NCT07592130

Brief 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. 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.

Trial Health

65
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
45

participants targeted

Target at P25-P50 for phase_2

Timeline
9mo left

Started Jun 2026

Shorter than P25 for phase_2

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 11, 2026

Completed
7 days until next milestone

First Posted

Study publicly available on registry

May 18, 2026

Completed
28 days until next milestone

Study Start

First participant enrolled

June 15, 2026

Expected
7 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 10, 2027

2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 25, 2027

Last Updated

May 18, 2026

Status Verified

May 1, 2026

Enrollment Period

7 months

First QC Date

May 11, 2026

Last Update Submit

May 11, 2026

Conditions

Keywords

Pediatric dental anxietyAromatherapyPediMelissa officinalisEssential oilsPediatric oral anesthesia

Outcome Measures

Primary Outcomes (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.

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

Secondary Outcomes (5)

  • Observed pain during needle insertion (SEM scale)

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

  • Self reported pain after treatment (Wong-Baker Faces)

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

  • Heart rate during dental treatment

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

  • Oxygen saturation during dental treatment

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

  • Adverse events related to Melissa officinalis essential oil

    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).

Study Arms (3)

Aromatherapy with Melissa officinalis essential oil - Brand A

EXPERIMENTAL

Children 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.

Other: Aromatherapy with Melissa officinalis essential oil - Brand A

Aromatherapy with Melissa officinalis essential oil - Brand B

EXPERIMENTAL

Children 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.

Other: Aromatherapy with Melissa officinalis essential oil - Brand B

Standard behavioral management

ACTIVE COMPARATOR

Children 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.

Other: Standard behavioral management

Interventions

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.

Also known as: Aromatherapy A
Aromatherapy with Melissa officinalis essential oil - Brand A

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.

Also known as: Aromatherapy B
Aromatherapy with Melissa officinalis essential oil - Brand B

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.

Also known as: Child behavioral control
Standard behavioral management

Eligibility Criteria

Age6 Years - 10 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • 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.

You may not qualify if:

  • 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.
  • 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.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (3)

  • 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.

    PMID: 39697190BACKGROUND
  • 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.

    PMID: 34849354BACKGROUND
  • 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.

    PMID: 41007011BACKGROUND

MeSH Terms

Interventions

Aromatherapy

Intervention Hierarchy (Ancestors)

Mind-Body TherapiesComplementary TherapiesTherapeuticsPhytotherapySensory Art TherapiesPsychotherapyBehavioral Disciplines and Activities

Central Study Contacts

Dhira Limón-Ramírez, DDS

CONTACT

Miguel Rosales-Berber, M.Sc,

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Due to the olfactory nature of the intervention, blinding of operators and participants is not feasible. Therefore, only the principal investigator and the outcome assessor will be blinded to group allocation. The operator performing the dental procedures and managing the aromatherapy device will be aware of the assigned intervention, due to the practical characteristics of the olfactory exposure. However, the individuals responsible for data analysis and for evaluating anxiety, pain, and physiological outcomes will not know which intervention each child received, in order to minimize assessment bias.
Purpose
OTHER
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Professor

Study Record Dates

First Submitted

May 11, 2026

First Posted

May 18, 2026

Study Start (Estimated)

June 15, 2026

Primary Completion (Estimated)

January 10, 2027

Study Completion (Estimated)

February 25, 2027

Last Updated

May 18, 2026

Record last verified: 2026-05