Comparing Green and White Noise for Reducing Anxiety in Patients During Root Canal Treatment

Abstract

Introduction: Anxiety and fear of pain significantly hinder the pursuit of root canal treatments, leading up to 15% of adults to avoid dental care. Since pharmacologic sedation involves risks and typically requires specialist administration, music therapy has demonstrated potential in reducing stress through neurobiological pathways. White noise, known for its static-like sounds, effectively decreases anxiety, while green noise, composed of natural sounds, has shown promise in reducing heart rate and blood pressure during dental procedures. However, their efficacy has never been compared in endodontics.
Aim & Objective: This study aims to compare the effectiveness of Green noise (528 Hz) and White noise (432 Hz) in reducing anxiety and pain during root canal treatment, contributing to evidence-based anxiety management strategies in endodontic practice.
Materials and Methods: Following ethical approval and clinical trial registration, a double-blind study was conducted with 54 patients aged 18-60 with symptomatic irreversible pulpitis in single-rooted teeth. Patients were randomly assigned to 3 groups i.e control (no music), white noise (432 Hz), or green noise (528 Hz) groups. Anxiety levels were assessed using the Corah Dental Anxiety Scale before treatment. Vital signs such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded pre- and post-treatment.
Results: ANOVA and paired t-tests revealed that post-operatively, heart rate (HR) decreased across all groups, except for the white noise group, which experienced an increase. Systolic SBP and DBP rose in the control and white noise groups but decreased in the green noise group to 122.45±5.12 (from 138.09±10.41) and to 76.81±5.41 (from 94.22±9.67), respectively. Pre-operatively, HR differed significantly between the control and both noise groups (p<0.001). Post-operatively, HR differences were notable between white noise and green noise (p=0.011) and between white noise and control (p=0.011). The green noise group showed significant changes in HR, SBP, and DBP pre- and post-op (p<0.001).
Conclusion: Green noise (528 Hz) effectively reduces anxiety and modulates physiological responses during root canal treatment, offering a non-invasive alternative to pharmacologic sedation.