How Hypnosis Can Manage Pain and Anxiety in the Dental Office

Hypnosis is a formalized method of applying the techniques of attention modification, paced breathing, and muscle relaxation. It has been employed in dentistry for more than 100 years. Highly regarded courses in hypnosis for clinicians are available on a regional basis from the American Society of Clinical Hypnosis. The courses are graded from beginner to advanced. A beginner’s course will equip the clinician with skills that can be used the next day in practice. A hypnosis course is an easy way to practice talking to patients about a more comfortable way to experience dental treatment.

The process of helping a patient reach a hypnotic state is called induction, as described in the following example:

The patient should be relaxed and sitting up.

Dentist: Please make yourself comfortable. You must be comfortable to get relaxed.
Do you feel comfortable now?

Patient: Yes.

Dentist: Now raise your arms over your head and then just let them drop into your lap. Good. You may have felt a moment of relaxation when you did that. Your whole body relaxed briefly. Please try it again. You may begin to sense that when you relax that your limbs get heavy. This heaviness is part of relaxation. Now try breathing slowly.
Take a deep breath, hold your breath as you are comfortable, and let it out slowly. Each time you breathe in and out, you will get more and more relaxed. You may want to close your eyes.

The dentist can count while giving breathing and suggestions for relaxation as follows:

Dentist: I would like you to tighten your arm and hand muscles; make them stiff out in front of you. Now as I count, I want you to imagine first tightening and then loosening the muscles. One, feel the muscles of your hands tighten and your arms stiffen. Two, make them really tight. Three, now begin to loosen them a little. Take a deep breath and let it out slowly. Four, imagine your muscles getting heavy and much looser. Take another breath. Five, your arms may not feel so heavy that they begin to fall into your lap.

Once a patient becomes comfortable, the dental work can be started. The dentist should alert the patient about an upcoming noise, bump, or other action. Throughout the procedure the dentist can continue to encourage the patient to maintain the relaxed quiet state.

Often, hypnosis sessions end by the clinician giving the patient posthypnotic suggestions, which usually take the form of praising the patient for doing well and suggesting that the feeling of calm and painlessness of the session will continue in the period after treatment. The patient should be told that practice at home improves the effectiveness of hypnosis.

Source: Dionne RA. 2002. Management of Pain and Anxiety In The Dental Office. W.B. Saunders. Philadelphia