Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS2 Paediatric dentistry > Dental fear and anxiety > Flashcards

Dental fear and anxiety Flashcards

1
Q

What is dental fear

A

a normal emotional reaction to one or more specific threatening stimuli in the dental environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is dental anxiety

A

a sense of apprehension that something dreadful is going to happen in relation to dental treatment, coupled with a sense of losing control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is dental phobia

A

a severe type of dental anxiety manifested as a marked and persistent anxiety in relation to clearly discernible situations or objects e.g. use of drill or to the dental situation in general

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is required for a diagnosis of dental phobia

A

there must be either complete avoidance of necessary dental treatment or endurance of treatment only with dread and in a specialist treatment situation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the UK prevelence of dental anxiety

A

11.6% adults, 4 times greater in 18-39 years old v 60+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the cycle of dental fear and anxiety

A
  • fear/ anxiety
  • avoidance
  • deterioration in dental status
  • feelings of shame and inferiority
  • fear/ anxiety etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A good thing to say to a dentally anxious patient

A

‘we’re going to take this step by step’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes dental anxiety?

A
  • negative medical and dental experiences
  • influenced by family and peers
  • media representations of dentistry
  • expectation of pain and discomfort
  • poor knowledge of modern analgesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 pathways identified which make children dentally anxious

A

Conditioning
- arising from objective dental pathology and subjective dental experiences.

Modelling
- children’s imitation of mother’s behaviour

Information

  • unwitting provision of frightening info
  • absorbing mother’s attitudes to dentistry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Characteristics of the anxious

A
  • high neuroticism and trait anxiety
  • pessimism and negative expectation
  • proneness to somatisation (manifestation of psychological distress by the presentation of physical symptoms)
  • low pain threshold (they are expecting pain)
  • co-morbid anxiety disorders
  • co-morbid depressive disorders
  • fear of negative evaluation
  • pessimistic and vulnerable
  • catastrophic
  • over-inclusive negativity
  • worry as a habit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are examples of anxious and neurotic thinking

A
  • fear of negative evaluation
  • pessimistic and vulnerable
  • catastrophic
  • over-inclusive negativity “life is a disaster/ failure/ pointless etc”
  • worry as a habit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do a patients negative thoughts impact their memories of treatment experience

A

inaccurate memories

benign experiences are recalled negatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the 3 provoking factors to fear/ avoidance/safety-seeking/ anticipating disaster

A

bad experience
high neuroticism
depression and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 3 maintaining factors to fear/ avoidance/safety-seeking/ anticipating disaster

A

selective memory and attention
high neuroticism
biased judgement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how is dental anxiety assessed in adults

A

The modified dental anxiety scale (MDAS) and the DAS-R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the diagnostic cut off for the MDAS

A

19/25

17
Q

how is dental anxiety assessed in children

A

picture tests (for young children and adolescents)

child experience of dental anxiety measure (CEDAM) for age 9-16

modified child dental anxiety scale (faces version) MCDASf for age 8-16

18
Q

What are the treatment strategies for Mild/moderate dental anxiety

A
  1. general attitude and the application of a general anxiety reducing treatment style
  2. pharmachological support
  3. teach coping strategies
19
Q

What should the general attitude and application of a general anxiety reducing treatment style be like?

A

explain the ‘fight and flight’ (how they can take control)

  • acknoledge patient’s anxiety
  • build trusting relationship
  • give realistic information
  • provide control e.g. agreed stop signal
  • provide high level of predictability (tell them at the start what you’re planning on doing and introduce the next appointment the same day)
20
Q

What pharmachological support can be used for treatment

A

nitrous oxide sedation (if necessary liaise with GMP regarding prescribing oral sedation prior to treatment)

21
Q

what coping strategies can be taught

A

relaxation and distraction

22
Q

What control signals can be used by the patient

A

Stop signals - gives control over the pace of the procedure

Rest signals - allows the patient to stop with the understanding that the treatment is not finished yet

Proceed signals - just as important

Provide options e.g. which tooth will we restore first?

23
Q

An example of a relaxation exercise

A

breathe in for 2 and out for 3 - helps lower tongue in place too

24
Q

How effective is music at relaxing a patient

A

not effective with children

effective with adults

25
Q

What ways can someone distract themselves

A
  • think pleasant and relaxing thoughts
  • do puzzles in their head (anagrams/ number games)
  • think of 5 things which makes them happy
26
Q

What are the behavioural treatment strategies for mod/severe dental anxiety/phobia

A

exposure-based treatment programme e.g. systematic desensitisation:
- trained in relaxation
- then encouraged to expose themselves to a hierarchy of fearful situations
(can be individual or group setting using imagined, video, computer based or real life confrontation)

For more complex cases, treatment could be carried out by a clinical psychologist in close cooperation with dentist

27
Q

What is the fear hierarchy

A 
sitting in the waiting room
seeing the needle
holding the needle
feeling the needle on the gum
intra-oral injection
28
Q

What is involved in simple desensitisation

A
  • relaxation training
  • give control in a calm manner
  • fear hierarchy
  • successive approximations
29
Q

What are cognitive treatment strategies

A
  • using pleasant and positive imagery
  • identifying challenging and modifying negative and unhelpful thoughts and replacing these with more positive and realistic thoughts
  • use of coping statements e.g. I can and I will
30
Q

How could you challenge evidence supporting negative thoughts

e.g. Belief: I have never coped well with pain and am prone to fail

A

What about when your child was born
What about your marriage
How are you enjoying your work

31
Q

Why is it helpful for highly anxious patients to have their fears challenged

A

when highly anxious patients have to come up with facts that do not confirm their fears, there is a subsequent decline in their perception of risk

32
Q

When might it be appropriate to refer an anxious patient on?

A
  • where dental anxiety may be a manifestation of underlying emotional problems or more serious mental difficulties
  • where there is a high treatment need, but the psychological consequences would be too overwhelming/ demanding for the patient. GA or IV sedation may be appropriate
33
Q

What are the optimal interventions

A
  • phobic avoidance needs desensitisation
  • giving info improves dispels fears (v effective)
  • simple desensitisation can be carried out in the clinic
  • inappropriate beliefs can be evaluated, challenged and restructured
  • severe cases of anxiety plus high need for treatment/ pain = maybe offer sedation
34
Q

How common is dental anxiety

A

1/10 patients will have high levels

35
Q

What provokes fearful behaviour

A
  • traumatic experiences
  • inappropriate beliefs/ expectations
  • neurotic traits
36
Q

What is better, behaviour management or managing behaviour

A

behaviour management (it’s about reducing the underlying fear and anxiety)

BDS2 Paediatric dentistry (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions