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Emotional Anxiety and Stress During Pediatric Dental TreatmentPhase 2No acronymNCT07592130

Melissa Officinalis Aromatherapy for Dental Anxiety in Children

A Phase 2 study testing Aromatherapy with Melissa officinalis essential oil - Brand A, Aromatherapy with Melissa officinalis essential oil - Brand B and Standard behavioral management in people with Emotional Anxiety and Stress During Pediatric Dental Treatment and Dental Anesthesia, run by Universidad Autonoma de San Luis Potosí.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This clinical study will look at whether a plant-based essential oil called "Melissa officinalis" (lemon balm) can help reduce fear and stress in children during dental treatment. Children between 6 and 10 years old who need a mandibular injection for a pulpotomy or pulpectomy will be invited to participate. Read more about this study

Who is it for?
Ages 6 to 10 years
What is being tested?
Aromatherapy with Melissa officinalis essential oil - Brand A, Aromatherapy with Melissa officinalis essential oil - Brand B and Standard behavioral management
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
No sites listed yet
Study dates
15 Jun 2026to 25 Feb 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 10 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Children aged 6 to 10 years at the time of enrollment.
  • Male or female pediatric patients in good general physical and mental health.
  • Require mandibular local anesthesia (inferior alveolar nerve block) for pulpotomy or pulpectomy of at least one primary molar.
  • No previous experience with dental local anesthesia.
  • Behavior classified as "positive" or "negative but accepting" (categories 2 or 3) according to the Frankl Behavior Rating Scale during the initial examination.
  • Ability of the child to understand simple verbal instructions appropriate for age.
  • Parent or legal guardian able and willing to sign written informed consent.
  • Child willing to provide verbal assent to participate in the study.

Who cannot join

  • History of previous dental local anesthesia.
  • Presence of dental emergencies (e.g., acute infection, severe pain, or swelling) requiring urgent treatment.
  • Known diagnosis of neurological, psychiatric, developmental, or behavioral disorders that may interfere with cooperation or with the assessment of anxiety and pain.
  • Systemic diseases or medical conditions (American Society of Anesthesiologists [ASA] physical status III or higher) that increase procedural risk or preclude participation according to the investigator's judgment.
  • Current acute upper respiratory conditions, such as common cold, rhinitis, sinusitis, or nasal allergy that could alter the sense of smell or breathing comfort.
  • Known allergy, hypersensitivity, or adverse reaction to Melissa officinalis, other Lamiaceae plants, essential oils, or components of the products used in the study.
Show all 10Show fewer
  • Use of anxiolytics, antidepressants, sedatives, or other psychotropic medications within the last 30 days.
  • Behavior rated as definitely negative (Frankl category 1) or definitely positive (Frankl category 4) at baseline.
  • Inability of parents or guardians to understand the study information or provide informed consent.
  • Participation in another clinical trial within the previous 30 days.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Dhira Limón-Ramírez, DDS contact

52 1 844 196 05 15

dhiraramirez0@gmail.com

Miguel Rosales-Berber, M.Sc, contact

+52 1 444 131 8166

About this study

Official title: Anxiolytic Effect of Inhaled Melissa Officinalis Essential Oil During Mandibular Local Anesthesia in Pediatric Dental Patients: A Randomized Controlled Clinical Trial

This clinical study will look at whether a plant-based essential oil called "Melissa officinalis" (lemon balm) can help reduce fear and stress in children during dental treatment. Children between 6 and 10 years old who need a mandibular injection for a pulpotomy or pulpectomy will be invited to participate. They will be randomly assigned to one of three groups: one group will receive aromatherapy with *Melissa officinalis* from brand A, another group will receive the same essential oil from brand B, and a third group will receive the usual behavioral management used in pediatric dentistry, but without aromatherapy.

The essential oil will be diffused in the dental room so that the child can gently inhale the aroma starting a few minutes before the injection and throughout the procedure. The study team will measure the child's dental anxiety using a child-friendly questionnaire with drawings of faces, observe pain behaviors during the injection, and record the child's own rating of pain with a faces scale. Heart rate and oxygen saturation will also be monitored as objective signs of stress. The goal is to find out whether "Melissa officinalis" aromatherapy is a safe, simple, non-invasive way to make dental visits less stressful and more comfortable for children, and whether there are meaningful differences between the two commercial products.

Read the detailed description

This is a single center, three arm, parallel group, randomized controlled trial in pediatric dental patients. Participants will be randomized in equal proportions (1:1:1) to one of three groups using permuted blocks, with allocation concealed in sequentially numbered, opaque, sealed envelopes prepared by an independent investigator. Due to the olfactory nature of the intervention, blinding of operators is not feasible; however, outcome assessors who record anxiety, pain scores, and physiological measures will be distinct from the operator and will remain unaware of group allocation until data analysis.

All clinical procedures will be performed by a single calibrated pediatric dentist using a standardized protocol that includes topical lidocaine 10% spray, inferior alveolar nerve block with lidocaine 2% with epinephrine 1:100,000, and subsequent pulpotomy or pulpectomy as indicated. Behavioral management techniques (tell-show-do, positive reinforcement, age appropriate language, and modeling when needed) will be applied in all groups, with the control group receiving only these non pharmacological strategies and no aromatherapy.

Being tested
Aromatherapy with Melissa officinalis essential oil - Brand A, Aromatherapy with Melissa officinalis essential oil - Brand B, Standard behavioral management
Keywords
Pediatric dental anxiety, Aromatherapy, PediMelissa officinalis, Essential oils, Pediatric oral anesthesia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aromatherapy with Melissa officinalis essential oil - Brand AOther

    Also called Aromatherapy A

    Melissa officinalis essential oil from Brand A (Young Living, Lehi, Utah, USA) will be placed in an electric nebulizer in the dental operatory at a standardized dilution in 10 mL of sterile distilled water. Diffusion will start 5 minutes before administration of topical anesthetic and inferior alveolar nerve block and will continue throughout the pulpotomy or pulpectomy procedure. Conventional behavioral management (tell-show-do, positive reinforcement, age appropriate communication) will also be used.

  • Aromatherapy with Melissa officinalis essential oil - Brand BOther

    Also called Aromatherapy B

    Melissa officinalis essential oil from Brand B (doTERRA, Pleasant Grove, Utah, USA) will be administered with the same nebulizer model and under the same conditions and timing used in the Brand A arm (5 minutes before and during local anesthesia and treatment). Conventional behavioral management will be applied in all cases.

  • Standard behavioral managementOther

    Also called Child behavioral control

    Behavioral techniques including tell-show-do, positive reinforcement, euphemistic wording, and modeling when needed will be used to facilitate cooperation during local anesthesia and pulpotomy or pulpectomy, without the use of essential oils.

Study groups in NCT07592130
Study groupRoleWhat they receive
Aromatherapy with Melissa officinalis essential oil - Brand AExperimentalChildren will receive aromatherapy with Melissa officinalis essential oil (Brand A) in addition to standard non pharmacological behavioral management during a mandibular local anesthetic procedure for pulpotomy or pulpectomy. A standardized dilution of Melissa officinalis essential oil from Brand A (Young Living, Lehi, Utah, USA) in 10 milliliters of sterile distilled water will be added to an electric nebulizer in the dentist office. Diffusion will begin five minutes prior to the topical anesthetic and inferior alveolar nerve block being administered, and it will continue during the pulpotomy or pulpectomy process. Additionally, age-appropriate communication, positive reinforcement, and tell-show-do behavioral control techniques will be employed.
Receives: Other: Aromatherapy with Melissa officinalis essential oil - Brand A
Aromatherapy with Melissa officinalis essential oil - Brand BExperimentalChildren will receive aromatherapy with Melissa officinalis essential oil (Brand B) in addition to standard non pharmacological behavioral management during a mandibular local anesthetic procedure for pulpotomy or pulpectomy. The same nebulizer model, timing, and circumstances as the Brand A arm will be utilized to give Melissa officinalis essential oil from Brand B (doTERRA, Pleasant Grove, Utah, USA) (5 minutes before and during local anesthesia and treatment). In every situation, traditional behavioral management will be used.
Receives: Other: Aromatherapy with Melissa officinalis essential oil - Brand B
Standard behavioral managementActive comparatorChildren will receive standard non pharmacological behavioral management during the mandibular local anesthetic procedure and restorative treatment, with no aromatherapy or additional olfactory stimulus in the operatory. Without the use of essential oils, behavioral strategies such as tell-show-do, positive reinforcement, euphemistic language, and modeling where necessary will be employed to promote compliance during local anesthetic and pulpotomy or pulpectomy.
Receives: Other: Standard behavioral management

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in dental anxiety (MCDASf score)

    Dental anxiety will be assessed using the Modified Child Dental Anxiety Scale with faces (MCDASf). Scores will be recorded at baseline (before exposure to the operatory or aromatherapy) and after completion of local anesthetic injection. The outcome is the change in MCDASf score (post anesthesia minus baseline) and will be compared among the three study groups.

    Measured: From baseline before the dental appointment to immediately after local anesthetic injection (approximately 15-20 minutes).

Secondary outcomes (5)
  1. Observed pain during needle insertion (SEM scale)

    Pain behavior during administration of the inferior alveolar nerve block will be evaluated using the Sound, Eye, Motor (SEM) scale by an independent, trained observer. Higher scores indicate more intense behavioral signs of pain.

    Measured: During needle insertion and anesthetic injection (approximately 1-2 minutes).

  2. Self reported pain after treatment (Wong-Baker Faces)

    After completion of the dental procedure, children will rate their pain using the Wong-Baker Faces Pain Rating Scale (0-10). Higher scores indicate greater perceived pain intensity.

    Measured: Immediately after completion of pulpotomy or pulpectomy (within 5-10 minutes).

  3. Heart rate during dental treatment

    Heart rate will be measured with a digital pulse oximeter at three time points: baseline (seated in the operatory), during the local anesthetic injection, and after completion of treatment. The outcome will be the mean heart rate and its change across time points within and between groups.

    Measured: Baseline, during injection, and post treatment (total monitoring period approximately 20-30 minutes).

  4. Oxygen saturation during dental treatment

    Peripheral oxygen saturation (SpO₂) will be measured with the same pulse oximeter at baseline, during injection, and post treatment, as an objective indicator of physiological stress or instability during the dental visit.

    Measured: Baseline, during injection, and post treatment (approximately 20-30 minutes).

  5. Adverse events related to Melissa officinalis essential oil

    All adverse events possibly related to exposure to Melissa officinalis essential oil (e.g., nausea, vomiting, dizziness, headache, respiratory symptoms, skin irritation, or other unexpected reactions) will be recorded throughout the visit. Serious adverse events will be documented and reported according to institutional and regulatory requirements.

    • Time

    Measured: From the start of aromatherapy (or entry into the operatory for the control group) to 30 minutes after the end of the dental procedure (single visit).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 May 2026
  2. Study start15 Jun 2026 (estimated)
  3. Primary completion10 Jan 2027 (estimated)
  4. Study completion25 Feb 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07592130
Sponsor's protocol ID
U.A.S.L.P. Estomatología
Other IDs
No funding
Acronym
No acronym
Status last verified
May 2026
First submitted
11 May 2026
Last updated
18 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: It has not yet been determined whether individual participant data (IPD) collected in this study will be made available to other researchers. The decision will depend on institutional policies, ethical committee recommendations, and future data-sharing agreements established after completion of the study.

Publications

  • Yadav A, Bailwad SA, Bhatnagar A, Roy M. Evaluation of the effect of essential oil aromatherapy on anxiety and pain during administration of local anesthesia in children: a randomized clinical trial. J Dent Anesth Pain Med. 2024 Dec;24(6):395-406. doi: 10.17245/jdapm.2024.24.6.395. Epub 2024 Nov 26.

    PubMed 39697190
  • Nirmala K, Kamatham R. Effect of Aromatherapy on Dental Anxiety and Pain in Children Undergoing Local Anesthetic Administrations: A Randomized Clinical Trial. J Caring Sci. 2021 Aug 23;10(3):111-120. doi: 10.34172/jcs.2021.026. eCollection 2021 Aug.

    PubMed 34849354
  • Rigillo G, Blom JMC, Cocchi A, Martinucci V, Favaro F, Baini G, Cappellucci G, Tascedda F, Biagi M. Medicinal Plants for Child Mental Health: Clinical Insights, Active Compounds, and Perspectives for Rational Use. Children (Basel). 2025 Aug 28;12(9):1142. doi: 10.3390/children12091142.

    PubMed 41007011

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Aromatherapy with Melissa officinalis essential oil - Brand A, Aromatherapy with Melissa officinalis essential oil - Brand B and Standard behavioral management in people with Emotional Anxiety and Stress During Pediatric Dental Treatment and Dental Anesthesia, run by Universidad Autonoma de San Luis Potosí.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 18 May 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Dhira Limón-Ramírez, DDS (52 1 844 196 05 15, dhiraramirez0@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in dental anxiety (MCDASf score) (time frame: From baseline before the dental appointment to immediately after local anesthetic injection (approximately 15-20 minutes).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07592130, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2026.

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