Nocebo response in dentistry: A systematic review and meta-analysis of adverse events in analgesic trials of third molar removal

Takeshi Watanabe*, Mette Sieg, Sigrid Juhl Lunde, Mads Persson, Pankaj Taneja, Lene Baad-Hansen, Maria Pigg, Lene Vase

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

Abstract

BACKGROUND: The nocebo response refers to the phenomenon where nonspecific factors, including negative verbal suggestion and treatment expectations, cause adverse events (AE) following a placebo treatment. Nonspecific factors are also likely to influence AE occurrence following administration of active pharmacological treatments.

OBJECTIVE: This meta-analysis aimed to estimate the nocebo response in dentistry by assessing the AEs prevalence in placebo- and active arms of randomised controlled trials (RCTs) assessing analgesic treatment following third molar (M3) surgery.

METHODS: A systematic search was performed in PubMed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. Eligible studies had to report the number of patients experiencing at least one drug-related AE (patients with AE ≥ 1) separately for the active and placebo arms. The proportion of patients with AE ≥ 1 and drug-related dropouts were pooled, and risk differences (RDs) between patients in the placebo- and active arm were calculated.

RESULTS: In 50 independent RCTs of 47 identified articles, the pooled rates of patients with AE ≥ 1 were 22.8% in the placebo arm and 20.6% in the active arm. The pooled rates of drug-related dropout were 0.24% in the placebo arm and 0.08% in the active arm. There were no significant RDs in patients with AE ≥ 1 and drug-related dropouts.

CONCLUSION: These results show that patients in the placebo arm reported AEs to the same extent as patients receiving active treatment, suggesting that most AEs in analgesic medication following M3 surgery may be attributed to the nocebo phenomenon.

OriginalsprogEngelsk
TidsskriftJournal of Oral Rehabilitation
Vol/bind50
Nummer4
Sider (fra-til)332-342
Antal sider11
ISSN0305-182X
DOI
StatusUdgivet - apr. 2023

Fingeraftryk

Dyk ned i forskningsemnerne om 'Nocebo response in dentistry: A systematic review and meta-analysis of adverse events in analgesic trials of third molar removal'. Sammen danner de et unikt fingeraftryk.

Citationsformater