Tooth Loss

Managing Dental Fear and Anxiety

Despite considerable advancements in dental techniques and the modern idea of pain-free dentistry, a recent Australian study found that 85% of the adult population still experience dental fear and anxiety. Patient anxiety towards dentistry is one of the great challenges facing the modern dental practitioner and as a result, remains at the forefront of every practitioner working at Gentle Dental Care (GDC). We are fortunate to offer various options for our patients to overcome and manage concerns and fears in order to achieve patient goals and relieve pain.

Dental fear and anxiety can originate from various aspects of the treatment experience, and specific concerns might be independent of other possible concerns. The source of a patient’s anxiety might be in relation to fear of gagging or choking, fear of injection, or a strong aversion to the sight or thought of blood. Patients might have concerns about perceived problems with getting numb, might have a low pain threshold or might have issues with trusting dental practitioners. We understand that there will be differences in the willingness of different patients to talk about their personal needs and treatment goals.

At Gentle Dental Care we are pleased to offer the following options to our patients in order to help them achieve the perfect smile. (Please note: each option is dependent on a thorough medical history that is completed before each appointment and is subject to review by your qualified dental practitioner)

1) In-chair relaxation techniques:

a. Breathing exercises – demonstrate to the patient how to control their breathing rate and reduce the ‘fight or flight’ response. This is easy to demonstrate to the patient and works well across all age groups.

b. Rest breaks – patients are given the opportunity to relax their jaw muscles and close during dental treatment at specific points during various dental procedures. This allows the patient full control over the procedure.

c. Signalling – the patient is encouraged at any stage to raise their hand if they want to pause treatment. This can be used to allow the patient a ‘rest break’ or to communicate to the dentist any concerns or problems.

d. Distraction – patients are offered music to help mask noises of instruments and reduce dental fear.

2) Oral sedation: subject to a medical history, dentists can prescribe an oral sedative (tablet/oral solution) to be taken 1 hour before a dental appointment. This can help with minor dental procedures and can be used with ‘in-chair relaxation techniques.’ Patients are not allowed to operate a vehicle whilst under oral sedation and will require a friend or

relative to accompany them to their appointments. Specific information is provided to each patient.

3) Inhalation sedation (“happy gas”): each surgery at GDC is equipped with inhalation masks for general treatment use. This can be used to manage minor dental anxiety and can be used when treating children.

4) Intravenous Conscious sedation (“IV sedation”): administered by our medical practitioners on site. Patients will require an assessment by both medical and dental practitioners and is used for moderate/severely anxious patients for procedures ranging from fillings, cleans and gum treatments, wisdom teeth removal and some dental implant procedures. For medical reasons this option is reserved for adult patients only. This option is readily available once a dentist completes a thorough examination.

5) General anaesthetic (“GA”): administered by our medical practitioners on site. This option is reserved for complicated dental procedures; e.g. difficult wisdom teeth removal, dental implant procedures and medically compromised patients requiring specialist care. This option is also available for children who are unable to tolerate treatment in the chair.

First and foremost, an initial appointment is required with a dentist in order to develop a comprehensive treatment plan. As part of the planning, your dentist will listen to your needs and chief concerns in order to develop a plan that will work to achieve your dental goals. At this appointment your dentist will manage your fear and anxiety with the above options available at GDC.

If emergency treatment is required to relieve pain or sensitivity, your GDC dentist will always try to address your pain as a priority in your treatment plan. On some occasions it is encouraged to attempt some form of basic dental treatment as a short-term measure to allow the patient the opportunity to seek dental treatment under an appropriate setting (e.g. dental extractions under IV sedation, root canal treatment, wisdom tooth extractions). As always we will work with the patient to listen to their needs and sometimes opt to delay treatment until moderate or severely anxious patients are treated under IV sedation or general anaesthetic. Your dentist will always aim to accommodate emergency appointments wherever possible.

For more information, please contact our surgeries to book a consultation with a dentist at Gentle Dental Care.

Dr Michael Lavorato, BDS (Adel.)

References:

1) Armfield JM. The extent and nature of dental fear and phobia in Australia. Aust Dent J2010;55:368–377.

2) Armfield JM and Heaton LJ. Management of fear and anxiety in the dental clinic: a review. Australian Dental Journal ADJ 2013, Volume 58 Issue 4, page 390-407.