title: The effect of informed consent on stress levels associated with extraction of impacted mandibular third molars.
abstract: OBJECTIVE
  To evaluate the effect of informed consent on stress levels associated with removal of impacted mandibular third molars.
  
  
  METHODS
  A total of 60 patients scheduled for extraction of impacted mandibular third molars participated in this study. The patients were unaware of the study's objectives. Data from 20 patients established the baseline levels of electrodermal activity (EDA). The remaining 40 patients were randomly assigned into 2 equal groups receiving either a detailed document of informed consent, disclosing the possible risks involved with the surgery, or a simplified version. Pulse, blood pressure, and EDA were monitored before, during, and after completion of the consent document.
  
  
  RESULTS
  Changes in EDA, but not in blood pressure, were measured on completion of either version of the consent document. A greater increase in EDA was associated with the detailed version of the consent document (P = .004). A similar concomitant increase (although nonsignificant) in pulse values was monitored on completion of both versions.
  
  
  CONCLUSIONS
  Completion of overdisclosed document of informed consent is associated with changes in physiological parameters. The results suggest that overdetailed listing and disclosure before extraction of impacted mandibular third molars can increase patient stress.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University-Hadassah, Jerusalem, Israel. nard@md.huji.ac.il
authors.forename: Nardy
authors.initials: N
authors.lastname: Casap
authors.forename: Michael
authors.initials: M
authors.lastname: Alterman
authors.forename: Guy
authors.initials: G
authors.lastname: Sharon
authors.forename: Yuval
authors.initials: Y
authors.lastname: Samuni
mesh_terms: D000704:Analysis of Variance; D001794:Blood Pressure; D016854:Dental Anxiety / Q000209:etiology*; D005712:Galvanic Skin Response; D006339:Heart Rate; D006801:Humans; D007258:Informed Consent; D008334:Mandible; D008964:Molar, Third / Q000601:surgery*; D016037:Single-Blind Method; D013315:Stress, Psychological / Q000209:etiology*; D014081:Tooth Extraction / Q000523:psychology*; D014095:Tooth, Impacted / Q000601:surgery