E lecture- overview of dental anxiety

Question 1

what is the anxiety cycle

Answer 1

fear anxiety leading to avoiding dental care leading to deterioration of dental care and then feeling of guilt and shame

Question 2

what is fear

Answer 2

an important inbuilt instinct and without it we would not have survived

Question 3

what is fear associated with

Answer 3

physiological arousal
blood rushing to the peripheral areas such as the muscles
high levels of circulating adrenaline

Question 4

what is the difference between fear and anxiety

Answer 4

anxiety can be more emotional

Question 5

what is trait anxiety

Answer 5

refers to a persons inbuilt tendency for them to be anxious in their every day lives

Question 6

what is state anxiety

Answer 6

anxiety that refers to specific things and situations and doesn’t move out of these

Question 7

what is a phobia

Answer 7

a phobia is an extreme fear which is defined as a psychiatric illness

Question 8

what are the symptoms of a phobia

Answer 8

fear of the situation that is out of proportion to the danger
cannot be explained
largely beyond voluntary control
leads of avoidance of the feared situation
avoidance distress that leads to the person avoiding the situation

Question 9

what is the percentage of people who are somewhat anxious of dental treatment according to the 1998

Answer 9

64%

Question 10

what percentage of people are even nervous to visit the dental according to the annual dental survey 1998

Answer 10

49%

Question 11

how are dental anxiety levels looking in USA

Answer 11

the anxiety levels are looking constant regardless of new and improved techniques

Question 12

what is the aetiology of dental anxiety

Answer 12

need to remember the biopsychosocial model:

Question 13

what is included in the biopsychosocial model:

Answer 13

biological: organs physiology and genetics
social: community family society
psychological: cognition emotion motivation

Question 14

what link has been made between dental anxiety and genetics

Answer 14

that there could be a genetic link but it is more a learnt behaviour

Question 15

which gender is more dentally anxious

Answer 15

generally females

Question 16

according to the survey what percentage of men were dentally anxious

Answer 16

43%

Question 17

what percentage of dentate females are dentally anxious

Answer 17

55%

Question 18

which gender records better attendance

Answer 18

women- possibly due to the fact they can admit their fear due to gender roles

Question 19

which other correlations can be found

Answer 19

between socioeconomic class and dental anxiety

Question 20

what is required from dentists to make patients feel more comfortable

Answer 20

TECHNICAL COMPETANCE

Question 21

what features are important in a dentist patient relationship

Answer 21

good communication skills

and taking a patients fear seriously

Question 22

in a survey of young people what percentage experienced dissatisfaction with their dentist or dental surgery

Answer 22

15%

Question 23

how much more likely are people who are dentally anxious going to experience bad behaviour

Answer 23

5 to 10 times

Question 24

how do patients evaluate dentists

Answer 24

attitude and behaviour 
approach to pain control 
the dentists ability to solve their problem 
staff attitude
convenience 
cost
physical factors

Question 25

what about dental treatment makes patients anxious

Answer 25

the fear of unknowing and the fear of extractions fillings etc and the anticipation of pain

Question 26

what is necessary for good anxiety control

Answer 26

good pain control

Question 27

why do they have a lower pain threshold

Answer 27

possibly due to the anxiety | or genuinely due to the lower pain threshold

Question 28

how do we recognise dental anxiety

Answer 28

``` not entering the clinic uncooperative uncommunicative over talkative aggressive looking distracted ```

Question 29

how do we recognise dental anxiety

Answer 29

``` gagging ask sweating shaking pale hyperventilation increased heart rate ```

Question 30

what scale do we use in clinic to rate dental anxiety

Answer 30

``` modified dental anxiety scale(MDAS)- more common and DAS( dental anxiety scale ```

Question 31

how do we use the dental anxiety scale(DAS)

Answer 31

4 item scale score 1-5 on each item and above 15 relates to dental phobia a=1 b=2

Question 32

what is the criticism for the DAS scale

Answer 32

that it is a little too emotive | and no scale for LA which is a big cause for dental anxiety

Question 33

what are the benefits of the MDAS scale

Answer 33

it is less emotive and has standard options to choose from

Question 34

how do we scale the MDAS

Answer 34

possible scores from 5-25 | and 19 can relate to dental phobia

Question 35

what is a drawback of both the MDAS and DAS

Answer 35

that they do not indicate which aspect the patient is dental anxious about

Question 36

how do we figure of which aspects of the dental treatment the patient is anxious about

Answer 36

dental fear surgery by kleinknechts

Question 37

how does kleinknechts dental fear survey work

Answer 37

27 dental situations rate 1-5 on anxiety eg making the appt

Question 38

if we just need an overview of dental anxiety which scale shall we use

Answer 38

the dental anxiety question are you afraid of coming to the dentist- correlates highly with DAS

Question 39

which is a scale that uses a 10 point scale

Answer 39

gatchels 10 point fear scale

Question 40

how does gatchels 10 point scale work

Answer 40

1- no fear 5- moderate fear 10-extreme fear anything over 8 is severe dental anxiety

Question 41

which scale is used for children

Answer 41

the vehnam scale0 has happy and sad faces on it to help children express fear

Question 42

how does the spielbergs scale for state trait anxiety work

Answer 42

works in two parts 1. how the patient generally feels- to measure their trait anxiety 2. the state scale

Question 43

is there correlation between the trait anxiety and dental anxiety

Answer 43

little correlation | but there is correlation between the state anxiety and dental anxiety

Question 44

what are the advantages of knowing about dental anxiety

Answer 44

can help tailor communications between patient and dentist evidence that knowledge of anxiety can help the dentist manage anxiety better people may be reluctant to disclose anxiety face to face builds a rapport

Question 45

what do we need to know when we plan treatment

Answer 45

how anxious are they what treatment specifically they are anxious of do they know what caused it what can we do differently how can we allow them to accept treatment