E lecture- overview of dental anxiety Flashcards
what is the anxiety cycle
fear anxiety leading to avoiding dental care leading to deterioration of dental care and then feeling of guilt and shame
what is fear
an important inbuilt instinct and without it we would not have survived
what is fear associated with
physiological arousal
blood rushing to the peripheral areas such as the muscles
high levels of circulating adrenaline
what is the difference between fear and anxiety
anxiety can be more emotional
what is trait anxiety
refers to a persons inbuilt tendency for them to be anxious in their every day lives
what is state anxiety
anxiety that refers to specific things and situations and doesn’t move out of these
what is a phobia
a phobia is an extreme fear which is defined as a psychiatric illness
what are the symptoms of a phobia
fear of the situation that is out of proportion to the danger
cannot be explained
largely beyond voluntary control
leads of avoidance of the feared situation
avoidance distress that leads to the person avoiding the situation
what is the percentage of people who are somewhat anxious of dental treatment according to the 1998
64%
what percentage of people are even nervous to visit the dental according to the annual dental survey 1998
49%
how are dental anxiety levels looking in USA
the anxiety levels are looking constant regardless of new and improved techniques
what is the aetiology of dental anxiety
need to remember the biopsychosocial model:
what is included in the biopsychosocial model:
biological: organs physiology and genetics
social: community family society
psychological: cognition emotion motivation
what link has been made between dental anxiety and genetics
that there could be a genetic link but it is more a learnt behaviour
which gender is more dentally anxious
generally females
according to the survey what percentage of men were dentally anxious
43%
what percentage of dentate females are dentally anxious
55%
which gender records better attendance
women- possibly due to the fact they can admit their fear due to gender roles
which other correlations can be found
between socioeconomic class and dental anxiety
what is required from dentists to make patients feel more comfortable
TECHNICAL COMPETANCE
what features are important in a dentist patient relationship
good communication skills
and taking a patients fear seriously
in a survey of young people what percentage experienced dissatisfaction with their dentist or dental surgery
15%
how much more likely are people who are dentally anxious going to experience bad behaviour
5 to 10 times
how do patients evaluate dentists
attitude and behaviour approach to pain control the dentists ability to solve their problem staff attitude convenience cost physical factors
what about dental treatment makes patients anxious
the fear of unknowing and the fear of extractions fillings etc
and the anticipation of pain
what is necessary for good anxiety control
good pain control
why do they have a lower pain threshold
possibly due to the anxiety
or genuinely due to the lower pain threshold
how do we recognise dental anxiety
not entering the clinic uncooperative uncommunicative over talkative aggressive looking distracted
how do we recognise dental anxiety
gagging ask sweating shaking pale hyperventilation increased heart rate
what scale do we use in clinic to rate dental anxiety
modified dental anxiety scale(MDAS)- more common and DAS( dental anxiety scale
how do we use the dental anxiety scale(DAS)
4 item scale
score 1-5 on each item and above 15 relates to dental phobia
a=1
b=2
what is the criticism for the DAS scale
that it is a little too emotive
and no scale for LA which is a big cause for dental anxiety
what are the benefits of the MDAS scale
it is less emotive and has standard options to choose from
how do we scale the MDAS
possible scores from 5-25
and 19 can relate to dental phobia
what is a drawback of both the MDAS and DAS
that they do not indicate which aspect the patient is dental anxious about
how do we figure of which aspects of the dental treatment the patient is anxious about
dental fear surgery by kleinknechts
how does kleinknechts dental fear survey work
27 dental situations
rate 1-5 on anxiety
eg making the appt
if we just need an overview of dental anxiety which scale shall we use
the dental anxiety question
are you afraid of coming to the dentist-
correlates highly with DAS
which is a scale that uses a 10 point scale
gatchels 10 point fear scale
how does gatchels 10 point scale work
1- no fear
5- moderate fear
10-extreme fear
anything over 8 is severe dental anxiety
which scale is used for children
the vehnam scale0 has happy and sad faces on it to help children express fear
how does the spielbergs scale for state trait anxiety work
works in two parts
- how the patient generally feels- to measure their trait anxiety
- the state scale
is there correlation between the trait anxiety and dental anxiety
little correlation
but there is correlation between the state anxiety and dental anxiety
what are the advantages of knowing about dental anxiety
can help tailor communications between patient and dentist
evidence that knowledge of anxiety can help the dentist manage anxiety better
people may be reluctant to disclose anxiety face to face
builds a rapport
what do we need to know when we plan treatment
how anxious are they
what treatment specifically they are anxious of
do they know what caused it
what can we do differently
how can we allow them to accept treatment
