Elsevier

Dental Abstracts

Volume 59, Issue 4, July–August 2014, Pages 212-214
Dental Abstracts

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Managing fearful or anxious patients

https://doi.org/10.1016/j.denabs.2014.03.042Get rights and content

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Background

About one in every seven individuals is highly anxious about undergoing dental treatment. These patients require careful and considerate management by dental practitioners. Various nonpharmacologic or pharmacologic techniques can be used to reduce fear and anxiety for dental patients. These include behavioral and cognitive approaches that can be adapted for the dental clinic or surgery facility.

Characteristics of Dental Fear and Anxiety

The various types, levels, and characteristics of dental anxiety and fear will indicate differing approaches to treatment. The Seattle System has categorized anxiety and fear for dental patients into four groups: those who are fearful of specific stimuli, those who are fearful of medical catastrophe, those who have generalized dental anxiety, and those who are distrustful of dental personnel. All patients should be presented with clear treatment options, but the dentist can tailor the options

Psychological Approaches

To enhance trust and control will require good communication and cooperation between the members of the dental team and the patient. Control includes encouraging the patient to take an active role in care and to communicate desires to the dentist and staff. Both parties must participate in this trust-building process. Patient satisfaction is increased when patients feel rapport with the dentist and see him or her as valuing understanding and acceptance of the needs and concerns of the patient

Dental Practice and Treatment Approaches

Reducing stress triggers in the dental environment may be effective for managing anxiety in some patients. The physical environment may be altered, with adorned rather than bare walls and cooler temperatures. The Snoezelen environment refers to an extensive environmental change with partial dimming of the lights, vibroacoustic stimuli, and consistent body pressure. These changes are not supported strongly by evidence as anxiety management techniques and require further research.

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Managing Children's Fear and Anxiety

Many of the techniques useful for adults can be adapted for use with children, but there are also behavioral modification techniques especially suitable for children. Included is modelling, wherein the child observes other children or their parents undergoing dental treatment without fear or aversive consequences. This modeling may be done live or filmed for viewing on a television, computer, or handheld device. Distraction was found especially helpful to decrease the levels of disruptive

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Armfield JM, Heaton IJ: Management of fear and anxiety in the dental clinic: A review. Austral Dent J 58:390-407, 2013

Reprints available from J Armfield, Australian Research Ctr for Population Oral Health, School of Dentistry, The Univ of Adelaide, Adelaide SA 5005; e-mail: [email protected]

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