Predicting adverse events in patients who are anxious about dental procedures

Background Dental extractions can cause significant anxiety making patients feel sick. In serious cases, extractions can cause unconsciousness and even death. Therefore, systemic adverse events must be completely avoided. We herein developed a method to predict dental extraction-related adverse events in patients. Methods The State-Trait Anxiety Inventory (STAIY-1) was administered before calculus removal and extraction, and STAIY-2 was administered before calculus removal in 93 patients (men, 44; women, 49). These patients were at a dental clinic for outpatient treatment. The vital signs like blood pressure, pulse rate, and arterial oxygen saturation and salivary amylase activity were measured at 2- and 4-min intervals before calculus removal as well as before extraction. Results Of the 93 patients, one man and one woman suffered from an adverse event. Maximum points for raw STAIY-1 scores were measured before extraction for both men and women, suggesting that performing the STAIY-1 survey prior to extraction is effective in predicting extraction-related adverse events. We also investigated rate changes (rate change = mean value during extraction − mean value during calculus removal/mean value during calculus removal) and mean pre-extraction pulse rates in patients who suffered from an adverse event. Adverse events occurred in men when there was a rate change of ≥ 0.225 and mean pre-extraction pulse rate was ≥ 90.0 bpm and in women when there was a rate change of ≥ 0.200 and the mean pre-extraction pulse rate was ≥ 95.0 bpm. We used these pulse rates as cutoff values. Conclusions Thus, the combined use of pre-extraction STAIY-1 results and pulse rate cutoff values could increase the success of predicting adverse events in such patients.