CASE REPORT article
Front. Physiol.
Sec. Autonomic Neuroscience
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1607816
A Case Series: Heart Rate Variability During Dental Treatment with Vasovagal Reflex
Provisionally accepted
- 1Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences,, Kagoshima University, Kagoshima, Japan
- 2Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences,, Kagoshima University, Kagoshima, Japan
- 3Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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The vasovagal reflex is the most frequent emergency that occurs during dental procedures, but its underlying mechanism is not understood. In this study, we conducted autonomic monitoring of patients with a history of vasovagal reflexes.We focused on the high-frequency component, an indicator of parasympathetic activity, and interrupted the treatment when the high-frequency component increased. Treatment was then resumed after confirming that there was no mood disturbance and no increase in the highfrequency component. In another patient with a history of dental treatment-induced vasovagal reflex, autonomic activity during treatment was measured under atropine sulfate hydrate administration.Discussion: Analysis of heart rate variability during the vasovagal reflex showed that parasympathetic hyperactivity was followed by sympathetic hyperactivity, indicating real-time changes in autonomic nervous system activity. In addition, the high-frequency component, which decreased after atropine sulfate hydrate administration, did not increase during treatment, along with the low-frequency to high-frequency ratio, a measure of sympathetic nervous system activity, and the vasovagal reflex did not occur. We believe that the visualization of a patient's autonomic nervous system activity during dental treatment will improve the quality of systemic management and lead to the realization of a safe and comfortable treatment environment.
Keywords: Autonomic Nervous System, activity case series, Dental treatment, Heart rate variability, vasovagal reflex
Received: 09 Apr 2025; Accepted: 01 Jul 2025.
Copyright: © 2025 Yamashita, Kibe, Yoshimine, Uto, Uchino and Sugimura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kaoru Yamashita, Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences,, Kagoshima University, Kagoshima, Japan
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