An interesting article titled “Effect of Audiovisual Treatment Information on Relieving Anxiety in Patients Undergoing Impacted Mandibular Third Molar Removal” written by Sung-Hwan Choi and et al. appears in the 2015 Journal and Oral and Maxilofacial Sugery (vol. 73, pp. 2087-2092). The authors set out to explore if providing patients undergoing wisdom teeth removal an audiovisual slide presentation that provided treatment information could improve patient knowledge of postoperative complications and decrease anxiety.
It is well known that patients having wisdom teeth surgery can have anxiety due to the needles and drills involved. Studies have shown that a lack of information about surgery and complications can lead to increased anxiety. Typically a written informed consent document is provided to patients prior to surgery. However, it is not clear how well patients can understand this information. The authors of the article designed a study to provide treatment information using an audiovisual slide presentation to help improve patient knowledge of postoperative complications and decrease anxiety before and after the removal of impacted mandibular wisdom teeth.
Patients included in the study were between 18 and 27 and treated in Seoul Korea. A total of 51 patients were included in the study who were randomly distributed into two groups. The first group received the Korean Dental Association Informed Consent document with a verbal explanation of the surgical procedure and eight potential postoperative complications (control group). The second group of patients received the same document and then viewed a narrated Powerpoint slideshow (audiovisual informed group). Two surgeons performed all surgeries. After each group was done receiving the information they were directed to complete a series of anxiety questionnaires. Additionally sociodemographic information was provided and any relevant history.
One week after the surgery, the patients returned for suture removal and were asked what they remembered from the information provided before surgery about the potential postoperative complications. The patients were also asked to complete the same questionnaires as they had done shortly before surgery.
Statistical analysis was performed on the data using IBM SPSS. All but 4 patients remembered at least one possible complication provided. The audiovisual informed group was significantly more likely to remember the complications of allergic reaction to local anesthesia or medication and trismus compared with the control group. On week after surgery there was substantial decreases in anxiety when compared to before surgery in both groups. The postoperative self-reported anxiety scores of the audiovisual informed group were significantly lower than those of the control group.
The results of the study confirmed the hypothesis that treatment information presented in an audiovisual slideshow could decrease patient anxiety after surgery for an impacted mandibular wisdom tooth. The results were consistent with a prior study showing decreasing the ambiguity of a situation could lessen the anxiety experienced.
The authors state
“It can be argued that supplementing any written information with an audiovisual presentation would be time consuming and add expense owing to the time required for the surgeon or staff to administer the informed consent process. However, the authors would argue the additional time required to view the slideshow would to be a small price to pay for achieving an understanding between the surgeon and patient, given that a considerable proportion of lawsuits result from a lack of understanding between the surgeon and patient, rather than errors in treatment.”
Further the authors do present a few limitations of their study. This includes not using a random population and a small sample size. Furthermore there were many more men in the study and the education level was not evenly distributed with most of the patients having postsecondary backgrounds. I personally like the idea of improving the current informed consent process and welcome further studies of this type to better information patients and lower anxiety. It may also be beneficial for those having dental surgery to talk it over with a therapist beforehand. Although this was not explored directly in the study perhaps having someone to discuss how you feel about the procedure beforehand may help make it less stressful.
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