Listening to music to reduce the pain and anxiety of third molar surgery


Surgical removal of third molars is a very procedure that is associated with level of preoperative patient anxiety that can affect the perception of pain during surgery. Medication may be used to manage this anxiety but is associated with side effects. Studies have suggested that listening to music may have beneficial effects on pain and anxiety.

The aim of this review was to assess the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions.


A protocol was registered with OSF registries and searches conducted in the Cochrane Library, Medline/PubMed, Embase and Scopus databases. This was supplemented by searches in the journals, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery, British Journal of Oral and Maxillofacial Surgery, and Journal of Cranio- maxillofacial Surgery.  Randomised controlled trials (RCTs) of the effects of listening to music on outcomes of third molar extraction published in English were considered.  Two reviewers independently selected studies and extracted data with risk of bias being assessed using the Cochrane tool. A narrative summary was presented.


  • 5 RCTs involving a total of 436 patients were included.
  • All of the studies were considered to be at high risk of bias as it was impossible to blind participants to music listening.
  • Time of music listening, and music genres varied between the studies.
  • 3 studies evaluated the effect of music on haemodynamic parameters (mean blood pressure and heart rate) with 2 find no difference and 1 a reduction of systolic pressure in favour of the music group.
  • 5 studies assessed anxiety with all studies showing a benefit in favour of the music group.


The authors concluded: –

Music may be an effective non-pharmacological measure to reduce preoperative anxiety in patients scheduled for third molar extraction; however, the hemodynamic effects and the effects on pain (both perioperative and postoperative) should be further explored.


A 2013 Cochrane review by Monteiro et al examined the effect of music on preoperative anxiety concluding,

music listening may have a beneficial effect on preoperative anxiety. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients. Therefore, we conclude that music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.

However, no dental or head and neck surgery trials were included in the review.

This new review looked specifically at third molar surgery publishing protocol on OSF registries. A number of major databases were searched, and this was supplemented by hand searches of a number of relevant journals. However, on English language publications were included so some relevant papers may have been excluded.  Only 5 studies were included and while it was impossible to blind participants to music listening 4 out of the 5 studies were also unclear regarding aspects of randomisation so this needs to be taken into consideration when interpreting the findings. While the findings suggest a positive impact of listening to music larger well conducted studies using common outcomes would be beneficial in clarifying the effect.


Primary Paper

Monteiro JLGC, da Silva Barbirato D, Moraes SLD, Pellizzer EP, do Egito Vasconcelos BC. Does listening to music reduce anxiety and pain in third molar surgery?-a systematic review. Clin Oral Investig. 2022 Oct;26(10):6079-6086. doi: 10.1007/s00784-022-04640-5. Epub 2022 Aug 23. PMID: 35999384.

Review protocol in OSF Registries

Other references

Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev. 2013 Jun 6;2013(6):CD006908. doi: 10.1002/14651858.CD006908.pub2. PMID: 23740695; PMCID: PMC9758540.

Picture Credits

Photo by Mohammad Metri on Unsplash


Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+