New Study: Lavender Essential Oil May Reduce Dental Anxiety, with More Significant Improvement in Children

*Image source: Journal of Dentistry

GoodNews · Report | Recently, a research team from the Department of Dentistry at the Federal University of Rio Grande do Norte, Brazil, published a scoping review in the Journal of Dentistry, systematically examining the clinical evidence of aromatherapy in dental practice. The results showed that inhaling essential oils may help alleviate dental anxiety, but the overall evidence for pain relief is insufficient and inconsistent.

The review included 20 controlled clinical trials with 3,460 subjects, evaluating the use of 11 essential oils in dental outpatient settings. Among the included studies, lavender essential oil (Lavandula angustifolia) was the most concentrated type, used in 13 clinical trials; other essential oils included sweet orange (Citrus sinensis, Citrus aurantium), chamomile, peppermint, lemongrass, etc.

Regarding anxiety outcomes, 17 studies reported favorable trends related to aromatherapy, while 3 studies observed no significant differences. In contrast, in the evaluation of pain outcomes, only 4 studies reported improvements in pain perception, and 7 studies showed no significant differences between the intervention and control groups, suggesting that the evidence consistency for aromatherapy in pain management is weak.

*Image source: Journal of Dentistry

Age-stratified analysis showed that all studies including pediatric populations reported anxiety reduction effects, and most also observed decreased pain perception (with only 1 study as an exception). In contrast, adult studies more frequently reported no significant effects, especially regarding pain-related outcomes. Some studies suggest that female patients may be more sensitive to anxiety improvement, but related results are inconsistent and lack sufficient gender-stratified analysis support.

In terms of administration methods, the implementation of aromatherapy is highly diverse, involving 9 inhalation methods, including diffusers, nebulizers, medicinal patches, oil-soaked cotton pads, atomizers, ceramic heaters, and nasal mask devices similar to nitrous oxide masks, with diffusers being the most common method. Intervention timing can be divided into pre-procedure use, intra-procedure use, or combined pre- and intra-procedure use. Pre-procedure exposure time ranged from 2–20 minutes, and intra-procedure duration was mostly between 20–35 minutes. Essential oil dosages varied significantly, for example, lavender essential oil dosages ranged from 2 drops to 50 drops per 100 mL of water, reflecting the current lack of unified dosage standards.

According to previous reports by GoodNews, non-pharmacological interventions have received attention in dental anxiety management. Research on the application of animal-assisted therapy in pediatric dentistry has shown it can reduce anxiety levels. Virtual reality technology has been used to distract patients to reduce treatment anxiety.

*Image source: Journal of Dentistry

The researchers noted that existing studies have methodological heterogeneity: intervention protocols, administration methods, dosage settings, and outcome measurement tools all lack standardization. Among the 20 studies, researchers used a total of 19 different anxiety assessment tools (such as STAI, MDAS, FIS, etc.) and 9 pain assessment tools, which largely limits the comparability of results.

In addition, only 1 study set up an olfactory control group (using sesame oil as an odor control), while most other studies used odorless controls or no intervention. This design flaw makes it difficult to distinguish whether the observed effects stem from the chemical components of essential oils or merely from odor masking in the dental environment.

The review did not report clear adverse events. However, the researchers emphasized that the monitoring and reporting of adverse reactions in the included studies were not systematic, with only 9 studies explicitly evaluating adverse reaction outcomes, and follow-up time was limited. Therefore, 'no adverse events reported' should not be interpreted as aromatherapy having confirmed clinical safety.

The research team pointed out that existing literature has not yet addressed aromatherapy applications in teeth whitening or perioral/facial harmonization procedures (such as hyaluronic acid fillers, botulinum toxin injections, PDO threads, etc.). Given that these procedures are often accompanied by mild pain or discomfort, the researchers believe they represent potential research directions worthy of further exploration.

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