How do you manage fear and anxiety in the dental clinic?
This summary is based on the article published in the Australian Dental Journal: management of fear and anxiety in the dental clinic: a review (December 2013)
Access Wiley Dental Publications
Context and Purpose of the Review
People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners.
The article presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery
in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized.
The importance of firstly identifying dental fear and then understanding its etiology, nature and associated components is stressed.
Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training, but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety.
Key Messages
- Successfully managing dentally fearful individuals is achievable for clinicians, but requires a greater level of understanding, good communication and a phased treatment approach.
- There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.
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Dental anxiety is a real problem with the affected population avoiding dental treatment. It becomes incumbent on the practitioner to note it, identify it, respect it and finally to talk about it with the patient with a view to offering paliative measures. Such measures could include explaining procedures to patients, offering them a mirror to watch, calming conversation, pharmacological agents and even GA.
The critical aspect is not to down play or ignore the patient’s anxiety or to be flippant about it.
I would suggest anyone wishing to add a most useful tool to your dental armamentarium, under the category of patient relaxation, check out NuCalm. It is relatively new to the dental community and was successfully used by the Chicago Blackhawks in their run to the Stanley Cup last spring.