dental fear and anxiety

Question 1

what is dental fear?

Answer 1

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

Question 2

what is dental anxiety?

Answer 2

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

Question 3

what is dental phobia?

Answer 3

a severe type of dental anxiety manifested as a marked and persistent anxiety in relation to clearly discernible situations or objects

Question 4

why do dentists find treating patients with anxiety a challenge?

Answer 4

dental fear may come across as aggressive/uncommunicative

Question 5

what 3 things worry dentists most?

Answer 5

• the dentist-px relationship
• px anxiety
• prevention

Question 6

why is avoidance a cycle?

Answer 6

teeth get worse

the px experiences embarrasment, shame, inferiority

Question 7

what is the aetiology of dental anxiety?

Answer 7

negative experience
family influence
media representation
expectation of pain

Question 8

how do children become dentally anxious? (pathways)

Answer 8

conditioning
-experiences
modelling
-imitate behaviour
information
-eg mothers attitude

Question 9

what are the characteristics of the anxious?

Answer 9

high neuroticism
pessimism
somatisation
low pain threshold
co-morbid anxiety disorders
co-morbid depressive disorders

Question 10

how to ensure px memory of tx is positive

Answer 10

debrief at end of tx so they know it went well

Question 11

what are the tx strategies for mild/mod dental anxiety? (5)

Answer 11

acknowledge px feeling of anxiety
engender a trusting relationship
provide realistic info
provide a high level of predictability
provide control

Question 12

what coping strategies can be taught?

Answer 12

relaxation
-breathing awareness
-muscle relaxation
distraction
-chat
-visualisation
imagery

Question 13

what pharmacological support can be given?

Answer 13

benzodiazepine

nitrous oxide

Question 14

describe blunting coping style

Answer 14

like to know what’s happening but not the process/sensory feelings in detail

• most common
• distraction effective

Question 15

describe monitor coping style

Answer 15

wants to know what’s happening

distraction not effective

Question 16

what can be used for control?

Answer 16

stop signals
-only during procedure
rest signals
proceed signals
provide options

Question 17

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

Answer 17

exposure-based eg desensitisation
1st muscular relaxation
exposure

Question 18

what is exposure therapy often combined with?

Answer 18

cognitive coping strategies

Question 19

what is challenging the evidence?

Answer 19

when highly anxious px have to come up with facts that don’t confirm fears there is a subsequent decline in risk perception

Question 20

what should be done in a very severe case?

Answer 20

referral to clinical psychologist etc.

Question 21

what should be done in a severe case when there is a high tx need?

Answer 21

GA