Anxiety and post-traumatic stress symptoms following wisdom tooth removal

A. de Jongh, M. Olff, H. van Hoolwerff, I.H.A. Aartman, B. Broekman, R. Lindauer, F. Boer

Research output: Contribution to JournalArticleAcademicpeer-review

37 Citations (Scopus)


The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.

Original languageEnglish
Pages (from-to)1305-1310
Number of pages6
JournalBehaviour research and therapy
Issue number12
Publication statusPublished - 1 Dec 2008


  • Dental anxiety
  • Oral surgery
  • Post-Traumatic Stress Disorder (PTSD)
  • Stress
  • Third molar
  • Wisdom tooth

Cite this