PhD Scientific Days 2026

Poster Session 1.O - Dental Research

Investigating the Efficacy and Safety of Pharmacological Interventions on Anxiety in Adult Patients Undergoing Dental Treatment

Name of the presenter

Major, Abel

Institute/workplace of the presenter

Center for Translational Medicine, Department of Oro-Maxillofacial Surgery and Stomatology

Authors

Abel Major¹, Laura Zsófia Tasi², Eszter Borbély², Darius Valentin Sandu², Bence Szabó², Anna Walter², Gábor Varga², Gábor Gerber³, Árpád Joób-Fancsaly⁴
1: Center for Translational Medicine, Department of Oro-Maxillofacial Surgery and Stomatology
2: Center for Translational Medicine, Semmelweis University
3: Faculty of Dentistry
4: Department of Oro-Maxillofacial Surgery and Stomatology

Text of the abstract

Introduction:
Over 15% of the population in Europe and the USA experiences significant dental fear and anxiety, leading to avoidance of dental care or reliance on general anesthesia, which is costly, carries risk and difficult to access. Although benzodiazepines are widely used to manage dental anxiety, their adverse effects underscore the need for safer alternatives and clearer guidance on drug selection, dosing, and timing.
Aims:
To systematically evaluate the efficacy and safety of non invasive anxiolytic and sedative interventions for adult patients with dental fear and anxiety.
Methods:
A systematic review and network meta analysis of randomized controlled clinical trials was conducted. Following study selection, data extraction was performed, and analyses were carried out using a random effects model. Eligible studies evaluated oral, sublingual, intranasal, inhalational, herbal interventions for adult dental fear and anxiety.
Results:
Benzodiazepines, such as alprazolam and midazolam, provided the most consistent anxiolysis but were associated with amnesia and psychomotor impairment. Herbal agents, including Valeriana or Passiflora demonstrated comparable anxiolytic efficacy with with a more favorable safety profile, particularly regarding amnesia and excessive sleepiness during and after treatment. Intranasal dexmedetomidine and midazolam were also identified as effective alternatives requiring minimal recovery time.
Conclusions:
Non invasive dental anxiolysis can be safely individualized. While benzodiazepines remain effective, there are possible safer alternatives, like herbal preparations, especially for ambulatory care. Herbal anxiolytics may be considered for patients with mild to moderate anxiety, particularly when avoidance of sedation is desirable or when benzodiazepines are contraindicated. Benzodiazepines remain appropriate for severe anxiety, provided that adequate monitoring and thorough risk assessment are implemented.
Funding:
Supported by the 2025-2.1.1-EKÖP-2025-00014 University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund (EKÖP-2025-467). Supported by the Semmelweis University Research, Development and Innovation Fund.