7 minute read
Discovering Dental Anxiety: What It Is, What It Looks Like and How To Help Patients Cope
Lifeline Liability
Discovering Dental Anxiety:
What It Is, What It Looks Like and How To Help Patients Cope
It’s unfortunate that few patients look forward to dental appointments. Generally, this can be attributed to minor inconveniences like taking time from work or finding child care. For some, however, the thought of receiving dental care produces so much distress that it can affect their oral health.
Dental anxiety and dental phobia are real conditions. One recent study published in the Journal of Dental Hygiene discovered that moderate to high dental anxiety is present in 19% of the population. Other studies place that percentage as low as 9% or as high as 24%. Even on the low end, it’s statistically likely that all dentists will serve patients who struggle with some level of anxiety.
For patients suffering from dental anxiety or phobias, special care is required. Patients with higher levels of anxiety tend to have a greater pain response, leading to increased tension for the dental team who treats them and, therefore, increased potential for making mistakes. Helping patients manage anxiety allows the patient to receive necessary dental care while reducing risks within your practice.
The term dental anxiety is used to describe feelings of unease, fear or stress before or during a dental appointment. These feelings can range from mildly troublesome to severe. Patients with severe dental anxiety can feel panicstricken at the thought of receiving any dental care.
Symptoms of dental anxiety vary widely from one patient to another. Some symptoms are physical and easily identifiable. Others are behavioral and may be mistaken for personality traits if you and your staff aren’t aware a patient struggles with anxiety. Signs of dental anxiety include: • Sweating • Racing heartbeat or heart palpitations • Repetitive, overwhelming thoughts • Low blood pressure • Fainting • Crying • Anger • Visible distress • Withdrawal, not speaking to anyone • Aggression
Dental phobia is this anxiety at its most severe. People with dental phobia are typically aware that their fear is totally irrational but are unable to do much on their own to overcome it. They exhibit classic avoidance behavior and will do anything possible to avoid going to the dentist. This avoidance of care often perpetuates the problem — necessitating complex or painful procedures. Some signs of dental phobia include:
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• Trouble sleeping the night before a dental appointment. • Feeling increasing anxiety while sitting in the waiting room. • Arriving for dental appointments but being unable to enter the office. • Crying, difficulty breathing or physical illness at the thought of visiting the dentist or having dental tools placed in the mouth.
Those suffering from severe dental anxiety or phobia are unlikely to seek dental care unless it becomes painfully necessary.
What causes dental anxiety?
The reasons for dental anxiety and dental phobia are as varied as the symptoms and behaviors they cause. • Fear of pain. This often stems from an early, unpleasant experience with dental care or from hearing dental
“horror stories” told by others.
• Feelings of helplessness and
loss of control. Some patients are uncomfortable with not knowing what is happening in their mouth during treatment or feel vulnerable when positioned in the dental chair. • Embarrassment. Halitosis, tooth discoloration or skin conditions may cause patients to feel worried over being judged or shamed. Other patients may feel humiliated if recommended treatment costs are beyond their ability to pay. • Fear of needles. This fear is not unusual among medical and dental patients. It’s associated with the potential for pain at the injection site or fear that injected anesthetic won’t work and they will feel the pain of the procedure.
A previous negative dental experience, an overactive gag reflex or fear of bad news can also contribute to dental anxiety.
Helping patients cope with dental anxiety
Fortunately, in most cases, dental anxiety is not insurmountable and can be managed through the joint efforts of the patient, dentist and staff. Along with eliminating stressors and providing distractions for your patients, communication is key. Here are some steps you can take to ensure open communication between you and your patients when it comes to dental anxiety. • Questions on your intake forms are a good place to begin conversations about patient anxiety and potential stressors. The Corah
Dental Anxiety Scale continues to be a reliable way to assess general dental anxiety. Flagging anxious patients early provides an opportunity to discuss their concerns and better prepare them ahead of examinations and procedures. • Educate your staff about dental anxiety so they will be aware of behaviors that signal an anxious patient has entered the office.
Noting this on the chart or otherwise signaling to the back office that the patient may be anxious gives the provider a heads-up to be aware of potential needs.
• If a patient can be identified as anxious prior to treatment, take a few moments to chat with them about their concerns before you begin. Once you understand a patient’s fears about dentistry, you will be better able to work with them to determine the best ways to make them less anxious and more comfortable. • For patients with high levels of anxiety, it may be beneficial to schedule an initial visit with them in a space within your practice where they feel safe, without triggering stimuli like the treatment chair or other equipment.
Discuss options you can safely offer to accommodate their anxiety, like access to media, noise-canceling headphones, a support person nearby or sedation. This is an opportunity to discover if their needs may be better met by another provider.
• Nonverbal communication is also important. In studying dental anxiety, researchers found that the dentist behaviors most closely associated with patient satisfaction were those portraying empathy, friendliness and a calm, competent demeanor. The study concluded that anxious patients perceive these traits to be an indication that the dentist would actively work to prevent pain.
When caring for anxious patients, you become responsible for managing both the patients’ dental and emotional health during their time in your office. Heightened awareness of anxiety, along with effective communication techniques, can support patients in managing their fears.
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