Open Wide ... And Relax

Hypnosis could play a significant role in at least three areas of dental care: managing acute pain during dental procedures, reducing the anxiety associated with visiting the dentist, and alleviating chronic orofacial pain.

These are the conclusions of a literature review by Angélique Thibault, a doctoral candidate in dental medicine at Université de Montréal, in collaboration with Faculty of Dentistry professors Pierre Rainville and Nathalie Rei.

In an article published in March in the American Journal of Clinical Hypnosis, Thibault presented evidence that hypnosis could and should be a useful complementary tool for oral-health professionals.

She surveyed 12 systematic reviews and meta-analyses published between 2000 and 2024. The majority of the studies were from Germany, where hypnosis is already incorporated into some medical practices. Other countries included the United States, Denmark, Italy, China and India.

Alleviating pain during procedures

Angélique Thibault

Angélique Thibault

Credit: Courtesy

"Contrary to popular belief, therapeutic hypnosis produces a modified state of consciousness in which the mind becomes more focused and receptive to suggestion, which can be harnessed to promote relaxation and alleviate pain," Thibault explained.

It's in managing acute pain during dental procedures, such as tooth extractions or cavity repairs under local anesthesia, that hypnosis seems to hold the most promise.

Thibault's analysis showed, for example, that patients who had a tooth extraction under hypnosis reported less pain, resulting in reduced need for local anesthesia during the procedure and for pain medication following the procedure.

Hypnosis was also found to be useful for pain relief during root canal procedures, with one study reporting that 45.2 per cent of patients who received focused hypnotic analgesia felt no pain during pulpal stimulation. Among patients who underwent standard hypnotic induction, 16.1 per cent experienced no pain.

"Furthermore, hypnosis was linked to improved physiological parameters in many patients, including lower heart rate and blood pressure, both signs of reduced stress and pain," said Thibault.

Help for anxiety, too

Hypnosis also appears to be an effective tool for alleviating "dental anxiety." Studies show that it reduces anxiety before and during treatment, often outperforming methods such as audiovisual distraction. In children, hypnosis not only decreases crying and verbal resistance, but also helps stabilize heart rate.

The results for chronic orofacial pain, such as that caused by temporomandibular joint disorders, are harder to interpret due to the limited number of available studies.

"Nevertheless, the research suggests that hypnosis can improve maximum mouth opening and reduce daily pain," said Thibault. "One study found a 55 per cent reduction in self-assessed pain after hypnosis sessions, compared with just 3.8 per cent in the control group that received no hypnosis."

However, she stressed that hypnosis alone cannot provide sufficient analgesia in all cases.

"Not enough people respond fully to hypnosis and are able to achieve complete analgesia," she explained. "Therefore, hypnosis should be seen as a complement to traditional techniques, one that can improve the patient's experience and quality of care."

Still not widely used

Despite these promising results, hypnosis is still not widely used in dental practice. Thibault attributes this to insufficient training, noting that only two of the 10 Canadian dentistry faculties she consulted offer even a brief introduction to hypnosis in their programs.

"There's a real need to raise awareness of this complementary approach and to standardize techniques and training for dentists so that hypnosis can be integrated into clinical settings," she said.

Another challenge is the heterogeneity of existing studies on hypnosis. "Hypnosis methods vary widely, from bringing in a professional hypnotherapist to using audio recordings to dentists performing hypnosis themselves," Thibault said. "Moreover, most studies don't clearly describe their protocols, making it difficult to reproduce the results."

For hypnosis to gain wider use in dentistry, several measures are needed, starting with standardization of techniques and protocols. "Specific training courses for dentists and their teams could be introduced, like those offered by the Société québécoise d'hypnose," Thibault suggested.

As well, more rigorous studies with active control groups and detailed intervention descriptions are needed to strengthen the scientific evidence. To achieve this, Thibault advocates integrating hypnosis into university curricula so that future dentists are familiar with it and can even undertake research projects in this area.

Finally, enhancing public awareness of therapeutic hypnosis is crucial. "Hypnosis is a serious medical tool, not just a spectacle for entertainment," said Thibault. "With rigorous research and gradual integration into dental practice, hypnosis could one day become a standard tool in dental care, improving patient comfort and reducing the need for medication."

About this study

"Evidence-based practice of hypnosis in dentistry: Narrative summary of reviews and meta-analysis," by Angélique Thibault, Pierre Rainville and Nathalie Rei, was published March 13, 2025 in the American Journal of Clinical Hypnosis.

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