Musical Intervention Reduces Patients' Anxiety in Surgical Extraction of an Impacted Mandibular Third Molar


Journal of Oral and Maxillofacial Surgery




PURPOSE: Patients undergoing impacted mandibular third molar (IMTM) extraction often have severe perioperative anxiety, which may lead to increased perceptions of pain and vital sign instability throughout surgery. Intraoperational musical interventions have been used during operations to decrease patient anxiety levels. We investigated the anxiolytic effects of musical intervention during surgical extraction of an IMTM. We tested the hypothesis that musical intervention would have positive effects on patients' vital signs, anxiety levels, and perceptions of pain. PATIENTS AND METHODS: We recruited 219 patients with IMTM surgery to participate in this study. Participants were randomly assigned to a music-treated group (106 subjects) or a control group (113 subjects). In a preoperative meeting, patient demographic data were collected, and the patients' favorite songs were selected. For the music-treated group, their selected music was played from the time of arrival to the operating room until the end of the operation. Perioperative anxiety and perceptions of pain were assessed using the Dental Anxiety Scale and the Visual Analog Scale, respectively. Patients' vital signs (blood pressure, heart rate, and respiratory rate) were monitored throughout the surgery. One-way analysis of covariance using perioperative anxiety as a covariant was performed to compare intraoperative anxiety levels and perioperative perceptions of pain between the 2 groups. Repeated measures analysis of variance was used to compare changes in vital signs across surgical stages between the 2 groups. RESULTS: Vital signs changed significantly throughout surgery according to the stage of the procedure. For both groups, vital signs increased from baseline and reached peak values at the time of the initial incision and then decreased quickly and plateaued within normal limits. There were no significant differences between groups in blood pressure; however, the music-treated group showed a significantly smaller change in heart rate than the control group. The music-treated group reported significantly less intraoperative anxiety than the nonmusic-treated control group when controlling for preoperative anxiety levels (F = 4.226, P < .05). CONCLUSION: These results support the hypothesis that the use of patient-chosen music during surgical extraction of an IMTM significantly lowers patient intraoperative anxiety levels.

Music and Health Institute Terms

Anxiety; Anxiety Scales; Blood Pressure; Dental Procedures; Heart Rate; Hospital Setting; Hospitalized Patients; Music Listening; Music Medicine; Oral Surgery; Pain; Pain Management and Control; Procedural Pain; Recorded Music Listening; Respiratory Rate; Self-Report Measures; Surgery; Surgical Patients; Visual Analog Scale (VAS); Vital signs

Indexed Terms

Anesthetics, Local; Blood Pressure; Dental Anxiety; Heart Rate; Hemostatic Techniques; Intraoperative Complications; Mandibular Nerve; Molar, Third; Nerve Block; Osteotomy; Pain Measurement; Pain Threshold; Postoperative Pain; Respiration; Suture Techniques; Tooth Extraction; Tooth, Impacted; Vital Signs

Study Type

Randomized Controlled Trial; Quantitative Methods

PubMed ID


Document Type