4. Could encourage patients to seek consultation more Could encourage patients to seek consultation more

5. Music Therapy Dental Fear/Anxiety Dental Anxiety Management

6. 1.What is the level of dental anxiety of UPM-CD patients seeking tooth extraction? 2.What is the comparison of the effect of with or without music therapy on dental anxiety of UPM-CD patients seeking tooth extraction? 3.What is the patient’s perception on the effect of the music during the treatment?

26. Screening of the patients through answering the Corah’s Dental Anxiety Scale Only those who scored ≥ 5 points Screening through the inclusion criteria set Single-blind: participants were not informed that there will be involvement of music in the study Signing of informed consent

27. participant was randomly assigned to either: control group or experimental group. both underwent the conventional extraction procedure experimental group had the soft and quiet music to listen script and the steps of the conventional extraction procedure

28. Briefing about the study and giving out of consent forms Screening of walk-in patients indicated for extraction Control Group (Without Music) Experimental Group (With Music) Conventional extraction procedure BPs and HRs taken preoperatively, during, and after the procedure Measuring anxiety level through revised Corah’s Dental Anxiety Scale BPs and HRs taken preoperatively, during, and after the procedure Extraction procedure done with music (soft and quiet type of music) Data Analysis

29. Table 1. Means of Anxiety Scores Mean Control9.09 Experimental Group9.63 OVERALL9.36

30. Difference in blood pressure records and heart rates with music (experimental) and without music (control)  multiple T-tests. P-values less than 0.05  statistically significant. Statistical Package for the Social Sciences (SPSS) software Version 11.0 for Windows. Levine’s test for equality of variances  statistically homogenous.

31. Figure 3. Comparison of Mean Systolic Readings (in mmHg) Pre- operatively, During, and After the Procedure

32. Figure 4. Comparison of Mean Diastolic Readings (in mmHg) Pre- operatively, During, and After the Procedure

33. Figure 4. Comparison of Heart Rate (in beats/minute) Pre- operatively, During, and After the Procedure

34. Table 2. Summary of Patient’s Answers to Post- treatment Question

35. studies have been conducted to determine the role of music on anxiety in general. anxious patients experience increase in blood pressure and heart rate esp. when indulged in stressful situations. dental extraction seems to be one of the apprehensive procedures in dentistry.

36. Corah’s dental anxiety scale: RangeAnxiety Rating 5 – 8Slight anxiety 9 – 12Moderate Anxiety 13 – 14High Anxiety 15 – 20Severe Anxiety (or phobia) Mean level  9.36 : MODERATE ANXIETY

37. Physiological sign of anxiety: heart rate, diastolic and systolic blood pressure Unlike other studies, the only statistically significant difference was in the systolic readings taken before the procedure between the control and experimental group.

38. Before the procedure, there may be intense anxiety that is perhaps due to increased excretion of aldosterone. The increase in systolic pressure may be due to adrenergic stimulation of the heart because of the feeling of anticipation on the part of the patients.

39. Somehow, with the introduction of music, it has calmed down the patient by reducing the activity in the sympathetic nervous system with a relaxation response (Harrison, 1996).

40. Guyton (1979) stated that the sympathetic nervous system increases the heart’s activity, and also dilates the coronaries. It has the ability to control the blood vessels in the body – capability to regulate both cardiac output and arterial blood pressure.

41. HEART RATE for the control group has a similar pattern for all three stages (before the procedure, during and after the procedure) control group has higher values Heart rate is directly related to the increased blood flow. So if the pressure is high, heart beats faster than usual thus increasing the heart rate.

42. About 55% liked the music heard during the procedure 45% said that the music was able to help in lessening the anxiety they were in no one answered that they didn’t like the music. they were able to notice the presence of music even if they were not told about it.

43. The mean anxiety level of the patients who participated in the study is 9.36, which signifies that overall, the study population had moderate anxiety level.

44. The group with music has lower mean blood pressure and mean heart rate records than the group without music. The mean blood pressure difference in the blood pressure and heart rate values taken before the procedure were the only association that was statistically significant. Others have mean difference as well but are not statistically significant.

45. Patient’s perception on the music used is that they liked the type of music and they were able to tell that somehow, the music helped in decreasing their anxiety.

46. Applying soft and quiet type of music decreases the level of anxiety during extraction procedures as physiological indicators of anxiety (blood pressure and heart rate) were lower in the experimental group. It can be beneficial for patients who will undergo tooth extraction.

47. Different rating scales can be used to measure the level of anxiety of the participants. Other symptoms of anxiety can be observed and tested as well. This study should be done in a bigger population to obtain significant statistical results.

48. Other type of music can be used and tested to determine its therapeutic property. Future study may consider controlling other variables such as the operator and length of the procedure.