International Journal of Clinical and Experimental

Hypnosis

ISSN: 0020-7144 (Print) 1744-5183 (Online) Journal homepage: http://www.tandfonline.com/loi/nhyp20

Hypnosis and Local Anesthesia for Dental Pain

Relief—Alternative or Adjunct Therapy?—A
Randomized, Clinical-Experimental Crossover
Study

Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway, Dagna Below,

Bernd d’Hoedt, Brita Willershausen & Monika Daubländer

To cite this article: Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway, Dagna Below,
Bernd d’Hoedt, Brita Willershausen & Monika Daubländer (2016) Hypnosis and Local
Anesthesia for Dental Pain Relief—Alternative or Adjunct Therapy?—A Randomized, Clinical-
Experimental Crossover Study, International Journal of Clinical and Experimental Hypnosis,
64:4, 391-403, DOI: 10.1080/00207144.2016.1209033

To link to this article: http://dx.doi.org/10.1080/00207144.2016.1209033

Published online: 02 Sep 2016.

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Intl. Journal of Clinical and Experimental Hypnosis, 64(4): 391–403, 2016
Copyright © International Journal of Clinical and Experimental Hypnosis
ISSN: 0020-7144 print / 1744-5183 online
DOI: 10.1080/00207144.2016.1209033

HYPNOSIS AND LOCAL ANESTHESIA FOR

DENTAL PAIN RELIEF—ALTERNATIVE OR
ADJUNCT THERAPY?—A RANDOMIZED,
CLINICAL-EXPERIMENTAL CROSSOVER
STUDY
Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway,
Dagna Below, Bernd d’Hoedt,
Brita Willershausen, and Monika Daubländer
University Medical Center, Mainz, Germany

Abstract: This prospective randomized clinical crossover trial was

designed to compare hypnosis and local anesthesia for experimental
dental pain relief. Pain thresholds of the dental pulp were determined.
A targeted standardized pain stimulus was applied and rated on the
Visual Analogue Scale (0–10). The pain threshold was lower under
hypnosis (58.3 ± 17.3, p < .001), maximal (80.0) under local anesthesia.
The pain stimulus was scored higher under hypnosis (3.9 ± 3.8) than
with local anesthesia (0.0, p < .001). Local anesthesia was superior to
hypnosis and is a safe and effective method for pain relief in dentistry.
Hypnosis seems to produce similar effects observed under sedation.
It can be used in addition to local anesthesia and in individual cases as
an alternative for pain control in dentistry.

According to the International Association for the Study of Pain

(IASP), pain is described as “an unpleasant sensory and emotional
experience associated with actual or potential tissue damage, or
described in terms of such damage” (Merskey, 1994, p. 2010). In order
to diagnose orofacial pain, both a comprehensive examination of all
participatory structures of the masticatory system and careful consid-
eration of the patient’s history are required. Acute pain sensations
and chronic maxillofacial pain must be distinguished from each other.
The gold standard for pain management in dental medicine is local
anesthesia (Malamed, 2006). However, psychological aspects play an

Manuscript submitted March 10, 2015; final revision accepted November 11, 2015.
Address correspondence to Dr. Thomas Gerhard Wolf, DDS, Department of Operative
Dentistry, University Medical Center of the Johannes Gutenberg University Mainz,
Augustusplatz 2, D-55131 Mainz, Germany. E-mail: thomaswolf@uni-mainz.de
Color versions of one or more of the figures in the article can be found online at www.
tandfonline.com/nhyp.

391
392 THOMAS GERHARD WOLF ET AL.

important role, in particular fear of “the shot,” in addition to side

effects and contraindications. Among the complications are bleeding
and hematoma, discomfort, temporary or persistent disruptions in
function of the anesthetized nerve, paresis of parts of the musculature,
or even infections. Short-term side effects such as an increase in heart
rate, sweating, and dizziness are observed relatively often, generally
as a result of the adrenalin contained in the local anesthetic solution.
Nevertheless, there are also rare and serious complications such as aller-
gic reactions to the contents of the solution that can result in shock,
intoxication, and stoppage of circulation (Daubländer, Müller, & Lipp,
1997). Material failures such as broken needles or incorrect techniques
in the application can occur. Despite correct, conscientious use and pre-
ventive measures, many of the complications cannot always be avoided
(Haas, 1998; Mercado & Weinberg, 2011). In recent years, an alterna-
tive therapeutic possibility in medicine and dentistry—hypnosis—has
received increasing attention worldwide (Jugé & Tubert-Jeannin, 2013;
Lu, 2002). It is implemented in a number of different situations for stress
and anxiety reduction as well as for pain management (Abdeshahi,
Hashemipour, Mesgarzadeh, Shahidi Payam, & Halaj Monfared, 2013;
Armfield & Heaton, 2013). Here, the pain-reduction effect is produced
through hypnotic focusing of consciousness by a modulation of the con-
trol of the psychological, physiological, and neurological experience of
pain, which in the individual life of a human being is conditioned and
discarded involuntarily (Erickson, 1967). In search of nonpharmaceu-
tical and minimally invasive alternatives, the subjective, individually
experienced pain threshold and pain intensity will be examined in this
crossover study in a clinical-experimental manner. Two methods, hyp-
nosis and local anesthesia, will be compared to each other. Thus, it will
be determined in this study whether the implementation of hypnosis
for pain management could replace or augment infiltration anesthesia
in dental medicine as an alternative method.

Method

In this study, 34 subjects in the age range of 21–54 years (M =

27.8 ± 7.97) were accepted. Of these, 22 were women and 12 men.
These subjects were recruited and informed about the study through
posters on the campus of the Johannes Gutenberg University in Mainz
and of University Medicine Mainz. After approval by the ethics com-
mission of the state chamber of physicians of Rhineland-Palatinate, the
experiments were carried out on two separate days. On Day 1, the
subjects were led through hypnosis, and, on the other day, they were
treated with a local anesthetic. Randomization was performed by the
Institute of Medical Biostatistics, Epidemiology and Informatics of the
Johannes Gutenberg University Mainz (IMBEI). During this process, the
 HYPNOSIS OR LOCAL ANESTHESIA FOR DENTAL PAIN 393

experiment was randomized to hypnosis or local anesthetic as well as

whether hypnosis would be used at the outset or not. There were dif-
ferent inclusion criteria for participation in this clinical-experimental
study. These were as follows: healthy, vital, and not previously treated
lateral incisor or canine in the upper jaw according to World Dental
Federation (FDI nomenclature 13–23, Universal Numbering System
6–11; no medication; intellectual comprehension of the study; informed
consent; of adult age; and no allergy to the local anesthetic. In addi-
tion, the subjects must have no previous experience in hypnosis. On the
respective day of the examination, the use of drugs as well as alcohol,
nicotine, and coffee were prohibited. The same tooth was selected and
tested in both experimental runs.
In both test runs, the respective pain threshold was measured and
a standardized pain stimulus was applied, which was evaluated by
the subject on the visual analog scale (VAS, 0–10). The pain manip-
ulations were performed using the SybronEndo Vitality Scanner 2006
(SybronEndo, Glendora, CA 91740, USA) (hereinafter called Vitality
Scanner). This is a device for pulp testing that can release indepen-
dent, electronically stable, constant electrical impulses from battery
voltage. Once there is contact between the tip of the probe and the
tooth to be tested, the intensity of the electric stimulus automatically
increases. This is visible on the indicator of the device, which registers
dimensionless values from 0 to 80. The subject experiences this stim-
ulus as an increasing, pulsating pressure, heat, or itching. The device
increases gradually to the maximum of 80 until contact between the
probe tip of the device and the tooth is interrupted. Both experimen-
tal runs were documented and recorded by using a monitoring device
that measures and records noninvasively the hemodynamic parame-
ters of a subject (Task Force® Monitor, CNSystems Medizintechnik AG,
Graz, Austria). Such hemodynamic parameters as impedance cardio-
graphy (ICG), finger plethysmography, electrocardiography (EKG), as
well as oscillometric (oscBP) and continuous blood pressure measure-
ment (contBP) for every heartbeat (beat-to-beat) could be measured
continuously and in real time.
On the day of the experiment in hypnosis, the subjects were induced
into a hypnotic state. Through association with three ideas of a pleas-
ant, relaxing place or condition, the subjects were guided by general
suggestions into a trance. A so-called “automatic responding protective
hand” (“cataleptic”) was installed; by using this with hand movements,
the subjects could signal for an interruption of treatment at any time
through their own volition. The subject was to imagine that he or she
was dissociated from the body and to perceive the desired trance place
through visual, auditory, kinesthetic, olfactory, and gustatory sensation.
The inner resources were to be activated through imagination and the
tests to be carried out during hypnosis. After subsequent association
394 THOMAS GERHARD WOLF ET AL.

back into the body and into the “here and now,” the self-hypnotic state
was ended.
On the day local anesthesia was tested, the subjects received
infiltration anesthesia by means of the computer-driven anesthesia
injector, The WandTM (Milestone Scientific Inc., Livingston, NJ, USA)
for examination of the experimental parameters. The device, equipped
with microprocessors, injects the anesthetic at a controlled pressure and
gives the precise dosage amount with regulated speed of flow. In the
clinical test, 1 ml Ultracain® D-S (Articain 4% + Adrenalin 1:200.000,
Sanofi-Aventis, Frankfurt am Main, Germany) was administered to the
subjects.
The data from this study were processed using the software program
IBM SPSS Statistics Version 20.0 (IBM Corp., 2011). For discrete vari-
ables a descriptive analysis was performed and medians, means, stan-
dard deviations, minimums, and maximums were collected. For group
comparisons, the Wilcoxon signed-rank test was used. The significance
level was p < .05.

Results
During induction into hypnosis, differences in subjective individ-
ual pain threshold (the subjectively individual pain intensity) were
observed in comparison to infiltration anesthesia and found to be
statistically significant, p < .001 (see Figure 1).
Here, the pain threshold had a mean value of 79.4 (±3.6) with a
minimum of 59 and a maximum of 80 after local anesthetic. The pain

Figure 1. Subjective individual pain threshold during local anesthesia (left) and hypnosis
(right) after stimulation with the pulp stimulation device (0–80; n = 34). The
subjective individual pain threshold was statistically significantly lower during
hypnosis compared to local anesthesia (80.0) (Wilcoxon Test; p < .001).
 HYPNOSIS OR LOCAL ANESTHESIA FOR DENTAL PAIN 395

Figure 2. Subjective individual pain intensity by standardized, reproducible testing and

evaluation by test subjects on the Visual Analog Scale (VAS, 0–10)(n = 34).

threshold during hypnosis by comparison had a mean value of 58.3

(±17.3; min: 34.3; max: 80.0). With one exception, the values for local
anesthesia were all at a maximum of 80, thus complete anesthesia
was achieved. Test subjects used the VAS (0–10) to rate the subjec-
tive, individually experienced pain intensity of the above-threshold
stimulus. After maximum stimulus with the pulp stimulus device
(maximum value: 80) during hypnosis (3.9 ± 3.8, min: 0.0; max: 10.0),
the rating was statistically significantly higher than in the test with local
anesthetic (0.0 ± 1.7, min: 0.0; max: 10.0) (see Figure 2). Only 1 subject
there had a subjectively experienced sensation of pain after injection of
the local anesthetic. Here, too, the values during hypnosis show a wide
distribution; in six cases, complete anesthesia was possible (∼18% of
the test subjects).
Different measurements were taken with respect to hemodynamic
parameters. With hypnosis, a trend in the direction of decreased sym-
pathetic nervous system (SNS) activity was determined. The values for
heart rate tended to be lower during hypnosis; however, differences
were not statistically significant. There were also differences in the val-
ues for mean arterial blood pressure. Here, the values during hypnosis
were higher in comparison to local anesthesia.
SNS activity is a dimensionless value, which is objectively calcu-
lated by the monitoring computer indirectly by frequency analysis of
the heartrate variability. The measured values of sympathetic nervous
activity (51.5 ± 18.6) during hypnosis were significantly lower than
under the influence of local anesthesia (61.3 ± 17.3).
After both test runs, the subjects were asked which method they
would prefer for pain relief at the next dental treatment. Nine indicated
396 THOMAS GERHARD WOLF ET AL.

Figure 3. SNS activity at different points of measurement of respective subjective individ-

ual pain threshold: blue is local anesthesia and red is hypnosis. Recording was
begun at “Start”; the points “O1” to “O3” represent measurements without the
particular therapeutic local anesthesia (LA) option or hypnosis (Hyp). The value
“I” signals intervention by the dentist, that is, the injection of local anesthesia or
the guiding into a trance state for hypnosis. The points “M1” to “M3” designate
the three respective measurements of subjective individual pain threshold with
the respective experiment type. The end of recording is indicated by “End.”

that they would prefer hypnosis as their method of choice, while

25 chose local anesthesia.
Only 6 of the test subjects wanted pain relief during all dental treat-
ments, while 28 of the subjects only wanted it if pain was anticipated
(See Figure 3).

Discussion

The use of hypnosis in the clinical context is often described as a

method that, in addition to its positive qualities regarding the manage-
ment of anxiety and pain, can improve quality of life, self-confidence,
and physical health. It is free of side effects and can be offered to both
children and adults (Adinolfi & Gava, 2013). This treatment was men-
tioned in dental journals and by dental associations more than 100 years
ago; many dentists used hypnotic suggestion as the only method of
anesthesia or in conjunction with local or systemic anesthesia during
tooth filling or even extraction therapies. When local anesthesia began
 HYPNOSIS OR LOCAL ANESTHESIA FOR DENTAL PAIN 397

to be implemented, hypnosis was still utilized, above all in nervous

patients or to support, to comfort, and to increase satisfaction (Andrick,
2013; Tarján & Gábris, 2008). In the present study, the use of hypno-
sis for pain relief was tested and compared in a clinical experiment to
a standardized local anesthesia procedure, The WandTM system. The
observed pain thresholds during hypnosis showed a broad distribu-
tion of data corresponding to a subjectively interindividual variability.
However, an elevated pain threshold during hypnosis was observed in
all subjects. This means that hypnosis could be used as the sole pain
therapy of choice in smaller restorative procedures such as fillings and
periodontal treatments in which a low level of pain is expected and lit-
tle local anesthesia will be used. The results of this study confirmed
those of Facco and colleagues (2011) who determined a significant
increase in the subjectively experienced pain threshold during hyp-
notic intervention although a different hypnosis technique was used.
With one exception, local anesthesia achieved absolute pain relief. This
clear superiority confirms the gold standard, local anesthesia, in this
experiment. Leith et al. observed this successful implementation of the
infiltration technique with the analgesic articain instead of lidocaine,
even in children, for safe and effective pain control (Leith, Lynch, &
O’Connell, 2012). The results for subjective individual pain intensity
from overthreshold stimulation according to evaluation on the VAS
under local anesthesia additionally confirms this method. In hypnosis,
there is also a broad variability present; a complete absence of pain was
experienced by 6 test subjects (∼18%). In a clinical study on extraction of
the third molar in the upper and lower jaw, Abdeshahi et al. (2013) also
compared hypnosis with local anesthesia. For each patient, one tooth
was extracted during hypnosis and one in the opposite side in the same
jaw under local anesthesia. Only 2 of 24 patients reported pain after
induction into hypnosis; after local anesthesia, 8 patients reported pain
during the procedure (Abdeshahi et al., 2013). The difference was statis-
tically significant, and, thus, hypnosis was superior to local anesthesia.
In addition to reducing pain, hypnosis also reduced anxiety as well as
postoperative bleeding. These results are in contrast to those observed
in the present study. Local anesthesia showed a strong effectiveness in
comparison with hypnosis, both in the studies on pain threshold as
well as those for pain intensity. This could be a result of the fact that in
hypnosis, which is a variation of hypnosis, other psychological mech-
anisms take effect. Due to the individuality of hypnosis in the present
study used, differences might appear compared to a standardized hyp-
nosis protocol like sometimes used with recordings (compact disc) in
several studies. In addition, the positive motivation necessary in med-
ically indicated and possibly urgent necessary interventions was not
present in this clinical-experimental study. The authors Abdeshahi et al.
(2013), however, also admit that the patients were carefully selected and
398 THOMAS GERHARD WOLF ET AL.

were to be treated surgically only by a dentist sufficiently trained and

experienced in hypnosis. Armfield et al. (2013) determined that suc-
cessful management of patients suffering from anxiety about dental
procedures is entirely possible for clinicians. However, understanding
and good rapport between doctor and patient is important. Treatment
in stages, with several treatment appointments of longer duration,
can also be necessary because of time-consuming reconstructive work.
Nonpharmacological possibilities for both children and adults must
therefore be found (Armfield et al., 2013). The authors of the present
study are in agreement with the assertions made by Abdeshahi et al.
and Armfield et al. that training in psychological aspects or the use
of hypnosis are indispensable for successful treatment. In the present
study, “face-to-face” was used to induce hypnosis. Through the stan-
dardized implementation of hypnosis in the past, it has already been
possible in some studies to conduct many treatments under hypno-
sis (Faymonville et al., 1998; Hermes, Hakim, & Sieg, 2004; Hermes,
Truebger, Hakim, & Sieg, 2005) and to gain further knowledge through
the documented results and further research of the combined usable
psychological-medical treatment options (Eitner, Bittner, Wichmann,
Nickenig, & Sokol, 2010; Facco, Pasquali, Zanette, & Casiglia, 2013;
Faymonville et al., 1997). Above all, a short induction into hypnotic
trance state is important for use in dental routine treatment in practice,
which in the present study was around minutes on an average. Another
therapeutic option for future treatments is the combination of hypno-
sis and local anesthesia, both for adults and children (Fanali, Gallo,
Tetè, & Salini, 1991; Faymonville, Meurisse, & Fissette, 1999; Gokli,
Wood, Mourino, Farrington, & Best, 1994; Liossi, White, & Hatira, 2006).
In unsuccessful treatments using a combination of local anesthesia and
inhalation sedation in children, Shaw and Welbury (1996) recommend
hypnosis combined with inhalation sedation for extraction therapy. The
combination of hypnosis and local anesthesia has also already proved
successful as an anxiety-reducing component (Morse, Schacterle, Furst,
& Bose, 1981). During the application of local anesthesia in the present
study, an elevation of heart rate, measured by means of arterial blood
pressure and SNS activity, was observed. This could possibly be traced
to the additional adrenalin contained in the local anesthesia solution or
the pain upon injection. The values during hypnosis lay statistically sig-
nificantly below those of local anesthesia despite the fact that the study
subjects experienced more severe pain during hypnosis. Although no
parameters were ascertained by means of an anxiety inventory, there is
reason to believe that the lower values during hypnosis reflect the anx-
iolytic effect of this method. Several cardiovascular changes were also
observed that have an effect on hypnotic intervention in a multidisci-
plinary context. Further studies on these effects, how they emerge and
 HYPNOSIS OR LOCAL ANESTHESIA FOR DENTAL PAIN 399

how they can be modulated, are necessary (Casiglia et al., 1997, 2006,
2007, 2012).
In this respect, it is interesting that approximately one quarter of the
study subjects selected hypnosis as their method of choice for pain man-
agement in the dentist’s chair. In terms of the subjective individual pain
threshold and blood pressure, the use of hypnosis is experienced as
very similar to the effect of sedation (Fanini, Poglio, Marci, Iovinelli,
& Antenucci, 1998). This was confirmed in this study. According to the
evaluation of the data, pain relief was nearly complete with one excep-
tion for local anesthesia, but the insertion of the injection syringe was
frequently described by the test subjects as very unpleasant or painful
(Nusstein, Burns, Reader, Beck, & Weaver, 2004). Because the WandTM
System showed, in comparison to conventional injection, a lower pain
level during injection, this technique is considered a very gentle method
and because of this was used as a reference (Yenisey, 2009).
A number of dental treatments, such as filling therapies in the case of
cervical defects, cause only a little or no subjectively experienced pain
in patients; in such cases, hypnosis could be used. A broad spectrum of
treatment indications is thus open to hypnosis. For minor procedures,
adjuvant use is recommended; however, hypnosis used alone for major
procedures is only possible in isolated cases. The gold standard is and
remains local anesthesia.

Conclusion
Both in the examinations for subjective individual pain threshold and
in the evaluation of standardized subjective individual pain intensity,
local anesthesia administered using The WandTM injection system was
superior to hypnosis. Activation of the SNS remained constant for the
most part during injection but was higher than in the hypnosis group.
Hypnosis can be considered for use in further indications. A clinical
monitoring of the results produced by this experiment is to be recom-
mended in order to monitor the effectiveness of hypnosis in a clinical
dental setting in routine treatments.

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402 THOMAS GERHARD WOLF ET AL.

Hypnose und Lokalanästhesie, um Zahnschmerzen zu lindern – Alternative

oder adjuvante Therapie ? Eine randomisierte, klinische Crossover-Studie

Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway, Dagna Below,

Bernd d’Hoedt, Brita Willershausen, und Monika Daubländer
Abstract: Diese prospektive randomisierte klinische Crossover-Studie
wurde designed, um Hypnose und Lokalanästhesie zur Behandlung von
experimentellen Zahnschmerzen zu vergleichen. Die Schmerzschwellen
der Zahnpulpa wurden bestimmt. Es wurde ein gezielter, standard-
isierter Schmerzreiz gesetzt und mittels der Visuellen Analog Skala
(0–10) aufgenommen. Die Schmerzschwelle war unter Hypnose niedriger
(58,3 ± 17,3; p < 0,001) und unter Lokalanästhesie maximal (80,0). Der
Schmerzreiz wurde unter Hypnose höher (3,9 +/- 3,8) bewertet als unter
Lokalanästhesie (0,0; p < 0,001). Die Lokalanästhesie war der Hypnose
überlegen und ist eine sichere und effektive Methode der Schmerzlinderung
in der Zahnmedizin. Hypnose scheint ähnliche Effekte hervorzurufen wie
sie unter Sedierung zu finden sind. Sie kann additiv zur Lokalanästhesie und
im individuellen Fall als Alternative zur Schmerzkontrolle herangezogen
werden.
Stephanie Reigel, MD

L’hypnose et l’anesthésie locale dans le soulagement des douleurs dentaires

— solution de rechange ou thérapie adjuvante? Une étude clinique
randomisée et croisée

Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway, Dagna Below,

Bernd d’Hoedt, Brita Willershausen et Monika Daubländer
Résumé: Cette étude clinique prospective, randomisée et croisée, visait à
comparer l’hypnose et l’anesthésie locale dans le soulagement expérimental
de la douleur dentaire. On a d’abord déterminé les seuils de douleur de la
pulpe dentaire des sujets. Puis un stimulus douloureux normalisé ciblé a été
appliqué et évalué à l’aide d’une échelle visuelle analogue (de 0 à 10). Le
seuil de la douleur était plus faible sous hypnose (58,3 ± 17,3; p < 0,001),
comparativement au seuil maximal (80,0) enregistré sous anesthésie locale.
Le stimulus douloureux a été perçu comme étant plus fort sous hypnose (3,9
± 3,8) que sous anesthésie locale (0,0; p < 0,001). L’anesthésie locale s’est
révélée supérieure à l’hypnose, et constitue une méthode sûre et efficace de
soulagement de la douleur en médecine dentaire. L’hypnose semble produire
des effets similaires observés sous sédation. Elle peut être utilisée en complé-
ment de l’anesthésie locale et, dans des cas particuliers, comme solution de
rechange pour le soulagement de la douleur en dentisterie.
Johanne Reynault
C. Tr. (STIBC)
 HYPNOSIS OR LOCAL ANESTHESIA FOR DENTAL PAIN 403

Hipnosis y anestesia local para el alivio del dolor dental - ¿terapia

alternativa o adjunta? Un ensayo clínico aleatorizado con diseño cruzado.

Thomas Gerhard Wolf, Dominik Wolf, Angelika Callaway, Dagna Below,

Bernd d’Hoedt, Brita Willershausen, y Monika Daubländer
Resumen: Este ensayo clínico prospectivo aleatorizado con diseño cruzado
se diseñó para comparar la hipnosis y la anestesia local para aliviar el dolor
dental experimental. Se determinaron los umbrales de dolor de la pulpa den-
tal. Se aplicó de forma focalizada un estímulo doloroso estándar que fue
evaluado mediante la Escala Visual Análoga (0–10). El umbral de dolor fue
menor bajo hipnosis (58.3±17.3; p < .001) y alcanzó el máximo (80.0) bajo
anestesia local. El estímulo de dolor fue calificado más alto bajo hipnosis
(3.9±2.8) que bajo anestesia local (0.0; p < .001). La anestesia local fue supe-
rior a la hipnosis y es un método para la reducción de dolor seguro y efectivo
en la odontología. La hipnosis parece producir efectos similares observa-
dos durante la sedación. Podría utilizarse adicionalmente a la anestesia local
y en casos individuales como una alternativa para el control de dolor en
odontología.
Omar Sánchez-Armáss Cappello
Autonomous University of San Luis Potosi,
Mexico