Tuesday, October 16, 2012

Dental Anxiety

It is estimated that as many as 75% of US adults experience some degree of dental fear, from mild to severe.  Approximately 5 to 10 percent of U.S. adults are considered to experience dental phobia; that is, they are so fearful of receiving dental treatment that they avoid dental care at all costs. Many dentally fearful people will only seek dental care when they have a dental emergency.   People who are very fearful of dental care often experience a “cycle of avoidance,” in which they avoid dental care due to fear until they experience a dental emergency requiring invasive treatment, which can reinforce their fear of dentistry.
Women tend to report more dental fear than men and younger people tend to report being more dentally fearful than older individuals. People tend to report being more fearful of more invasive procedures, such as oral surgery than they are of less invasive treatment, such as professional dental cleanings or prophylaxis.


 Direct experiences

Direct experience is the most common way people develop dental fears. Most people report that their dental fear began after a traumatic, difficult, and/or painful dental experience. However, painful or traumatic dental experiences alone do not explain why people develop dental phobia. The perceived manner of the dentist is an important variable. Dentists who were considered "impersonal", "uncaring", "uninterested" or "cold" were found to result in high dental fear in students, even in the absence of painful experiences, whereas some students who had had painful experiences failed to develop dental fear if they perceived their dentist as caring and warm.

 Indirect experiences

  • Vicarious learning: Dental fear may develop as people hear about others' traumatic experiences or negative views of dentistry (vicarious learning).
  • Mass media: The negative portrayal of dentistry in mass media and cartoons may also contribute to the development of dental fear.
  • Stimulus Generalization: Dental fear may develop as a result of a previous traumatic experience in a non-dental context. For example, bad experiences with doctors or hospital environments may lead people to fear white coats and antiseptic smells, which is one reason why dentists nowadays often choose to wear less "threatening" apparel. People who have been sexually, physically or emotionally abused may also find the dental situation threatening.
  • Helplessness and Perceived Lack of Control: If a person believes that they have no means of influencing a negative event, they will experience helplessness. Research has shown that a perception of lack of control leads to fear. The opposite belief, that one does have control, can lead to lessened fear. For example, the belief that the dentist will stop


Treatments for dental fear often include a combination of behavioral and cognitive strategies to help patients reduce their fear.pharmacological techniques.
Many people who suffer from dental fear may be successfully treated with a combination of "look, see, do" and gentle dentistry. People fear what they don't understand and they also, logically, dislike pain. If someone has had one or more painful past experiences in a dental office then their fear is completely rational and they should be treated supportively. Non-graphic photographs taken pre-operatively, intra-operatively and post-operatively can explain the needed dentistry. Pharmacologic management may include an anxiety-reducing medication.
Most importantly is the need to provide an injection of anesthetic extremely gently. Certain parts of the mouth are much more sensitive than other parts; therefore it is possible to provide local anesthesia (a "novocaine" shot) in the less sensitive area first and then moving the injection within the zone of just-anesthetized tissue to the more sensitive area of the mouth. This is one example of how a dentist can dramatically reduce the sensation of pain from a "shot." Another idea is to allow the novocaine time (5 - 15 minutes) to anesthetize the area before beginning dental treatment.

We are a practice that specializes in patient comfort. Earning the trust of our patients by thoroughly educating them of their dental choices in a caring enviroment eases patient anxieties says Dr. Cherukuri.  "I love taking care of patients of all ages especially those with special needs or those who need an extra touch of TLC".


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