Managing the Phobic Dental Patient

Introduction:

We all fear pain and it’s a well-known reason for people to avoid seeing the dentist. Most end up having severe periodontal problems leading to loss of teeth. Approximately 4-11% people suffer from dental phobias and avoid seeking dental care at all costs. Many of them end up in emergency situations that require invasive procedures like extraction or pulpotomy, which further reinforces their phobia.

What causes dental phobia? About 75% of such patients have had a bad childhood experience in a dentist's office. Another 25% suffer from other issues like post traumatic stress disorders e.g., war veterans, domestic violence and childhood sexual abuse, anxiety disorders, substance abuse, for whom dental phobia becomes an unpleasant side effect. Also a lot of these patients didn't have a good access to dental care. Indirect experiences such as hearing about traumatic experiences/views of a friend or family member about dentistry may also contribute towards development of phobias.

Patients feel fear not so much from the actual pain but from the lack of control that they feel lying in a dental chair. That creates a lot of anxiousness in some patients, as they don’t feel helpless. Most dentists continue treating all patients in a similarly assuming that they all have similar pain level and will handle the procedure in the same way. Dentists should be mindful of their patient’s level of tolerance and make them aware of the entire procedure ahead of time so that they are able to handle the unexpected situations. They should take time to ensure that the patient feels comfortable at every step. Use of medications and wide array of techniques can help patients eliminate pain and anxiety and making dental visits a pleasant experi...

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..., patience and training in behavior management. This is really important, as evidence suggests that there is no difference between the oral health outcomes of people who have dental fear as compared to those who don’t. Appropriate techniques like behavior modification, sedation, medication etc., can help patients recognize and overcome their fear and modify their utilization of dental behavior. This will establish trust and increase patient compliance.

Works Cited

1.Predicting dental avoidance among dentally fearful Australian adults.

Armfield JM.

2. The effects of dental anxiety and irregular attendance on referral for dental treatment under sedation within the National Health Service in London. Milgrom P, Newton JT, Boyle C, Heaton LJ, Donaldson N.

3. Effect of fear on dental utilization behaviors and oral health outcome.

Meng X, Heft MW, Bradley MM, Lang PJ.