Caries treatment in a four-year-old boy using hypnosis – a case report

This clinical case report demonstrates the successful application of hypnosis in an anxious four-year-old boy in whom two primary molars were treated with a composite filling. The almost 16-minute pediatric dental treatment was performed without complications and without interruptions. It could be shown that hypnosis can be used for the pediatric dental treatment of decayed primary tooth lesions. In the specific individual case hypnosis was not only used adjuvant but as an alternative to local anesthesia. A dental anxiety reducing effect and an elimination of pain perception were observed, so that the treatment was possible without anesthesia. It was also found that the commu- nication and rapport between the practitioner and the four-year-old child were improved using hypnosis. There is still a need for high quality studies on the numerous positive effects that hypnosis has on pediatric dental treatment

The Efficacy, Safety and Applications of Medical Hypnosis: A Systematic Review of Meta-analyses

Background: The efficacy and safety of hypnotic techniques in somatic medicine, known as medical hypnosis, have not been supported to date by adequate scientific evidence. Methods: We systematically reviewed meta-analyses of randomized controlled trials (RCTs) of medical hypnosis. Relevant publications (January 2005 to June 2015) were sought in the Cochrane databases CDSR and DARE, and in PubMed. Meta-analyses involving at least 400 patients were included in the present analysis. Their methodological quality was assessed with AMSTAR (A Measurement Tool to Assess Systematic Reviews). An additional search was carried out in the CENTRAL and PubMed databases for RCTs of waking suggestion (therapeutic suggestion without formal trance induction) in somatic medicine. Results: Out of the 391 publications retrieved, five were reports of meta-analyses that met our inclusion criteria. One of these meta-analyses was of high methodological quality; three were of moderate quality, and one was of poor quality. Hypnosis was superior to controls with respect to the reduction of pain and emotional stress during medical interventions (34 RCTs, 2597 patients) as well as the reduction of irritable bowel symptoms (8 RCTs, 464 patients). Two meta-analyses revealed no differences between hypnosis and control treatment with respect to the side effects and safety of treatment. The effect size of hypnosis on emotional stress during medical interventions was low in one meta-analysis, moderate in one, and high in one. The effect size on pain during medical interventions was low. Five RCTs indicated that waking suggestion is effective in medical procedures. Conclusion: Medical hypnosis is a safe and effective complementary technique for use in medical procedures and in the treatment of irritable bowel syndrome. Waking suggestions can be a component of effective doctor-patient communication in routine clinical situations

A hypnotic turbo-induction technique for wisdom tooth extraction.

The hypnotic turbo-induction technique has been used for more than three decades for various indications in dentistry and medicine. The use of the technique is described step by step using therapeutic communication and hypnotic suggestions in a dento-surgical treatment of a 48-year-old adult man. In a 15-minute appointment, two maxillary third molars (wisdom teeth) have been extracted without interruptions/complications by a dental team in a private practice trained in dental/medical hypnosis. The hypnotic turbo-induction technique proved to be a successful application method for anxiety reduction/relaxation, pain relief as well as postoperative wound healing after the extraction of wisdom teeth, which had to be extracted due to a medical indication. Anxiety- and pain reducing effects were noted by the patient during and after the treatment; rapid wound healing was noted by the dental team at the follow-up appointment one week later in this case. The cooperation of the two dental professionals trained in hypnosis proved to be beneficial, especially when the dentist must concentrate on the dento-surgical treatment, the dental assistant can concentrate on both the patient and the hypnosis and to maintain the hypnotic state by additional suggestions. Clinical research is needed to further investigate the effects of the proposed hypnotic turbo-induction technique

Significant variation in salivation by short-term suggestive intervention: a randomized controlled cross-over clinical study

Introduction Most dental procedures require a dry working environment. Although many evaporative drying methods are available, an additional reduction of salivary flow would often be helpful. Methods This prospective randomized cross-over study compares salivary production in 31 volunteers during direct, indirect, and non-suggestive (control group) intervention. Overall, each volunteer underwent four salivation measurements, i.e. two measurements during two different types of hypnotic suggestion (indirect and direct) arranged in random order and two control sections. All four measurements were conducted successively. Results Both suggestive methods significantly reduced salivary production in comparison to the two control sections (direct suggestion Δ = 1.46 grams per 5 min, p < 0.001, indirect suggestion Δ = 0.94 grams per 5 min, p = 0.039). Direct suggestion showed a significantly higher reduction of salivary production than indirect suggestion (Δ = -0.53 grams per 5 min, p = 0.001). Conclusions Hypnotic suggestion represents a simple and inexpensive method to reduce salivation and could thus create a better working environment for more comfortable dental treatments for both patients and dentists

Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma.

Pediatric midline high-grade astrocytomas (mHGAs) are incurable with few treatment targets identified. Most tumors harbor mutations encoding p.Lys27Met in histone H3 variants. In 40 treatment-naive mHGAs, 39 analyzed by whole-exome sequencing, we find additional somatic mutations specific to tumor location. Gain-of-function mutations in ACVR1 occur in tumors of the pons in conjunction with histone H3.1 p.Lys27Met substitution, whereas FGFR1 mutations or fusions occur in thalamic tumors associated with histone H3.3 p.Lys27Met substitution. Hyperactivation of the bone morphogenetic protein (BMP)-ACVR1 developmental pathway in mHGAs harboring ACVR1 mutations led to increased levels of phosphorylated SMAD1, SMAD5 and SMAD8 and upregulation of BMP downstream early-response genes in tumor cells. Global DNA methylation profiles were significantly associated with the p.Lys27Met alteration, regardless of the mutant histone H3 variant and irrespective of tumor location, supporting the role of this substitution in driving the epigenetic phenotype. This work considerably expands the number of potential treatment targets and further justifies pretreatment biopsy in pediatric mHGA as a means to orient therapeutic efforts in this disease