Management of fear and anxiety in the dental clinic: a review

Abstract

People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.

The effect of dental anxiety on the dental status of adult patients in the Lodz region

“…Termin ten po raz pierwszy został użyty przez Berggrenai Meynerta 12 w 1984 r., ale jak pokazują badania z ostatnich lat, jest nadal obecny w wielu publi kacjach. 1,15,28 Arfmield et al 15 odnotowali, że 39% osób ze średnim i wysokim poziomem lęku znalazło się w "błęd nym kole". Ankietowani odwiedzali dentystę tylko w przy padku bólu, a gdy dolegliwości ustępowały, rezygnowali z dalszej opieki stomatologicznej.…”

“…Dla pacjenta sama obecność w gabi necie czy też ułożenie w pozycji leżącej w otoczeniu in strumentarium może być przyczyną uczucia naruszenia strefy intymnej. 15,16 Badania pokazują, że bodźcem wy zwalającym największy lęk jest podanie znieczulenia za pomocą igły i strzykawki oraz maszynowe opracowanie ubytku. 12,17 Lęk stomatologiczny może niekorzystnie wpływać na inne dziedziny życia, co pokazują obserwacje duńskiej populacji cierpiącej na dentofobię.…”

Connection between the child's behavior in the dental office and premature tooth extraction

“…Depending on the child's behavior in the dental office, when the patients are negative, the dentists must find an appropriate method to influence their behavior and predispose them to maximum assistance during treatment. The use of behavioural techniques is recommended to influence the negative behavior of children in order to reduce their fear of dental treatment (12,13,14,15).…”

Evaluation of anxiety associated with dental visit and treatment experience: A short study

“…Pharmacological methods to manage anxiety in dental clinic are premedication, sedatives and hypnotics, anti histaminic, conscious sedation, general anesthesia [9].…”