title: Effect of deep pressure input on parasympathetic system in patients with wisdom tooth surgery.
abstract: OBJECTIVE
  Deep pressure input is used to normalize physiological arousal due to stress. Wisdom tooth surgery is an invasive dental procedure with high stress levels, and an alleviation strategy is rarely applied during extraction. In this study, we investigated the effects of deep pressure input on autonomic responses to wisdom tooth extraction in healthy adults.
  
  
  METHODS
  A randomized, controlled, crossover design was used for dental patients who were allocated to experimental and control groups that received treatment with or without deep pressure input, respectively. Autonomic indicators, namely the heart rate (HR), percentage of low-frequency (LF) HR variability (LF-HRV), percentage of high-frequency (HF) HRV (HF-HRV), and LF/HF HRV ratio (LF/HF-HRV), were assessed at the baseline, during wisdom tooth extraction, and in the posttreatment phase.
  
  
  RESULTS
  Wisdom tooth extraction caused significant autonomic parameter changes in both groups; however, differential response patterns were observed between the two groups. In particular, deep pressure input in the experimental group was associated with higher HF-HRV and lower LF/HF-HRV during extraction compared with those in the control group.
  
  
  CONCLUSIONS
  LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The results suggest that the application of deep pressure alters the response of HF-HRV and facilitates maintaining sympathovagal balance during wisdom tooth extraction.
authors: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology and Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Hsin-Yung
authors: HY
authors: Chen
authors: Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
authors: Hsiang
authors: H
authors: Yang
authors: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors: Ling-Fu
authors: LF
authors: Meng
authors: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Pei-Ying Sarah
authors: PS
authors: Chan
authors: Department of Biomedical Engineering, Ming-Chuan University, Taoyuan, Taiwan.
authors: Chia-Yen
authors: CY
authors: Yang
authors: Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan. Electronic address: hmchen51@ntuh.gov.tw.
authors: Hsin-Ming
authors: HM
authors: Chen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy; D018592:Cross-Over Studies; D016854:Dental Anxiety / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010275:Parasympathetic Nervous System / Q000502:physiology*; D011312:Pressure; D016037:Single-Blind Method; D013315:Stress, Psychological; D013624:Taiwan; D055815:Young Adult
keywords: anxiety; dental fear; stress; supportive care