This study found that inhalation of lemongrass essential oil during dental scaling and root planning alleviates anxiety by both objective and subjective report measures.
In this article, we summarise the study, Effect of aromatherapy with lemongrass (Cymbopogon citratus) on the anxiety of patients undergoing scaling and root planning: A randomized clinical trial. (1).
Plant name and species
Lemongrass (Cymbopogon citratus)
Aim of study
To explore whether the use of lemongrass essential oil alleviates anxiety in adult patients undergoing dental scaling and root planning (SRP) for the first time.
Study method
The study was a randomised, parallel-design, placebo-controlled and single-blind trial carried out in a single dental facility in Iran. It was not possible to blind the participants to the smell of lemongrass.
Drops of the lemongrass or placebo were applied to cotton gauze and held at the nostrils for the duration of the SRP treatment, which lasted around 35 minutes. The procedure used an ultrasonic scaler device to clean the teeth.
The following measures were taken prior to treatment:
- Demographic questions
- Spielberger’s State-Trait Anxiety Inventory-State Scale (STAI-S, Likert scale)
- Heart rate
- Blood oxygen
- Systolic and diastolic blood pressure
Toward the end of treatment:
- Heart rate Blood oxygen
- Systolic and diastolic pressure
- Anxiety scale (STAI-S)
- Visual analog pain scale (VAS)
- Overall satisfaction questions (e.g. indicate your level of satisfaction with the treatment performed, and would you like aromatherapy to be used on you again during future dental treatments?)
Herbal preparation
100% pure lemongrass essential oil was used (Narin Gol, Iran). Four drops (0.2 ml) of essential oil were diluted in 100 ml of distilled water and poured onto sterile cotton gauze. For the control group, four drops of distilled water were used as a placebo. The gauze was held at the nostrils and the patients inhaled the scent.
Sample size
The sample was 40 healthy adults undergoing scaling and root planning (SRP) for the first time. They were included if they had no systemic health problems, non-smokers, no allergies to medicinal plants, no diagnosed anxiety or mood disorder. Other exclusion criteria were applied. They were asked to refrain from using perfumes or eating spicy food such as garlic for 12 hours before the dental visit. Of the 40 patients recruited, two dropped out leaving n=19 in each group.
Results of study
The demographic features of both lemongrass and control groups were similar.
Comparing the pre- and post-operative data, signs of anxiety were clearly apparent during the dental treatment with increases in blood pressure in the control group, although the perceived anxiety scores were not significantly different.
Compared to the control group, those receiving lemongrass essential oil experienced significant reductions in systolic and diastolic brood pressure, had a reduced heart rate and reduced levels of anxiety. On this scale, scores of around 40 relate to moderate levels of anxiety, and patients using lemongrass saw a 6-point reduction on average.
There were no changes in blood oxygen saturation, nor were there significant changes in the perceived level of pain between groups. Most of the patients using lemongrass said that they would like to use aromatherapy in future dental visits (18 out of 19 participants).
Further statistical tests looked at the relationship between pain and anxiety. There was a significant correlation between the level of pain and increase in the postoperative anxiety score of the patients in the control group, and high levels of anxiety were associated with lower satisfaction with the treatment.
In the lemongrass group, a similar pattern of correlations were apparent although not significant, possibly due to the herb having anxiolytic effects.
No side effects were noted for either group.
Discussion
Scaling and root planning (SRP) is used to treat gingivitis and periodontitis, and often are a cause of pain, discomfort and anxiety. This study used objective and subjective measures to explore the effects of lemongrass essential oil on the patient experience.
This study showed that lemongrass applied for the duration of the treatment reduced anxiety and cardiovascular changes associated with stress. There was no change in the level of perceived pain, nor did blood oxygen saturation change which can drop during times of stress.
The study cannot rule out placebo effects as it was not possible to blind the participants to the aroma of lemongrass. The combination of physiological measures gives some confidence in the physical response.
In a similar study that looked at the effects of lavender extract on anxiety in patients undergoing root canal treatment, lavender also displayed an anxiolytic effect. This study used a similar subjective anxiety inventory but also with a scented placebo (2). This further supports the potential of aromatic herbs in reducing stress and anxiety during dental treatments.
The major challenge in these studies is blinding of the patients and assessors, but combining objective and subjective measures does create a more robust study. Future studies could compare multiple essential oils. The end-point assessment was in the final third portion of the treatment; more precise measures of blood pressure and the stress response could be obtained through real-time monitoring as feelings of anxiety could have varied during the treatment.
Conclusion
The study showed that inhalation of lemongrass essential oil during a common 30-minute dental procedure reduced anxiety in patients, and was associated with haemodynamic changes suggestive of reduced stress levels. The aromatherapy was well-received and safe, so is a simple intervention to use in dental surgeries, and perhaps during other minor treatments that cause anxiety.
References
- Maybodi FR, Herandi V, Vaezpour MS. Effect of aromatherapy with lemongrass (Cymbopogon citratus) on the anxiety of patients undergoing scaling and root planning: a randomized clinical trial. BMC Complement Med Ther. 2025 Mar 11;25(1):100. https://doi.org/10.1186/s12906-025-04834-w
- Razavian H, Mazaheri M, Shiri A. Effect of Lavender Oral Drops in Reducing Dental Anxiety Among Patients Requiring Endodontic Treatment: A Randomised Clinical Trial. Eur Endod J. 2025 Jan;10(1):66-72. https://doi.org/10.14744/eej.2024.06641
