Evaluation of Optimal Chair Position for Patients Undergoing Dental Procedures using Pulse Oximetry- A Prospective Clinical Study


  • SRM Dental College & Hospital, Department of Oral and Maxillofacial Surgery, Chennai, Tamil Nadu, 600089, India


Patient anxiety in the dental office creates an unacceptable situation for the dentist as well as patient, during procedures. Patient position on a dental chair can influence the levels of patient anxiety. The aim of the study was to determine the best patient position for maximal comfort and minimal anxiety. The objectives were (1) to assess the heart rate and (2) to assess the oxygen saturation in five different positions on a dental chair. The study was a prospective clinical trial involving 108 subjects. The inclusion criteria were healthy patients, aged 18-25 years. The exclusion criteria were patients with respiratory disorders, anaemia, cardiac disorders and other systemic problems. Every patient was made to assume 5 different postures - (1) Standing, (2) Sitting upright, (3) Semi-supine, (4) Semi-supine with legs bent and (5) Supine. A pulse oximeter probe was attached and the SpO2 (in percentage) and pulse rate (in beats/min) of every subject was recorded. As a result, the oxygen saturation was the highest in the standing posture (98.07) followed by sitting upright (97.85), supine and semi-supine posture (97.79), respectively. The heart rate showed a marked reduction from sitting upright (86.19) to supine (77.46) posture and the difference was statistically significant. When the patients bent their legs, there was a sudden spike in SpO2 as well as heart rate (P value-0.03) which was statistically significant. The study concluded that patient was most comfortable in semi-supine or supine posture with periodic legs-bent position.


Chair Position, Dental Treatment, Pulse Oximetry, SpO2

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Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: Literature review. Clin Cosmet Investig Dent. 2016; 8:35. https://doi.org/10.2147/CCIDE.S63626. PMid:27022303 PMCid:PMC4790493

Dhuva DJM, Kshisagar RA, Dhuvad MM, et al. Comparative evaluation of vital parameters during third molar surgery under local anaesthesia with and without sedative agents. J Clin Diagn Res. 2014; 8:57–60. https:// doi.org/10.7860/JCDR/2014/11043.5332. PMid:25654033 PMCid:PMC4316339

Pallí EJ, Obispo CA, Navarro BG, Murat J, Montero RA, Rojas S, et al. Analytical parameters and vital signs in patients subjected to dental extraction. J Clin Exp Dent. 2017; 9:223–230. https://doi.org/10.4317/jced.53474. PMid:28210440 PMCid:PMC5303322

Peterson LJ, Ellis E, Hupp JR, Tucker MR, et al. Contemporary Oral and Maxillofacial Surgery, 4th Edition; 2003.

Ulrich RS. Effects of healthcare environmental design on medical outcomes. Design and Health: Proceedings of the Second International Conference on Health and Design. Stockholm, Sweden: Svensk Byggtjanst; 2001. p. 49–59.

Basaranoglu G, Bakan M, Umutoglu T, Zengin SU, Idin K, Salihoglu Z, et al. Comparison of SpO2 values from different fingers of the hands. SpringerPlus. 2015; 4:561. https://doi.org/10.1186/s40064-015-1360-5. PMid:26543696 PMCid: PMC4627972

Jubran A. Pulse oximetry. Critical care. 1999; 3:11. https:// doi.org/10.1186/cc341. PMid:11094477 PMCid:PMC137227 8. Lahmann C, Schoen R, Henningsen P, Ronel J, Muehlbacher M, Loew T, Tritt K, Nickel M, Doering S, et al. Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. J Am Dent Assoc. 2008; 139:317–324. https://doi.org/10.14219/jada.

archive.2008.0161. PMid:18310736

Corah NL, O’Shea RM, Ayer WA, et al. Dentists’ management of patients’ fear and anxiety. J Am Dent Assoc. 1985; 110:734–736. https://doi.org/10.14219/jada.archive.1985.0427. PMid:3859545

Cohen SM, Fiske J, Newton JT, et al. Behavioural dentistry: The impact of dental anxiety on daily living. J Am Dent Assoc. 1985; 110:734–736.

Lee WL, Sung HC, Liu SH, Chang SM, et al. Meditative music listening to reduce state anxiety in patients during the uptake phase before Positron Emission Tomography (PET) scans. Br J Radiol. 2017; 90:20160466. https://doi.org/10.1259/bjr.20160466. PMid:27897034 PMCid:PMC5685102

Collins JA, Rudenski A, Gibson J, Howard L, O’Driscoll R, et al. Relating oxygen partial pressure, saturation and content: The haemoglobin-oxygen dissociation curve: Breathe (Sheff). 2015; 11:194–201. https://doi.org/10.11 83/20734735.001415. PMid:26632351 PMCid:PMC4666443

Gupta A, Bhat TMM, Bansal N, Gupta G, et al. Ergonomics in dentistry. Int J Clin Pediatr Dent. 2014; 7: 30–34. https://doi.org/10.5005/jp-journals-10005-1229 PMid:25206234. PMCid:PMC4144062

Corah NL, Gale EN, Illig SJ, et al. Assessment of a dental anxiety scale. J Am Dent Assoc. 1978; 97:816–819. https://doi.org/10.14219/jada.archive.1978.0394. PMid:31377

Elliott M, Coventry A, et al. Critical care: The eight vital signs of patient monitoring. Br J Nurs. 2012; 13; 21:621–625. https://doi.org/10.12968/bjon.2012.21.10.621. PMid:22875303

Mower WR, Myers G, Nicklin EL, Kearin KT, Baraff LJ, Sachs C, et al. Pulse oximetry as a fifth vital sign in emergency geriatric assessment. Acad Emerg Med. 1998; 5:858–865. https://doi.org/10.1111/j.1553-2712.1998.tb02813.x. PMid:9754497

Smith GB, Prytherch DR, Watson D, Forde V, Windsor A, Schmidt PE, Featherstone PI, Higgins B, Meredith P, et al. SpO2 values in acute medical admissions breathing airImplications for the British Thoracic Society guideline for emergency oxygen use in adult patients?. Resuscitation. 2012; 83:1201–1205. https://doi.org/10.1016/j.resuscitation.2012.06.002. PMid:22699210

Hall GM, Salmon P, et al. Physiological and psychological influences on postoperative fatigue. Anesth Analg.2002; 95:1446–1450. https://doi.org/10.1097/00000539200211000-00064. PMid:12401642

Banchero N, Sime F, Peñaloza D, Cruz J, Gamboa R, Marticorena E, et al. Pulmonary pressure, cardiac output, and arterial oxygen saturation during exercise at high altitude and at sea level. Circulation. 1966; 33:249–262. https://doi.org/10.1161/01.CIR.33.2.249. PMid:25823098

Marklew A. Body positioning and its effect on oxygenationa literature review. Nurs Crit Care. 2006; 11:16–22. https://doi.org/10.1111/j.1362-1017.2006.00141.x. PMid:16471294

Tierney Jr LM, Whooley MA, Saint S, et al. Oxygen saturation: A fifth vital sign? West J Med. 1997; 166:285–286.

Jensen LA, Onyskiw JE, Prasad NG, et al. Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart & Lung. 1998; 27:387–408. https://doi.org/10.1016/S0147-9563(98)90086-3

Ceylan B, Khorshid L, Güneş ÜY, Zaybak A, et al. Evaluation of oxygen saturation values in different body positions in healthy individuals. J Clin Nurs. 2016; 25:1095–1100. https://doi.org/10.1111/jocn.13189. PMid:26879626

Gift AG, Stanik J, Karpenick J, Whitmore K, Bolgiano CS, et al. Oxygen saturation in postoperative patients at low risk for hypoxemia: Is oxygen therapy needed? Anesth Analg. 1995; 80:368–372. https://doi.org/10.1213/00000539199502000-00028


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