Dear Ankur,

In Finland they serve hot coffee or tea in the private sector while you are waiting for the always late dentist. I can assure you that coffee and tea have no anxiety-reducing effect, in contrast coffeine (tein) increases anxiety and keep you alert and awake. I do not find any references supporting the opposite.

Thanks Beatrice,

I have been able to get some literature supporting use of cocoa for controlling anxiety.  I don't know if it may be effective in dental setting.

http://www.ncbi.nlm.nih.gov/pubmed/23364814

http://www.ncbi.nlm.nih.gov/pubmed/24100674

www.ncbi.nlm.nih.gov/pubmed/22822453

I read the abstracts of your papers. Perhaps hot cocoa is good before dental treatment but surely not directly after.  I never got cocoa in a dentist's waiting room, probably it would have been nice to get it as a child.  

1. Mood was unchanged by treatment acutely  [with cocoa] while cognition was unaffected by treatment at all time points. 

 2. Keeping in view the pleiotropic health benefits of cocoa, it may have the potential to be used for the prevention/treatment of allergies, cancers, oxidative injuries, inflammatory conditions, anxiety, hyperglycemia, and insulin resistance.

 3. The study was performed by BioAnalytical Science, Nestlé Research Center, Nestec Ltd, Lausanne 26, Switzerland :The milk chocolate (17% of our population is lactose intolerant) resulted in the decrease of anxiety in high anxiety trait subjects, whereas dark chocolate and cheese and crackers respectively improved the anxiety level and the energetic state of low anxiety trait participants.  

After this the anxiety-laden persons can change focus and start to ruminate over becoming fat.

Thanks vBéatrice Marianne Ewalds-Kvis for your comprehensive reports

Check this review paper:

Nutr Rev. 2013 Oct;71(10):665-81. doi: 10.1111/nure.12065.

Effects of chocolate on cognitive function and mood: a systematic review.

Scholey A, Owen L.

"Two studies failed to demonstrate behavioral benefits but did identify significant alterations in brain activation patterns. "

I feel that achieving a higher level/ more profound local anaesthesia may be a crucial factor in determining intra-operative comfort of the patient. Historically, Cocaine was the first known local anaesthetic. The connection is that it is derived from cocoa leaves. The critical point is that do cocoa beans contain any anaesthetic or 'cocaine-mimetic' substance that may cause a synergistic effect with Xylocaine? 

Cocaine does not come from cocoa leaves, but from coca leaves

maybe some sources have caused this ambiguity I am not sure if they can be relied on. 

http://media.johnwiley.com.au/product_data/excerpt/46/08138199/0813819946-125.pdf

Review: Cocoa Butter and Xylocaine 5% W/ Glucose 7.5%

Summary: drug interactions are reported only by a few people who take Cocoa Butter and Xylocaine 5% W/ Glucose 7.5% together.

This review analyzes the effectiveness and drug interactions between Cocoa Butter and Xylocaine 5% W/ Glucose 7.5%. It is created by eHealthMe based on reports from FDA and social media, and is updated regularly.

Cocoa butter has active ingredients of cocoa. (latest outcomes)

Xylocaine 5% w/ glucose 7.5% has active ingredients of lidocaine hydrochloride.

The best thing you can do for a child' s dental health as well as adult patient's is giving them some xylitol chewing gums before, after and always. Findings from Finland.

Thanks Beatrice, is it possible to share the source of the review/ publication.

Efficacy of xylitol containing chewing gums has been established. Xylitol has been extensively studied for its caries cessation effects in various forms. However, it should be used at levels not exceeding 20 g/ day in children. Xylitol containing chewing gums should be avoided in children less than 4 years due to obvious reasons. Safety of xylitol in pregnency and breast feeding has not yet been established and should be avoided. Further it is known to cause diarrhea and intestinal gas.

There are a wide variety of anxiety control mechanisms ... but

good communication and positive engagement with the patient comes first.... 

Really, everybody uses xylitol chewing gums in Finland. Nota bene tests are done at rats or mice in concentrations above what any human is capable of daily usage.

I was wondering if any possible effect would be more psychological more than bilological. Pain is a multifactorial phenomenon and is influneced by biopsychosocial factors. I was wondering, if i was a coffee drinker, having a nice cup of coffee would change my mined, relax me , make think about something else before my dental appointment...maybe the hot beverage has more of a pscychological efect on pain modulation. Any thoughts?

I wonder if taking   preoperative hot drink can increase the bleeding from the site

I am not paid to promote Xylitol chewing gums but  I compare the effect on my own teeth while working in Sweden without xylitol for 6 years where I often suffered from dental problems  with  my stay in Finland where the dentist sugested this chewing gum within 15 min after a meal, so I provide some information:

"Xylitol is found naturally in a number of fruits and vegetables (including strawberries, raspberries, pears, cauliflower and plums).

The human body produces between 5 and 15 grams of xylitol each day as it metabolizes carbohydrates. (It's an intermediate compound in the glucuronate-xyulose metabolic pathway.)

When manufactured, the starting agricultural product is usually birch trees or corn cobs.

The U.S. Food and Drug Administration (FDA) classifies it and has approved its use as a "food additive" (1963).

In packaging and advertising, the FDA allows manufacturers to make the claim that xylitol products "do not promote dental caries."

Worldwide, it's been approved for use in foods, pharmaceuticals, and oral health products in more than 35 countries.

The World Health Organization’s Joint Expert Committee on Food Additives and the European Union’s Scientific Committee for Food have both approved its use.

Side effects founfd in Finland:

Side effects.

Makinen (1976) studied the effects of xylitol consumption on fifty-two humans over a two-year period. On average, members of this test group consumed 1.5 kg of xylitol per month, which averages out to roughly fifty grams per day (over four times the maximum adult daily dosing suggested for preventing tooth decay).

No ill effects were found, with the exception of the minor/manageable side effects discussed in our next paragraph.

Gastrointestinal side effects.

If there's an area of concern, it's one related to gastrointestinal side effects. Xylitol is digested slowly in the large intestine and ingesting comparative large amounts of it can create a laxative effect (soft stools or even diarrhea).

It usually only creates gastrointestinal problems when it's consumed at levels that approach fifty grams per day (over 5 times what most adults need for cavity prevention). At lower levels, lesser difficulties may be experienced such as flatulence, minor stomach cramps or nausea.

Solutions.

The incidence of these symptoms will vary with each individual and are typically dose-size related. A reduction in either per-serving or daily-dosing amounts usually provides a remedy. Other solutions can be to get a greater portion of your xylitol exposure from sources that can be spit out (mouth rinse, toothpaste) or, if necessary, cease your xylitol consumption all together.

Medical uses of xylitol.

Diabetes

Because xylitol is absorbed more slowly than sucrose (table sugar), it does not contribute of elevated blood sugar levels and the associated hyperglycemia caused by an insufficient insulin response. It's glycemic index is 7.

Osteoporosis

Some research suggests that xylitol consumption may help to increase bone density. If so, some day it may have a use as a treatment for osteoporosis.

Ear and upper respiratory infections

Xylitol may be an aid in preventing ear infections (acute otitis media), by way of having an inhibitory effect on the bacteria that cause this condition.

Do not feed your pets with xylitol!

I feel that there is no adequate evidence to support use of any hot beverage pre operatively for anxiety control in dental or medical patients. Further, there is scant literature to support the likelihood of such an association. Though there have been studies that support the anxiety reducing effect of cocoa, the evidence seems ambiguous for a use in dental setting. An in-human trial of such an association could be appropriate only once anxiolytic  effects of cocoa have been established through preclinical and exploratory studies. It however, cannot be entirely negated that cocoa 'may' have some effect. However, this effect may completely be placebo effect. 

Ishag, it may be possible. Further, if the same physiology that increases bleeding locally actually works - it will also result in shorter effect of local anaesthetic rather than increase.

Yes Ankur Sharma  some local  factor may  play  a role

 This kind of behaviour is psychological rather than bilological. Tea and coffee if works no harm in trying.