT
Fear and anxiety are common problems seen in dentistry, esp. with oral surgery and root canal treatment (RCT). Fear and anxiety can affect the heart rate and blood pressure of the patient which may potentially affect the quality of care provided, the healing process, and the patient's willingness to undergo follow-up care.
Can we harness our ancient Vedic knowledge to mitigate problems associated with fear and anxiety?
In a recent prospective, randomized, placebo-controlled study 30 patients requiring root canal treatment RCT with baseline Visual Analog Scale for anxiety (VAS-A) > 4 were randomly assigned to 3 groups - a yogic relaxation technique (YRT), Alprazolam (0.25/0.5 mg 1 hour before the procedure), and placebo respectively.
In the YRT group, the participants performed Bhramari and Nadi Shodan Pranayamas. The former has a soothing effect on the mind and nervous system while the latter balances both brain hemispheres.
Finally, a pre-recorded Panchkosha-guided meditation developed by Indian yoga guru Sri Sri Ravi Shankar was used which claims to clear out the repressed mental conflicts and the associated negative emotions.
In Group 1, after 30 minutes of administering YRT, access openings were prepared. The baseline, pre, and post-treatment scores were assessed using appropriate statistical tools.
Results showed significantly greater improvements in the anxiety scores in the YRT group compared to the other two groups both 10 min before and after RCT.
All parameters tested - anxiety, pain, blood pressure, and pulse rate had superior outcomes in the YRT group compared to the other groups and this difference was statistically significant. These beneficial effects may be attributed to better regulation of the sympathetic system and hypothalamic-pituitary-adrenal axis by YRT.
The study results were similar to the published literature review reiterating the benefits of yoga in reducing anxiety and stress.
Thus, the authors observed a promising role of YRT in the alleviation of anxiety in patients undergoing RCT. A single session of Yoga for 30 minutes can significantly reduce stress and anxiety levels. The suggested mechanism can be a decrease in the conflict between body and mind using YRT.
In conclusion, YRT is an effective method for reducing anxiety among patients undergoing RCT and can be used as an alternative to other pharmacologic measures in anxious patients.
Reference: Verma MR, Rao RD, Langade D, Jain AK, Guha A, Mohan M. Assessment of yogic relaxation techniques for its anxiolytic effects in patients requiring endodontic treatment: A prospective, randomized controlled study. J Conserv Dent [serial online] 2021 [cited 2021 Oct 14];24:209-13.
Available from: https://www.jcd.org.in/text.asp?2021/24/2/209/327853
Dr. Meenakshi Verma
Dr. Meenakshi Verma is Professor at BVP Dental College and Hospital, Navi Mumbai. She did her MDS in 1988 from GDCH Mumbai. She is a recipient of the TD Chugh Trophy in the first Endodontic Convention. Dr. Meenakshi is a trained Ayush Certified yoga instructor with a diploma in yoga - Empanelled by the ministry of external affairs as an international teacher of Indian culture, and also a Faculty with the Art of Living and SSIAR.
Dr. Rahul Rao completed BDS (1995) from AB Shetty Dental College, Mangalore, and MDS in Conservative Dentistry & Endodontics (2002) from GDCH, Mumbai. He is a Professor & PG Guide in BVP Dental College and Hospital, Navi Mumbai. His current research pursuits include the conservative management of deep caries, and burnout among dentists.