title: Anxiety Related to Nonsurgical Root Canal Treatment: A Systematic Review.
abstract: BACKGROUND
  Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes. Dental anxiety has been associated with pain, fear, care avoidance, and more invasive treatments including nonsurgical root canal treatment (NSRCT). The very words root canal are deeply embedded in societal consciousness. Better understanding of dental anxiety may prevent treatment avoidance. The purpose of this study was to conduct a systematic review of NSRCT-associated anxiety.
  
  
  METHODS
  Inclusion/exclusion criteria defined MEDLINE, Cochrane Library, psychINFO, manual, and citation searches. Title lists and abstracts were read to determine utility; data were extracted, summarized, and compiled into an evidence table, and meta-analyses were performed.
  
  
  RESULTS
  Defined searching produced 835 titles; 36 articles were included, mostly representing modern populations from countries with very high human development indices. Major sources of heterogeneity included differing study aims, outcome measures, clinical settings, locations, operators, sample selection, and sample size. Meta-analysis of 18 articles including 1989 subjects gave a pretreatment anxiety rating of 39 (standard deviation, 9) on a normalized 100-point scale. Meta-analysis of 4 articles including 232 subjects gave a post-treatment anxiety rating of 27 (standard deviation, 5) on a normalized 100-point scale, representing a 30% reduction. A L'Abbe plot of 5 studies also showed that anxiety decreased after NSRCT. Limited data indicated that gender, age, and prior NSRCT experience influenced NSRCT-associated anxiety. NSRCT-associated anxiety was ranked high among dental treatments, often close to oral surgery.
  
  
  CONCLUSIONS
  NSRCT-associated anxiety was generally moderate. Anxiety decreased after NSRCT. Limited evidence suggested that anxiety is influenced by patient and treatment factors.
authors: UCLA School of Dentistry, Los Angeles, California.
authors: Sameera
authors: S
authors: Khan
authors: UCLA School of Dentistry, Los Angeles, California.
authors: Reza
authors: R
authors: Hamedy
authors: UCLA School of Dentistry, Los Angeles, California.
authors: Yuejuan
authors: Y
authors: Lei
authors: UCLA School of Dentistry, Los Angeles, California.
authors: Rikke S
authors: RS
authors: Ogawa
authors: UCLA School of Dentistry, Los Angeles, California. Electronic address: snwhite@dentistry.ucla.edu.
authors: Shane N
authors: SN
authors: White
mesh_terms: D006801:Humans; D016854:Dental Anxiety / Q000523:psychology; D010146:Pain; D012390:Root Canal Therapy
keywords: Anxiety; dental fear; dental phobia; meta-analysis; review; root canal therapy; systematic