Assessment of preoperative and Postoperative anxiety and Haemodynamic changes in surgical Removal of Impacted Lower Third molar

AIM OF THE STUDY: The aim and objective of this study was to assess the amount of anxiety and fear in patients undergoing surgical removal of impacted lower third molar using subjective and objective scales. MATERIALS AND METHODS: This study was done in Ragas Dental College and Hospital in Department of Oral and Maxillofacial Surgery during the period May 2014 - August 2015. We studied 50 patients (27 were male and 23 were female) of mean age 28.3 (SD 5.925), who were posted for surgical removal of impacted lower third molar under local anesthesia, operated by a single operator trainee in oral and maxillofacial surgery. Informed Consent was obtained from each subject participating in the study. Patients were evaluated in three consecutive time intervals, pre operatively (T0), immediate postoperatively (T1) and seven days later (T2). Each patient’s anxiety was assessed using Modified Dental Anxiety Scale (MDAS), Spielberger’s State-Trait Anxiety Inventory (STAI), and Dental Fear Survey (DFS). The objective parameters i.e. blood pressure, heart rate, and oxygen saturation was also recorded at the above stated three time intervals. The obtained data was analyzed using repeated measures ANOVA, independent sample test, and Chi-square test. RESULTS: Results of present study showed that there were significant differences in MDAS between immediately before and immediately after (p=0.0001) and between immediately after and seven days after procedure (p=0.0001). In both State and Trait scales of STAI there were significant differences between before and immediately after (p=0.0001) and between immediately after and 7 days later (p=0.0001). The DFS also showed differences between before and immediately after (p=0.0001) and immediately after and seven days later (p=0.0001). Dental anxiety after tooth removal may be influenced by number of blocks / injections, duration of the operation and Pederson’s difficulty score and anxiety at 7 days is due to number of injections / blocks and Pederson’s difficulty score. The changes between systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were significant between all the three time intervals (p=0.0001), but all are within normal limits. CONCLUSION: There was difference in levels of anxiety at three time intervals which is assessed using Modified Dental Anxiety Scale (MDAS), State- Trait Anxiety Inventory (STAI), and Dental Fear Survey (DFS). The study concluded that majority of patients of sample were anxious at immediately after procedure. There was significant difference in variables, number of blocks/injections, Pederson’s difficulty score, and duration of procedure immediately after and after 7days. The haemodynamic changes recorded were increased in immediately after impaction and decreased after 7 days later. The changes obtained were within normal limits. Anxiety and fear play an important role in haemodyanamic changes as in present study. So there is a necessity to adopt proper stress reduction protocols in every institutions / clinics. Hence assessing anxiety and control of anxiety should be encouraged in minor oral surgical procedures