Effect of binaural beats and isochronic tones on anxiety during impacted mandibular third molar surgery: a randomized controlled trial.

Abstract

Dental anxiety is a common problem in oral surgery practices. Recently, interest has increased in non-pharmacological methods to reduce anxiety, such as auditory stimulation. This randomized controlled trial evaluated the effects of binaural beats (BB) and isochronic tones (IT), two forms of auditory stimulation, on dental anxiety and physiological parameters during impacted mandibular third molar surgery. Ninety patients were assigned equally to BB, IT, and control (no intraoperative auditory stimulation) groups. Anxiety levels were assessed using the MDAS, DFS, STAI-S, and a visual analogue scale pre- and postoperatively. The BB and IT group patients also completed a satisfaction questionnaire. Physiological parameters (respiratory rate, pulse rate, blood pressure [SBP, DBP], oxygen saturation) were recorded at eight surgical stages. No significant between-group differences were observed in the pre- or postoperative anxiety questionnaire scores. Isolated between-group differences in physiological parameters were observed: mean SBP at incision was lowest in the BB group (P = 0.041), while mean respiratory rate at anaesthesia was lowest in the IT group (P = 0.015). The majority of BB and IT group patients (78.3%) reported that they would prefer auditory stimulation in future dental treatments. The findings indicate that BB and IT have a limited effect on reducing dental anxiety during impacted mandibular third molar surgery and do not support a definitive anxiolytic benefit. Auditory stimulation may transiently influence certain stress-related physiological responses; however, further studies using objective neurophysiological measures and standardized protocols are required to clarify their role in oral surgery.