# Effect of Music-Based Interventions on Dental Anxiety During Restorative Dental Treatment: A Randomized Controlled Trial

## TL;DR

This study shows that listening to music during dental treatment can reduce anxiety and stress in patients.

## Contribution

The study is the first to simultaneously evaluate subjective anxiety and multiple physiological stress markers during dental treatment with music.

## Key findings

- Music groups had significantly lower blood pressure, heart rate, and cortisol levels compared to the control group.
- Both classical and Turkish music reduced anxiety equally effectively.
- Oxygen saturation increased in music groups but decreased in the control group.

## Abstract

Background/Objectives: Dental anxiety is a common clinical problem that negatively affects patient cooperation, treatment acceptance, and physiological stability during dental procedures. This randomized controlled clinical trial study aimed to evaluate the effectiveness of music-based interventions in reducing dental anxiety and stress responses during restorative dental treatment. The null hypothesis was that music exposure would not result in significant differences in anxiety levels or physiological stress parameters compared with standard dental care. Methods: Seventy-five patients with moderate to high pre-treatment dental anxiety (MDAS ≥10) were randomly assigned to three groups: classical music, Turkish music, and control (no music) (n = 25 per group). Anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Restorations were performed using a standardized adhesive protocol. Physiological parameters, including systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and oxygen saturation (SpO2), as well as salivary cortisol and alpha-amylase levels, were measured before and after restorative treatment. Salivary cortisol and amylase levels were measured using a Human ELISA Kit. Statistical analysis was performed using paired t-tests and one-way ANOVA with Tukey’s post hoc test (p < 0.05). Results: Both music groups showed significant reductions in SBP, DBP, HR, cortisol, amylase, and MDAS scores compared to the control group (p < 0.05). Oxygen saturation increased significantly in the music groups, whereas it decreased significantly in the control group. There were no significant differences between classical and Turkish music regarding their anxiety-reducing effects. Conclusions: Music-based interventions effectively reduce dental anxiety and physiological stress during restorative dental procedures. This study is novel in simultaneously evaluating subjective anxiety scores and multiple physiological and biochemical stress markers in adult patients undergoing restorative treatment, supporting music as a simple and non-invasive adjunct in clinical dentistry.