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Hypnosis is a physiological mind activity characterized by focused attention, absorption, dissociation and plastic imagination. In the early 19th century, several hundred surgical interventions were described with hypnosis as the sole anesthetic, in an epoch when no anesthetic drugs were available; then hypnosis was prejudicially abandoned and forgotten after its introduction. In the past two decades, an increasing number of studies on hypnosis has shown its capacity to modify the activity of the prefrontal cortex, default mode network and pain neuromatrix (including the anterior cingulate cortex, amygdala, thalamus, insula and somatosensory cortex) and increase pain threshold up to the level of surgical anesthesia. Hypnotic analgesia also prevents pain-related cardiovascular response: therefore, it may stand comparison with pharmacological anesthesia, yielding true protection from stress for the patient. The wealth of data available in the literature provides clear evidence of its meaningful effects on perioperative emotional distress, pain, medication consumption, physiological parameters, duration of surgery and outcome. Hypnosis may be used as follows: 1) as sole anesthetic, in minor surgery and invasive maneuvers and/or selected patients; 2) as adjuvant of pharmacological anesthesia (local anesthesia and/or sedation); 3) as an adjuvant technique in both pre- and postoperative phases in patients submitted to general anesthesia. Hypnosis, unlike any other therapeutic tools, does not call for drugs or equipment and is an attractive technique: it is free of charge, not burdened with proved adverse events and promises to help improving cost/benefits ratio.

Hypnosis, despite its effectiveness, has been neglected. The aim of this study is to show the effectiveness and manageability of hypnosis as a stand-alone technique in dentistry. Three patients underwent 6 oral surgery procedures (surgical third-molar removal, implant surgery, maxillary bone augmentation, and mucogingival surgery) with hypnosis as the only anesthetic. Two of the 3 patients had difficulties: 1 was sensitive to multiple chemicals, had Addison disease, and had previously experienced anaphylactic reactions to local anesthetics; the other was allergic to lidocaine and had undergone a paradoxical reaction to pharmacologic sedation in the past. All 3 patients had 2 preoperative sessions each to assess their perioperative risk, level of anxiety, hypnotic susceptibility, and capacity to develop full hypnotic analgesia. On a surgery day, hypnosis was induced and hypnotic analgesia was obtained according to a standard protocol, a procedure taking no more than 9 minutes in each case. Each surgical procedure was then completed successfully with the patient in a painless condition of full relaxation and sense of well-being, with stable cardiovascular parameters. None of the patients required postoperative analgesics, which were prescribed for use as needed. Hypnosis is a valuable tool in dentistry, enabling the safe and rapid relief of anxiety and phobia and raising patient pain thresholds to the level of surgical analgesia. Unlike drugs and equipment, it is always readily available, cost-free, and has no adverse effects when administered by competent professionals. Hypnosis can be used for sedation in most patients and as a stand-alone technique in those with appropriate hypnotic susceptibility, improving the well-being and safety of patients. [ABSTRACT FROM AUTHOR]

Dental fear is an universal phenomenon justifying the increasing relevance of psychology and the behavioral sciences to dental training and clinical practice. It has a wide-ranging and dynamic impact in patients' lives and shows some links with other anxiety disorders, as described in psychiatry, such as post-traumatic stress disorder (PTSD) and phobia. Pharmacological sedation has been introduced and used more and more over the past two decades, in order to relieve dental anxiety and phobia and let the patient face oral surgery safely. However, its use is only a step in a much more complex approach, the aim of which is helping the patient to overcome their anxiety and get rid of it. The appropriate approach includes several steps: (1) assessing dental anxiety; (2) proper communication and ensuring patients are thoroughly informed; (3) iatrosedation to make patients comfortable and earn their trust; (4) a properly performed local anaesthesia, able to ensure a full analgesia; and (5) hypnosis and/or a wise use of drugs to ensure full anxiety control as needed. latrosedation combines the principles of verbal and non-verbal communication and the emphatic approach pertaining to neurolinguistic programming. Given its effectiveness in relieving dental anxiety, it should be regarded as the essential strategy of communication with the patient. Hypnosis is a powerful tool in dentistry. A relevant advantage, unique to hypnosis, is its twofold role: (1) achieving an effective and even deep sedation and amnesia while maintaining the patient's collaboration; and (2) treating dental anxiety and phobia, helping the patient to overcome it, as well as other associated anxiety disorders (e.g., claustrophobia). As far as eye movement desensitizaion and reprocessing (EMDR) is concerned, there is still a shortage of information on EMDR in dentistry, but it might be potentially useful when dental phobia is related to previous bad experiences involving PTSD components. The superiority of hypnosis and other behavioural techniques in comparison with pharmacological sedation lies in their ability to help patients rid themselves of their dental anxiety. While pharmacological sedation only affords a temporary respite and helps the patient to cope with a single procedure, hypnosis and iatrosedation can effectively allow for both an excellent sedation in a physiological way and the treatment of patient's anxiety, helping them to get rid of their fear and other anxiety components. [ABSTRACT FROM AUTHOR]