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THE USE OF HYPNOTIC TECHNIQUES
TO REDUCE THE USE OF ANALGESICS FOR DENTAL SURGERY.
C. Devin Hastings
that this article is a summary of a report written by Bjorn Enqvist of
Eastman Dental Center and Karolinska Institute, Stockholm Sweden and of
work done by Kerstin Fischer of Falu Hospital, Falun, Sweden. Complete
report reprints can be requested from Bjorn Enqvist, D.D.S.,
Eastmaninstitutet, Dalagatan 11, 113 24 Stockholm, Sweden.
AIM: The purpose of the following study was to investigate whether
preoperative hypnosis techniques can reduce stress and improve healing and
patient recovery from dental surgery.
ABSTRACT: This study was designed to evaluate the effectiveness of
hypnosis techniques used prior to dental surgery. Two groups of patients
were assigned. One was the experimental group in which hypnosis was
utilized and the second was a control group which received no hypnosis
coaching. The experimental group listened to an audio hypnosis program
containing a relaxation induction. Also included on the audio program were
posthypnotic suggestions for healing and recovery. Suggestions were also
given regarding ways to achieve control over stress and pain. One surgeon
was assigned to all 69 patients in the study. 36 were in the control
(non-hypnotic) group and 33 received the benefits of hypnosis motivational
coaching (the experimental group). Anxiety increased significantly in the
control group while those who listened to the audio program maintained
their initial baseline levels of calm. Post-operative intake of
pain-killers was significantly less in the experimental group as compared
to the control group.
A fascinating aspect of this study is that a number of controlled studies
have been cited stating that hypnotic techniques have reduced bleeding
associated with tooth extractions in hemophiliacs. (1)
Also of interest is that two more Swedish studies have found that the use
of hypnosis prior to dental surgery revealed a significant decrease in
bleeding postoperative facial swelling (2). It was also noted that less
time was needed for recuperation in the hospital where the surgery was
performed (3). What is of compelling interest is that these patients
received no personal hypnosis training but instead, only listened to a
preoperative hypnosis audio program.
STUDY GROUP AND METHODS: The 36 control group patients were
slightly older (M = 28.5 years, SD = 5.35) than the experimental group
patients (M = 27.7 years, SD 6.23). 19 men and 17 women participated in
the control group while 14 men and 19 women were in the experimental
After an initial exam, the experimental group received an envelope with
information, instructions and a hypnosis tape. The control group also
received an envelope with identical contents except they received no
hypnosis tape. Patients were randomly assigned to each group by a
non-biased distribution of the envelopes. Neither the surgeon nor the
assisting personnel were aware of group assignments.
The audio tape was a 20 minute program containing the following 6
1) A mental and physical hypnotic relaxation induction.
2) Suggestions for the inner creation of a safe place.
3) Suggestions to positively influence unconscious knowledge of how to
control bleeding, coagulation and healing.
4) Pain relief methods utilizing dissociation and direct suggestions.
5) Instructions on creating a personal way to create and experience a
relaxed state of being. Calming words, pictures and/or breath control were
6) A 120 second segment of soft music accompanied by suggestions was used
at the end of the session to help a patient to return to a ‘normal’ state
The experimental group patients were instructed to listen to the tape
daily before surgery. In the event of unexpected reactions, the patients
were given the phone number of the hypnotherapist who created the audio
session. 2 patients were excluded from the study because they listened to
the tape 1 or fewer times. The other patients in the study listened to the
hypnosis program at least three times.
RESULTS: As previously stated, anxiety in the preoperative control
group increased significantly between initial surgery registration and the
day of surgery. The experimental group reported no increase in anxiety.
The pain-killer used was Citodon (Pharcetamol-Codeinphosp). In the control
group, 28% of the patients consumed three or more equipotent doses of the
analgesic whereas only 3% of the experimental group consumed three or more
There was no difference in the experience of pain by both groups though
again, it must be noted that analgesic consumption was much less in the
It must be noted that in order for this study to be statistically valid, a
larger number of participants is needed to see differences in other
SUMMARY: One can draw the conclusion that there is a great deal of
thought provoking, credible information gleaned from these studies that
shows hypnosis to be quite useful for those facing surgery.
(1) Lucas, O.M. (1962) Dental extraction in hemophiliac: Control over
emotional factors by hypnosis. American Journal of Clinical Hypnosis, 7,
(2) Enqvist, B., von Konow, L., & Bystedt, H. (1995a). Pre- and
perioperative suggestion in maxillo-facial surgery: Effects on blood loss
and recovery. International Journal of Clinical and Experimental Hypnosis,
(3) Enqvist, B., von Konow, L., & Bystedt, H. (1995b). Stress reduction,
preoperative hypnosis and perioperative suggestion in maxillo-facial
surgery. Stress Medicine, 11, 229-233
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