Effect of deep pressure input on autonomic regulation during wisdom tooth extraction: From waiting room to surgery

Abstract

Background and purpose: Tooth extraction is a common dental procedure associated with heightened anxiety, particularly during the waiting period before treatment. This stress response is regulated by the autonomic nervous system (ANS), comprising the sympathetic nervous system (SNS), which induces excitatory responses, and the parasympathetic nervous system (PsNS), which promotes relaxation. Deep pressure input, delivered through weighted vests and blankets, has been shown to shift ANS dominance from the SNS to the PsNS, facilitating stress reduction. This study investigated the effects of deep pressure input on ANS modulation using a weighted vest during the waiting phase and a weighted blanket during the tooth extraction phase.

Materials and methods: Healthy adults were randomly assigned to a control group or an experimental group. The control-group subjects underwent wisdom tooth extraction without deep pressure input, while the experimental-group subjects wore a weighted vest during the waiting phase and used a weighted blanket during the tooth extraction procedure. Heart rate (HR), low-frequency heart rate variability (LF-HRV), and high-frequency heart rate variability (HF-HRV) were measured to assess ANS activity.

Results: The control-group subjects exhibited increased HR, elevated LF-HRV, and reduced HF-HRV, indicating the stress-induced sympathetic activation. In contrast, the experimental-group subjects showed significantly lower HR and higher HF-HRV, demonstrating the enhanced parasympathetic activation that persists throughout the tooth extraction procedure.

Conclusion: Deep pressure input for high-anxiety patients can effectively reduce stress and enhances the parasympathetic activation during the wisdom tooth extraction procedure. After a large-scale clinical study, it may enter clinical application for high-anxiety patients.

Keywords: Anxiety; Deep pressure; Stress reduction; Tooth extraction; Weighted blanket; Weighted vest.

Figure 1

Comparison of heart rate (HR) between the control (Ctrl) and experimental (Exp) groups across the baseline phase (T0), the waiting phase (Tw), the treatment phase without a weighted blanket (Tx), the treatment phase with a weighted blanket (Tx-WB), and the post-treatment phase (pTx). Error bars represented the standard deviation of the mean.

Figure 2

Comparison of percentage of low frequency component of heart rate variability (LF-HRV) between the control (Ctrl) and experimental (Exp) groups across the baseline phase (T0), the waiting phase (Tw), the treatment phase without a weighted blanket (Tx), the treatment phase with a weighted blanket (Tx-WB), and the post-treatment phase (pTx). Error bars represented the standard deviation of the mean.

Figure 3

Comparison of percentage of high frequency component of heart rate variability (HF-HRV) between the control (Ctrl) and experimental (Exp) groups across the baseline phase (T0), the waiting phase (Tw), the treatment phase without a weighted blanket (Tx), the treatment phase with a weighted blanket (Tx-WB), and the post-treatment phase (pTx). Error bars represented the standard deviation of the mean.

Figure 4

Comparison of ratio of low frequency/high frequency components of heart rate variability (LF/HF-HRV) between the control (Ctrl) and experimental (Exp) groups across the baseline phase (T0), the waiting phase (Tw), the treatment phase without a weighted blanket (Tx), the treatment phase with a weighted blanket (Tx-WB), and the post-treatment phase (pTx). Error bars represented the standard deviation of the mean.