Anxiety Control Flashcards
What is Dental Anxiety?
General emotional response to an unknown danger or perceived threat.
Anticipatory due to previous negative experience.
What is Dental fear?
An intense biological response to immediate damager which is specific.
Encourages caution and safety.
What is Dental Phobia?
Clinical Mental disorder.
Overwhelming and debilitating fear of an object, place, situation or animal.
Interferes with every day life.
What are the potential causes of dental fear and anxiety?
Previous experiences- traumatic event, usually in childhood.
Learned experience- seeing parents scared, hearing others talking about it.
Fear of criticism
Fear of dress (scrubs), fear of the dental environment (sounds, sights, smells)
Lack of communication
Helplessness
Invasion of body orifice
Age
Stage of development- age, learning difficulties
Personality
Genes
What might be the triggers for dental anxiety?
Fearful of specific stimuli- drills, needles, pain, dental setting
Fear that something will go wrong during treatment
Mistrust of dental professional- lack of control, loss of self esteem, fear of judgement
Generalised dental anxiety- pt cannot pin point the exact trigger but the key factor is worry.
What is cognitive behavioural therapy?
A brief psychological therapy that is based on the idea that our thoughts, feelings and behaviours are all linked.
It provides psychoeducation and uses behavioural modification techniques and cognitive restructuring skills to challenge unhelpful beliefs and behaviours.
What is trauma?
An event of actual or extreme threat of physical or psychological harm which an individual experiences as traumatic and which has long lasting effects.
How does trauma influence dental fear and anxiety?
Someone who has previous trauma can be very triggered by the dental setting
- feeling out of control, having things done to them without feeling like they have given full consent, the lights, sound of the drill.
What life events would be traumatic?
Life threatening illness
Domestic abuse
Sexual abuse
Rape
Assault
Acute health crisis
ACE- caregiver separation, caregiver substance abuse, physical neglect, emotional neglect.
Describe the concept of “universal precaution”?
Assume that all patients are anxious because they may not have disclosed previous traumatic life events to you.
This will make the patient feel safe, empower them, give them choice, allow them to trust us.
This is a trauma informed approach.
On average, how many people in the UK have dental fear and anxiety?
1 in 4
What is the impact on dentists if patients have dental fear and anxiety?
Prolonged appointments
Stressful
More extensive treatment required due to neglect
Failed appointments
What mode of assessment could you use to assess someone’s level of dental fear and anxiety?
Modified Dental Anxiety Scale- can be used in people aged 16 years and older.
Score 5-25, to be classed as severe anxiety/phobic you need to score more than 19 or 5/5 on LA question.
Modified child dental anxiety scale-faces version (MCDAsf)
- valid for childeren aged 8-15.
Score between 9-45, greater than 27 indicates severe DFA/phobia.
What treatment options are available for someone with dental fear and anxiety?
Psychological- CBT
Pharmacological approaches- oral sedation, IV sedation, Inhalation sedation or general anaesthetic.
Important to still do CBT regardless to help the patient cope with sedation and GA.
Describe the building blocks of fear and anxiety?
