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Title | There Is Insufficient Evidence For The Efficacy Of NuCalm Technology In Preventing/Treating Anxiety In Dental Patients | ||||||||||||
Clinical Question | In an anxious patient needing operative and restorative procedures, does the NuCalm system prevent or reduce anxiety as perceived by the patient, compared to placebo? | ||||||||||||
Clinical Bottom Line | Currently, no evidence stronger than patient and dentist testimonials is available regarding the combination of therapies provided in NuCalm. Regarding the individual components of the NuCalm package: weak evidence (one small cohort study evaluated in this CAT) exists supporting cranial electrostimulation for dental anxiety. No evidence directly addresses the use of blackout glasses, GABA-related dietary supplements, nor acoustic stimulation for dental anxiety. At this time we do not have adequate evidence with which to evaluate the NuCalm method. (See Comments on the CAT below) | ||||||||||||
Best Evidence | (you may view more info by clicking on the PubMed ID link) | ||||||||||||
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Evidence Search | #80 Search (#52) AND #79 8 #79 Search (#77) OR #78 59691 #78 Search "Anxiety"[Mesh] 43402 #77 Search "Fear"[Mesh] 20657 #72 Search (#51) AND #71 0 #71 Search "Dietary Supplements"[Mesh] 25754 #69 Search #51 AND (#63 OR #64 OR #65) 0 #68 Search (#51) AND #59 0 #67 Search (#51) AND #56 2 #66 Search (#51) AND #52 2 #65 Search "sunglasses" OR "sun glasses" 316 #64 Search "blackout glasses" 0 #63 Search "Darkness"[Mesh] 10545 #59 Search (#57) OR #58 33417 #58 Search "theanine "[Substance Name] 110 #57 Search "gamma-Aminobutyric Acid"[Mesh] 33310 #56 Search "Acoustic Stimulation"[Mesh] 27643 #54 Search "Electric Stimulation"[Mesh] 108964 #52 Search cranial electrotherapy stimulation 415 #51 Search "Dental Anxiety"[Mesh] 1628 #50 Search nucalm |
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Comments on The Evidence |
No studies are available on the NuCalm package of treatments. The single study reviewed used cranial electrotherapy stimulation, only one of the components of the NuCalm approach. This cohort study (not clearly randomized) assigned 17 patients to active cranial electrotherapy stimulation and 16 patients to sham stimulation, double-blinded. Dental anxiety was evaluated with the visual analog scale (VAS) before, during, and after a dental appointment. All patients completed the study; because this was a one-appointment study per patient, follow-up and recall bias were not applicable. It is not clear that the two groups were similar at the start (different mean ages, different self-reported anxiety levels at the beginning) which weakens our confidence in the results. No competing interests were mentioned. | ||||||||||||
Applicability | Keeping in mind the evidence reviewed is weak and does not directly address the original question, based on patient ages and dental needs, our average patients should have qualified for this study. The electrical stimulator used, although the particular model may no longer be available, seems to be feasible for general practice use. No harms reported in the study. Benefit: possible reduction in anxiety from electrical stimulation. | ||||||||||||
Specialty/Discipline | (General Dentistry) (Behavioral Science) | ||||||||||||
Keywords | anxiety, electrical stimulation, auditory stimulation, dietary supplements, NuCalm |
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ID# | 746 | ||||||||||||
Date of submission: | 11/18/2010 | ||||||||||||
deahl@uthscsa.edu | |||||||||||||
Author | S. Thomas Deahl, II, DMD, PhD | ||||||||||||
Co-author(s) | UTHSCSA Dental Class of 2013 | ||||||||||||
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