How to Manage Dental Anxiety

Patients who have dental anxiety will often avoid dental visits and dental care. Left untreated, a patient with dental anxiety may let dental problems fester to the point of permanent damage to their teeth, gums, and even the underlying bone structure. Therefore, it’s in the dentist’s best interest to help patients overcome dental anxiety to receive the care their mouth needs.

Causes of Dental Anxiety

According to the BetterHealth Channel of Victoria, AU: “Dental anxiety is fear, anxiety or stress associated with a dental setting.”

The patient will have a vivid mental association between the stress and fear of pain and the smells from the cleaning antiseptic, the feel of a dental bib, the sound of a dental drill, and more. When the patient experiences these sensory inputs or even just imagines them, they may feel a building sense of uncomfortable urgency to avoid pain.

The sensations from dental anxiety can be very uncomfortable and very real but do not have any one root cause. A patient may feel dental anxiety due to a bad dental experience when they were a child or they may have built up an unhealthy image about dental procedures after hearing horror stories from a person they trust or their anxiety may be due to an underlying psychological condition such as depression, bipolar disorder, or schizophrenia.

It may help to understand that dental anxiety and dental phobia are not the same. The two have significant similarities but dental phobia is more severe and more difficult to treat.

How Dental Anxiety Can Affect Your Life

According to the National Institutes of Health:

“…dental anxiety affects an individual’s life in multiple ways. The physiological impacts included signs and symptoms of the fright response and feelings of exhaustion after a dental appointment, while the cognitive impacts included an array of negative thoughts, beliefs, and fears. The behavioral impacts included not only avoidance but also other behaviors related to eating, oral hygiene, self-medication, crying, and aggression. A significant impact on general health due to sleep disturbance was also reported, which influenced both established and new personal relationships. Furthermore, social interactions and performance at work were affected, due to feelings of low self-esteem and self-confidence.”

How to Manage Dental Anxiety?

Any remedy for Dental Anxiety begins with clear, transparent communication between the patient and dentist. Start by acknowledging that the discomfort the patient experiences is real. Then, work with the patient to understand the specific triggers that aggravate a patient’s anxiety and take proactive steps to eliminate or mitigate those triggers before and during the dental visit.

Behavioral Techniques

Behavioral techniques rely on making procedural adjustments to help alleviate the patient’s stress as much as possible.

During the discussion with the patient about their anxiety, do they cite loud drilling noises as a stressor? Offer alternatives to drilling when applicable. If the dental office has multiple bays or patient rooms, consider hosting the patient in the quietest possible location, away from patients who might be undergoing drilling.

Does the patient point to an aversion to needles? Communicate to the patient in advance of their visit whether or not needles will be necessary to eliminate the fear of the unknown. If needles are to be used, discuss topical anesthetic options with the patients to numb the area.

Does the patient experience higher stress in noisy offices? Consider putting the patient in a quiet dental bay and providing noise-canceling headphones.

It’s not possible to cover every adjustment in one article as the right change depends on the patient’s needs, but the key is to communicate with the patient openly before the visit so the best possible arrangements can be made.

Medical Techniques

Sometimes, a little chemical help is just what the doctor ordered. Of course, a chemical application should always be done with consent and with risks explained, acknowledged, and accepted in advance. If the patient is open to it and the risks are acceptable, the best course of action to help a patient overcome their Dental Anxiety may be one of the following:

• General anesthesia
• Conscious sedation
• Relative analgesia (happy gas)
• Anxiety reliever medication (oral anxiolytic tablets)

Where to Get Help?

Helping a patient overcome Dental Anxiety is not easy and shouldn’t be taken lightly. If talking with a patient and offering Behavioral or Medical techniques is not enough, encourage the patient to seek counsel from a mental health provider. Even if counseling is outside the realm of dental medicine, counseling them today resolves their anxiety tomorrow and ensures they get the dental maintenance they need for a lifetime.