Parasympathetic effect of deep pressure input on third molar extraction in adolescents

J Formos Med Assoc. 2019 Sep;118(9):1317-1324. doi: 10.1016/j.jfma.2019.05.026. Epub 2019 Jun 13.


Backgroud/purpose: Deep pressure input is used to normalize physiological arousal due to stress. Third molar extraction is an invasive dental procedure with high stress for the patient, and an alleviation strategy is rarely applied during tooth extraction. In the present study, we investigated the effects of deep pressure input on autonomic responses during the procedures of third molar extraction in healthy adolescents.

Methods: A randomized controlled crossover design was used for adolescents who were allocated to experimental and control groups that received intervention with or without deep pressure input, respectively. Autonomic indicators, namely the heart rate, percentage of low-frequency heart rate variability (LF-HRV), percentage of high-frequency heart rate variability (HF-HRV), and low-frequency/high-frequency heart rate variability ratio (LF/HF-HRV), were assessed at the baseline, during molar extraction, and in the posttreatment phase.

Results: The results indicated that third molar extraction caused significant autonomic parameter changes in both groups; however, differential response patterns were observed between two groups. In particular, application of deep pressure input in the experimental group was associated with higher HF-HRV and lower LF/HF-HRV during third molar extraction compared with those in the control group.

Conclusion: LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The present study suggests that the application of deep pressure alters the response of HF-HRV and facilitate maintaining sympathovagal balance during third molar extraction.

Keywords: Autonomic response; Deep pressure; Dental fear; Heart rate variability (HRV).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Autonomic Nervous System / physiology*
  • Cross-Over Studies
  • Dental Anxiety*
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Molar, Third / surgery*
  • Taiwan
  • Tooth Extraction / psychology*