Dental Fear and Anxiety

Question 1

what is the definition of dental fear?

Answer 1

a normal emotional reaction to one or more specific threatening stimuli in the dental environment

Question 2

what is the definition of dental anxiety?

Answer 2

a sense of apprehension that something dreadful is going to happen in relation to dental treatment, coupled with a sense of losing control

Question 3

what is the definition of dental phobia?

Answer 3

a severe type of dental anxiety manifested as a marked and persistent anxiety in relation to clearly discernible situations or objects or to the dental situation in general

Question 4

how can you tell between dental anxiety and dental phobia?

Answer 4

Dental Anxiety:
- patient still goes to dentist

Dental Phobia:

• complete avoidance of necessary dental treatment
• or endurance of treatment only with dread and in a specialist treatment situation

Question 5

what are some causation factors of dental anxiety?

Answer 5

• degas i’ve medical and dental experiences
• influenced by family and peers
• poor media representations of dentist
• expectation of pain
• poor knowledge of modern analgesia

Question 6

how can children become dentally anxious?

Answer 6

• Conditioning = arises from objective dental pathology & subjective dental experiences
• Modelling = child imitates mothers behaviour
• Information = unwitting provision of frightening information

Question 7

what are some characteristics of anxious patients?

Answer 7

• high neuroticism & trait anxiety
• pessimism & negative expectation
• proneness to somatisation
• low pain threshold

Question 8

how does anxiety and neurotic thinking present in patients?

Answer 8

• fear of negative evaluation
• pessimistic & vulnerable
• catastrophic thoughts

Question 9

how can dental anxiety be assessed in adults?

Answer 9

• Dental Anxiety Scale (DAS)

- Modified Dental Anxiety Scale (MDAS)

Question 10

what is the diagnostic cut off for severe DFA in the MDAS test?

Answer 10

> 19/25

Question 11

how can dental anxiety be assessed in younger children?

Answer 11

• the Venham Picture Test

- the Facial Image Scale (FIS)

Question 12

how can dental anxiety be assessed in children aged 8+?

Answer 12

• The Modified Child Dental Anxiety Scale (MCDAS)

- Child Dental Experience of Dental Anxiety Measure (CEDAM)

Question 13

what does the Facial Image Scale involve?

Answer 13

children are asked to point at the face they most feel like

Question 14

what are some treatment strategies for mild/moderate dental anxiety?

Answer 14

• acknowledge patients feeling of anxiety
• engender a trusting relationship
• provide realistic info
• provide control*

Question 15

what are some coping strategies that can be used in treatment for patients with mild/moderate dental anxiety?

Answer 15

• relaxation = simple breathing awareness techniques

- distraction

Question 16

what are some medical options/treatments for patients with mild/moderate dental anxiety?

Answer 16

• prescribe benzodiazepine (adults) before treatment

- nitrous oxide sedation

Question 17

how can control be provided to a dentally anxious patient?

Answer 17

Use of:

• stop signals
• rest signals
• proceed signals

Question 18

what is the function of a stop signal?

Answer 18

gives control over the pace of the procedure & helps coping

Question 19

what are behavioural treatment strategies for moderate/severe dental anxiety/phobia?

Answer 19

• systemic desensitisation
• muscular relaxation
• exposure therapy
• cognitive coping strategies

Question 20

If a severely dentally anxious/phobic patient presented with a high treatment need, what may have to be done in order to be able to undertake the procedure?

Answer 20

• intravenous sedation

- general anaesthetic