University of Worcester Worcester Research and Publications

Perioperative Propranolol Against Dental Anxiety: A Randomized Controlled Trial

Steenen, S. A., Su, N., van Westrhenen, R., van Wijk, A. J., Tjia, D. S. L., de Lange, J. and de Jongh, Ad (2022) Perioperative Propranolol Against Dental Anxiety: A Randomized Controlled Trial. Frontiers in Psychiatry, 13 (842353). ISSN Online: 1664-0640

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Background: Promising results from a trauma reactivation study on post-traumatic stress disorder suggest that propranolol is capable of attenuating symptoms of traumatically induced mental disorders by blocking memory reconsolidation.

Methods: A randomized, parallel, placebo-controlled, quadruple-blind trial was designed to determine the effectiveness of perioperative propranolol during exposure to dental extractions in reducing dental anxiety in patients with dental anxiety or dental phobia. Between November 2014 and December 2018, 52 patients with high levels of fear in anticipation of dental extractions who were referred to a department of oral and maxillofacial surgery for at least two tooth and/or molar removals with 1 month in between were included. On the first visit participants received either 120 mg of perioperative oral propranolol (n = 19) or placebo (n = 17), and a core fear memory was reactivated 1 h preoperatively. The primary outcome was change in severity of dental anxiety from baseline to 1-month follow-up, as indexed by the short version of the dental anxiety inventory (S-DAI). Secondary outcome measures were change in intra-operative state anxiety and specific phobia diagnoses.

Results: Linear mixed model (LMM) yielded no statistically significant difference in change of dental trait anxiety from baseline to 1-month follow-up between propranolol and placebo groups (Cohen's d = 0.23). S-DAI scores decreased in both study arms from baseline to follow-up (propranolol arm: from 32.1 [SD = 7.3] to 29.1 [SD = 8.8]; placebo arm: from 31.6 [SD = 7.5] to 27.1 [SD = 6.5]). Also, administering propranolol was not associated with a significant difference in change of intra-operative state anxiety or phobia diagnoses between groups over time.

Conclusions: The results do not concur with earlier findings regarding post-traumatic stress disorder, and suggest that individuals with traumatically induced fears or phobias do not benefit from the application of perioperative propranolol.

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Uncontrolled Discrete Keywords: dental anxiety, phobic disorders, propranolol, randomized controlled trial, reconsolidation, extinction
Divisions: College of Business, Psychology and Sport > School of Psychology
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Copyright Info: © 2022 Steenen, Su, van Westrhenen, van Wijk, Tjia, de Lange and de Jongh.
Depositing User: Miranda Jones
Date Deposited: 20 May 2022 12:18
Last Modified: 20 May 2022 12:18

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