Screening Female Patients With Autonomic Nervous System Imbalance Using the Toho Medical Index Before Tooth Extraction.

OBJECTIVE

Imbalanced autonomic nervous system (ANS) activity raises concerns about the development of systemic complications during dental treatment. The purpose of this study was to determine whether a psychological test (Toho Medical Index (TMI)) prior to the impacted mandibular third molar extraction can identify patients with potentially imbalanced autonomic function.

MATERIALS AND METHODS

In this prospective study, 34 healthy adult patients with no history of systemic disease were assigned to either the autonomic imbalance group (type II, III, IV) or the control group (type I) based on the results of the TMI. We evaluated sympathetic nervous system activity (low/high frequency (LF/HF)), parasympathetic nervous activity, heart rate (HR), and systolic blood pressure (SBP) values before extraction of the impacted mandibular third molar.

RESULTS

LF/HF and SBP in the autonomic imbalance group were significantly higher preoperatively than those in the control group. In addition, preoperative HF values were significantly lower in the autonomic imbalance group compared to those in controls (Mann-Whitney U test, p < 0.05); no significant group differences in HR were found (Mann-Whitney U test, p < 0.05).

CONCLUSION

ANS activity before extraction of the impacted mandibular third molar was assessed subjectively using the TMI and objectively using HR variability analysis. Our findings suggest that some patients do not have symptoms specific to dysautonomia but have an imbalance of autonomic function before extraction of the impacted mandibular third molar, and TMI can identify such patients.