Psychology and Dental Anxiety

Question 1

Prevalence of dental phobia?

Answer 1

Dental phobia is the most prevalent specific phobia in holland
UK adult survey study 1988 = 1/3 of UK adult population are dentally anxious
Pt’s with dental phobia consume time and resources
Stress for dentists

Question 2

Impact of dental anxiety?

Answer 2

3% avoid completely (Lenk 2013)
Dental health state poor
Poor OH
Risks from sedation

Question 3

What are dental fears?

Answer 3

Fear is a primitive, basic emotion tied to the fight of flight response, activated in response to an imminent and specific threat
Anxiety is a conditioned response characterised by anticipation of or worry about a potential future threat

Question 4

Components of fear?

Answer 4

Subjective experience of apprehension
Psycho-psychological changes
Attempts to avoid or escape

Question 5

Difference between fear and anxiety?

Answer 5

Fear = Describes feelings of apprehension about tangible and realistic dangers
Anxiety = feelings of apprehension that are difficult to relate to tangible sources of stimulation
Inability to identify sources of ones fears = usually anxiety

Question 6

Origins of fear and phobia?

Answer 6

Evolution
Preparedness
Predisposing genetic and environmental factors

Question 7

Aetiology of dental anxiety?

Answer 7

Involve a spectrum of factor
Related to past dental experiences 
General and specific fears 
Other personality factors
Conditioning experiences
Stress reactive personality 
Specific beliefs about health professionals 
Late onset dental fear = conditioning experiences, irregular service use and external locus of control

Question 8

What are the 3 systems of fear?

Answer 8

Cognitive
Behavioural
Physcial

Question 9

Cognitive features of fear?

Answer 9

Feeling out of control within dental setting = feel trapped
Significant error in perception of dental procedure
Hyper vigilance of behavioural stimuli also internal somatic changes
Catastrophic misinterpreations of fear response

Question 10

Behavioural features of fear?

Answer 10

Avoid dental tx
Escape
Limited attendance
Use of anaesthetics, anxiolytics
Attachment to 1 dentist

Question 11

Types of dental fear?

Answer 11

1. Dental phobia
2. . Other specific phobia (gagging)
3. Post traumatic stress disorder
4. Complex phobias
5. Panic disorders
6. Other psychiatric disorders

Question 12

How to manage pts with dental phobia?

Answer 12

Behavioural and cognitive - CBT
Collaborative/relationship
Psychoeducation
Guided discovery
Exposure
Relaxation