Over view and measurement of dental anxiety Flashcards
What are the GDC guidelines regarding dental anxiety?
Dentist have a duty to provide and patients have a right to expect adequate and appropriate pain and anxiety control
Give examples of pharmacological methods of pain and anxiety management
- LA
2. Conscious sedation techniques
Briefly talk through the dental anxiety cycle that patients may suffer from
- Patient feels fearful and is anxious
- This leads to them avoiding dental care
- Deterioration of dentition
- Feelings of guilt, shame and inferiority
What does trait anxiety refer to?
Refers to a persons inbuilt tendency to feeling anxious in their everyday life
What does state anxiety refer to?
State anxiety is more specific and related to certain objects of situations and seems not to occur outside of these
What is the difference between anxiety and fear?
Anxiety is a more emotional experience
What is a phobia?
Phobia is fear which completely overwhelms a person and has been defines as a psychiatric illness
Give some characteristic features of a phobia
- Fear of a situation that is out of all promotion to the danger
- Cannot be explained or reasoned away
- Largely beyond voluntary control
- Leads to avoidance of the feared situation
- Avoidance, distress and/or anticipatory anxiety interfere with life
How many people, according to the adult dental health surgery, are nervous of dental treatment
64% of dentate adults are somewhat or definitely nervous of dental treatment
How many people, according to the adult dental health surgery, are nervous of visiting the dentist
49%
State three factors that contribute to the aetiology of dental anxiety
- Biological factors
- Psychological factors
- Social factors
Give examples of biological factors that may cause dental anxiety
Possibly genetics (however a lot of debates surrounding this)
Which scientist argues that dental phobia is genetic and why?
Steven pinker argues that phobias are inbuilt and come from out evolutionary past
Give examples of social factors that may cause dental anxiety
- Children may pick up dental anxiety from their parents, siblings or friends
- Gender roles
- Social class
Is dental anxiety more apparent in men or women?
Women
43% women vs 55% men
Why might studies have shown that women are more dentally anxious than men?
- Women are more prepared to admit they are anxious
2. Women are more prepared to go to the dentist despite their anxiety
What do patients expect from their dentist?
- Communication
What can affect the quality of the patient dentist relationship?
Previous negative experiences
What is essential to building a good patient dentist relationship?
Taking a patients feelings seriously and not belittling them
How do patients evaluate their dentists?
- They look at the dentists attitudes and behaviour
- They look at the dentist approach to pain control and the reduction of anxiety
- They evaluate the dentist’s ability to solve their dental problems
- Look at staff attunes and behaviour
- Cost factors
- Physical cues
Which dental Treatments do most patients fear?
- Extractions
- Drilling
- Injections
What is essential for good anxiety control?
Good pain control
Why might dental phobic patients complain of more pain than non phobic patients?
- They may have a lower pain threshold
2. Their anxiety state may contribute to pain perception
How can we recognise dental anxiety?
Patient may:
- Not enter the room
- Be uncommunicative
- Be over talkative
- Look distracted
- Be uncooperative
- Be aggressive
- Sweat or shake
- Be pale and hyperventilate
What should you do if you suspect a patient has dental anxiety?
Ask them
Name a way we formally measure dental anxiety
- Dental anxiety scale
- Modified dental anxiety scale
- Gatchels 10 point fear scale
- Photo anxiety questionnaire
- Dental anxiety inventory
- Childrens fear survey schedule
- Venham picture
- Venham anxiety and behaviour rating scaling
How do we use the dental anxiety scale?
We ask a patient a series of questions and place them on a scale
A scale of over 15 indicates a phobia
A score of over __ indicates phi according to the dental anxiety scale
15
What are some criticism of the dental anxiety scale?
- The options for the questions are rather emotive
2. Theres no question about LA
How have the criticism to the dental anxiety scale been overcome?
The modified dental anxiety scale has been made
What are the differences between the modified and normal dental anxiety scale
- Uses less emotive language
- Possible scores range from 5-25
- Score of over 19 indicates dental phobia
- Includes a question on local anaesthetics
What are the drawbacks of both the modified and normal dental anxiety scale
They do not provide very specific information about which specific aspects of dental treatment the patient is anxious about
How does getchels 10 point fear scale work?
It rates you dental fear from 1-10 10 being extreme fear
What is an advantage of using anxiety scales in a dental setting?
- Knowledge of anxiety can help to tailor your communication skills
- Evidence that knowledge of anxiety levels helps dentists to alleviate anxiety
3, People may be reluctant to disclose their anxiety face to face
What is a disadvantage of using anxiety scales in a dental setting?
It has been argued that the act of fill-in gin the questionnaire may cause a patient to focus on their anxiety thus reinforcing
What do you need to know to plan your treatment
- How anxious is the patient
- What specifically is the patient anxious about
- Do they know the cause of their anxiety
- What do their want you to do differently
- How can you help them to accept treatment
