Dental phobia : Treatment negligence
Dental phobia is one of the main reason for dental treatment negligence.Fear of getting a needle prick ,or pain ,dental instruments and drills associated with it.As a practioner we see kids and adults afraid or anxious about getting a dental treatment .People with dental phobia often avoid the dentist and neglect the oral health ,which may worsen the dental conditions and are forced to take invasive procedures .Dentalphobia is very common in children as they get to know things from their parents and their friends.
There is a complex set of factors that lead to development and maintenance of significant dental anxiety
-cognitive conditioning
Conditioning is the process by which a person learns through one’s own personal experience be it good or bad
Eg: children undergoing invasive procedures in their first dental visit tender to be more anxious about their dental visit
-Informative
This indirect pathway relates to fear acquisition through gaining information from parents ,friends with previous traumatic dental experience, television, media etc
-Vicarious
The vicarious pathway suggest that the fear is acquired through imagination , experience or actions of another person
-verbal threat
This is similar to the informative pathway , however it is more reliant on the emotion of fear elicited by the word of mouth
-Parent modelling
There is significant relationship between parents and child dental fear especially of that of their mothers.
Management of dental fear
Dental fear varies from very mild to severe so management of dental fear should be tailored according to each individual.It can be managed with short term methods like (hypnosis and general anesthesia) and long term methods (cognitive behavioural therapy and development of coping skills)similarly distraction techniques can be used to draw patients attention such as television/music or physical distraction .More recent research indicates that the use of conscious sedation combined appropriate communication techniques may relieve the anxiety in the long-term.
Psychocognitive
Modelling
Modelling is a form of psycho- behavioural therapy used commonly in pediatric dentistry .It involves the showing of the procedure under a simulated environment .It allows the patient to observe the behaviour of the friends or family and accomodate new coping mechanism
Tell- show-do
The technique enhances on telling the procedure to be done , showing the instruments to be used and procedure how it’s to be done and positively approaching and doing the procedure with a positive outcome
Behavioural techniques
A technique known as behavioural control involves the person giving a signal to the clinician when to stop the procedure. This can be simply done by asking the patient to stop during the procedure in case of discomfort which gives them the control and in still trust over the dentist
Cognitive behavioural therapy
CBT for anxiety is done by psychologist and trained dentist. some other techniques that may be useful include distraction, relaxation techniques, and music therapy.
Environment changes
The ambience creates a major difference in the anxiety levels.Right from the receptionist to the dental assistant and doctors should keep a positive environment especially to patients with previous traumatic experience.There is some small evidence that the waiting areas with soft music playing and dimmer lights and cooler in temperature produces a more calming effect.
Hypnosis
Progressive muscle relaxation
Muscle relaxation techniques helps create a calm atmosphere inside the body and reduces the stress level and create better treatment outcome
Systematic desensitisation
Desensitisation in dentistry refers to the gradual exposure of a new procedure to the patient in order to calm their anxiety.This should be done in a systematic and controlled way without triggering their anxiety levels.
Medication
Pharmacological techniques to manage dental fear ranges from premedication prior to the procedure, conscious sedation to general anesthesia.
There are multiple measures to overcome your dental fear and get your dental needs sorted. Don’t wait to regret .Get your teeth checked at the time and save your teeth from invasive procedures.
Patient counselling
Conscious sedation