Anxiety in Dental Care
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Questions and Answers

What can patients with moderate levels of anxiety benefit from?

  • Information about the procedure (correct)
  • Private one-on-one counseling
  • Long-term hospitalization
  • A list of medications
  • What is the primary aim of Cognitive Behavioural Therapy (CBT)?

  • To modify maladaptive beliefs and behaviors (correct)
  • To provide nutritional advice
  • To induce sleep through medication
  • To conduct extensive psychological evaluations
  • Which of the following is NOT a pharmacological intervention mentioned?

  • General anesthesia
  • Conscious sedation
  • Cognitive therapy sessions (correct)
  • Medication prescriptions for relaxation
  • What type of service does the Special Care Dentistry Department provide?

    <p>Referrals for patients with anxiety management (D)</p> Signup and view all the answers

    How many sessions does systematic desensitization typically involve in CBT?

    <p>6-10 sessions (D)</p> Signup and view all the answers

    Which of the following describes a potential intervention for pain management?

    <p>Medication prescriptions (C)</p> Signup and view all the answers

    What is defined as an emotional state of apprehension or dread preceding a dental encounter?

    <p>Dental anxiety (A)</p> Signup and view all the answers

    Where can patients access information about the NHS Dental Psychology Service?

    <p>Online resource at Guys and St Thomas NHS (A)</p> Signup and view all the answers

    Which of the following best describes a reaction to threatening stimuli in dental situations?

    <p>Dental fear (B)</p> Signup and view all the answers

    What physiological changes can occur due to dental anxiety?

    <p>Nausea and muscle tension (B)</p> Signup and view all the answers

    Which of the following is a behavioral response to dental anxiety?

    <p>Avoiding dental care (A)</p> Signup and view all the answers

    How is dental phobia different from dental anxiety?

    <p>Dental phobia is a stronger and more persistent fear (A)</p> Signup and view all the answers

    Which strategy is NOT typically associated with managing dental anxiety?

    <p>Reducing sedation techniques (A)</p> Signup and view all the answers

    What cognitive symptoms may occur with dental anxiety?

    <p>Reduced concentration and poor memory (D)</p> Signup and view all the answers

    Which of the following components is NOT part of dental anxiety?

    <p>Emotional (B)</p> Signup and view all the answers

    What score on the Modified Dental Anxiety Score indicates no to low levels of anxiety?

    <p>5-9 (A)</p> Signup and view all the answers

    What percentage of individuals experience moderate anxiety levels according to the Modified Dental Anxiety Score?

    <p>36% (A)</p> Signup and view all the answers

    Which of the following is a personal factor contributing to dental anxiety?

    <p>Negative experiences (D)</p> Signup and view all the answers

    What is a common belief about dental anxiety concerning gender?

    <p>Females are more dental phobic. (D)</p> Signup and view all the answers

    Which factor is NOT identified as a personal contributor to dental anxiety?

    <p>Cost of care (D)</p> Signup and view all the answers

    What triggers could contribute to an individual's dental anxiety?

    <p>The sound of the drill (A)</p> Signup and view all the answers

    According to the content, what is one effect of negative media on dental anxiety?

    <p>It can increase anxiety levels. (A)</p> Signup and view all the answers

    What coping ability can impact an individual's experience of dental anxiety?

    <p>Personal reaction to stress (D)</p> Signup and view all the answers

    Which of the following age groups can experience dental anxiety?

    <p>Individuals of all ages (D)</p> Signup and view all the answers

    What is NOT a symptom of extreme dental anxiety according to common understandings?

    <p>Calmness during procedures (B)</p> Signup and view all the answers

    What is one impact of dental anxiety on oral health?

    <p>Higher caries rates (B)</p> Signup and view all the answers

    Which of the following is NOT a sign of dental anxiety?

    <p>Excitement (A)</p> Signup and view all the answers

    Which tool is considered a valid measure of dental anxiety?

    <p>Modified Dental Anxiety Score (MDAS) (C)</p> Signup and view all the answers

    What cycle does dental fear create?

    <p>A vicious cycle of dental fear (C)</p> Signup and view all the answers

    What physiological sign might indicate dental anxiety?

    <p>Elevated pulse (C)</p> Signup and view all the answers

    How should dental care providers assess for anxiety in patients?

    <p>By asking patients verbally about their anxiety (B)</p> Signup and view all the answers

    Which of the following could be considered a cognitive sign of dental anxiety?

    <p>Racing thoughts (C)</p> Signup and view all the answers

    When is the Visual Analogue Scale (VAS) recommended for use?

    <p>As a modified version for children (A)</p> Signup and view all the answers

    What emotion is commonly associated with dental anxiety?

    <p>Fear (A)</p> Signup and view all the answers

    Which behavior might suggest a patient is experiencing dental anxiety?

    <p>Frequent throat clearing (B)</p> Signup and view all the answers

    What is a benefit of using positive imagery in memory reconstruction for anxious patients?

    <p>It encourages the recall of positive aspects. (D)</p> Signup and view all the answers

    Which of the following is a non-pharmacological intervention for anxiety management?

    <p>Cognitive behavioural therapy (A)</p> Signup and view all the answers

    What role does environmental change play in anxiety management?

    <p>It uses sensory stimuli to decrease anxiety. (C)</p> Signup and view all the answers

    Which of the following sensory stimuli is suggested to help decrease anxiety?

    <p>The smell of lavender (A)</p> Signup and view all the answers

    In memory reconstruction, which of the following aids can help patients remember positive feelings?

    <p>Images of smiling (D)</p> Signup and view all the answers

    What is the primary focus of psychotherapeutic interventions in anxiety management?

    <p>Changing negative thought patterns. (A)</p> Signup and view all the answers

    What type of intervention is conscious sedation classified as?

    <p>Pharmacological (B)</p> Signup and view all the answers

    Which of the following techniques is NOT a form of non-pharmacological intervention?

    <p>Medication analgesia (A)</p> Signup and view all the answers

    What is an example of a potential negative recall in anxious patients?

    <p>Unpleasant past dental visits (B)</p> Signup and view all the answers

    Which of the following best describes communication skills in the context of anxiety management?

    <p>Engaging with patients empathetically. (C)</p> Signup and view all the answers

    Flashcards

    Dental Anxiety

    An emotional state characterized by apprehension, uneasiness, or dread related to dental encounters or stimuli. It can range from mild to severe and be tied to specific or general situations.

    Dental Fear

    A reaction to threatening stimuli in dental settings triggering fight or flight responses.

    Dental Phobia

    A persistent, intense fear of dental care, an extreme form of dental anxiety. It is a diagnosable and manageable condition.

    Physiological Component of Dental Anxiety

    Physical changes in the body like increased heart rate, sweating, raised blood pressure, palpitations, nausea, and muscle tension.

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    Behavioral Component of Dental Anxiety

    Behavioral responses like avoiding dental care, canceling appointments, reducing time in the chair, and practicing meticulous oral hygiene to avoid treatment.

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    Cognitive Component of Dental Anxiety

    Thoughts and mental processes associated with dental anxiety, such as negative thinking, reduced concentration, and poor memory.

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    Adult Dental Health Survey: Dental Anxiety

    The prevalence of dental anxiety in the adult population, as measured in 2009.

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    First Time Dental Anxiety Measured

    The first official measurement of dental anxiety in adults, according to the 2009 Adult Dental Health Survey.

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    Providing preparatory information

    Providing relevant information to patients about the procedure, expected sensations and coping behaviors. This helps manage anxiety and prepare them for the dental experience.

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    Cognitive Behavioral Therapy (CBT)

    A therapeutic approach aimed at changing negative thoughts and behaviors related to dental anxiety. This can include gradual exposure to fearful situations.

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    Pharmacological interventions

    A type of intervention that uses medication to manage anxiety during dental procedures. This could involve general anesthesia or sedation.

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    Special Care Dentistry Department

    Specialized care provided to patients with dental anxiety.

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    Clinical Psychologists

    A service that provides psychological support for patients with dental anxiety. They can help with managing pain, fear and phobias.

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    Identifying and measuring Dental Anxiety

    Understanding and recognizing the signs, causes and how dental anxiety affects people's lives.

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    Management strategies

    Various techniques and strategies used to manage and reduce dental anxiety. This could include CBT, relaxation techniques, and sedation.

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    Non-Pharmacological Interventions

    Management strategies that don't involve medication.

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    Communication Skills

    Using communication techniques to help patients feel comfortable and safe.

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    Behavior Modification

    Techniques to modify a patient's behavior, often used to reduce anxiety.

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    Psychotherapeutic Interventions

    Using specialized therapies to address mental health or emotional issues.

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    Environmental Change

    Creating a calming environment to reduce anxiety. This might include things like soothing music, calming smells, or positive images.

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    Memory Reconstruction

    Recalling positive past experiences to counter negative memories.

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    Positive Imagery

    A technique within memory reconstruction that encourages patients to visualize positive images.

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    Medication - Analgesia

    Medication used to reduce pain.

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    Conscious Sedation

    A type of medication used to calm anxiety.

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    Anaesthesia

    A type of medication used to induce a temporary loss of consciousness.

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    Modified Dental Anxiety Score

    A scale used to measure the level of anxiety someone experiences when visiting a dentist.

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    No to low levels of anxiety

    A score of 5-9 on the Modified Dental Anxiety Score indicates a low level of anxiety when visiting a dentist.

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    Moderate anxiety levels

    A score of 10-18 on the Modified Dental Anxiety Score indicates a moderate level of anxiety when visiting a dentist.

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    Extreme anxiety levels

    A score of 19 or higher on the Modified Dental Anxiety Score indicates an extreme level of anxiety around a dentist.

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    Dental Anxiety Impact

    Dental anxiety can lead to avoidance of dental appointments, resulting in poorer oral health due to lack of preventative care and treatment.

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    Dental Fear Cycle

    A vicious cycle where fear of dental treatment leads to avoidance, which then leads to worsening oral health, thus reinforcing the fear.

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    Negative or traumatic experiences

    Past experiences, like a painful or scary dental procedure, can contribute to a person's dental anxiety.

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    Dental Anxiety Signs

    Signs of dental anxiety may include physiological changes like sweating, rapid pulse, and breathing difficulties, as well as behavioral changes like irritation, panicking, and worrying.

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    Triggers

    Certain triggers like sounds, smells, or sensations can lead to dental anxiety.

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    Recognizing Dental Anxiety

    Recognizing signs of dental anxiety can help dental professionals provide appropriate support and adjustments to make the patient more comfortable.

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    Loss of control

    Feeling a lack of control during dental procedures can be a source of anxiety.

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    Coping abilities

    A person's coping abilities, like how they handle stress, can influence their dental anxiety levels.

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    MDAS (Modified Dental Anxiety Score)

    The Modified Dental Anxiety Score (MDAS) is a validated tool used to assess dental anxiety in adults.

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    VAS (Visual Analogue Scale)

    The Visual Analogue Scale (VAS) is a modified version of the MDAS for children.

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    Family members or friends' experiences

    Family members or friends' dental experiences and opinions can influence a person's dental anxiety.

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    Dental Anxiety Manifestations

    Dental anxiety can manifest in various ways, including psychological, behavioral, and physiological changes.

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    Cost of care or worries about costs

    Concerns about the cost of dental care or worrying about financial burdens can contribute to dental anxiety.

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    Dental Anxiety Barrier

    Dental anxiety is a significant barrier to accessing dental care, leading to delayed treatment and ultimately poorer oral health outcomes.

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    Importance of Assessment

    Identifying and measuring dental anxiety allows dental professionals to address it and provide tailored care to ease patient concerns.

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    Dental Anxiety Complexity

    Dental anxiety is a complex issue with both psychological and physiological dimensions, requiring a multi-faceted approach to effectively manage.

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    Study Notes

    Anxiety in Dental Care

    • This presentation covers anxiety in dental care, including definitions, prevalence, impact, signs, assessment, management strategies, and interventions.

    Intended Learning Outcomes

    • Students should be able to recognize signs of dental anxiety and describe its impact.
    • Students should understand sources/origins (aetiology) of anxiety and fear related to dental care.
    • Students should be able to describe methods to assess dental anxiety.
    • Students should be able to outline management strategies for dental anxiety.

    Assessment

    • Formative: Discussion on Moodle, patient care
    • Summative: Clinical practice record
    • Future: Effective clinical practice and patient care

    Context

    • Focuses on definitions, prevalence, and impact of dental anxiety.

    Definitions

    • Dental anxiety: An emotional state (feelings of apprehension, uneasiness, or dread) preceding dental encounters or dental-related stimuli. It ranges from mild to severe and can be related to specific or general situations.
    • Dental fear: A reaction to threatening stimuli (in dental situations) leading to fight-or-flight responses.
    • Dental phobia: A strong, persistent, and intense fear of dental care; an extreme form of dental anxiety, diagnosed and managed.

    Dental Anxiety Components

    • Physiological: Body changes (increased heart rate, sweating, raised blood pressure, and muscle tension).
    • Behavioural: Actions (avoiding dental care; canceling visits; reducing time in the dental chair; meticulous oral hygiene).
    • Cognitive: Thoughts (about the situation; reduced concentration; and poor memory).

    Prevalence of Dental Anxiety

    • The 2009 Adult Dental Health Survey was the first to measure dental anxiety using a Modified Dental Anxiety Score (MDAS).
    • A significant portion (51%) of the population surveyed experienced no or low levels of dental anxiety.
    • A notable proportion (36%) experienced moderate dental anxiety.

    Origins of Dental Anxiety

    • Personal: Negative/traumatic experiences (especially in childhood), triggers (sounds, sights, smells, feelings), loss of control, and coping abilities, and medical history
    • Social: Family members' or friends' experiences, cost of care, social circumstances, and negative media perceptions.

    Impact of Dental Anxiety on Oral Health

    • Anxiety can lead to decreased attendance, increased treatment need, reduced quality of life, and higher caries rates; poor oral health.
    • The cycle of dental fear and treatment delay can reinforce dental anxiety.

    Signs and Assessment

    • How to identify and measure dental anxiety is discussed.
    • Recognizing and assessing behavioral (irritation, panicky), emotional (outbursts, worrying), and physiological signs (posture, sweating, pulse, clearing throat), is crucial.
      • Observe patients presenting in the reception area.

    Measures of Dental Anxiety

    • Modified Dental Anxiety Score (MDAS): A valid and reliable tool to measure dental anxiety, useful for all ages.
    • Visual Analogue Scale (VAS): Appropriate for children, a variation of the MDAS.

    Modified Dental Anxiety Score (MDAS)

    • Patients rate their anxiety on a scale of 1 (not anxious) to 5 (extremely anxious).
    • This is measured for 5 aspects of dental care.
    • Scores are added to determine the level of anxiety (low, moderate, or high)

    Strategies and Referral

    • Interventions for Management:

      • Pharmacological: Anaesthesia, conscious sedation, medication/analgesia; referred to a specialist
      • Non-pharmacological: Communication skills, behavior modification, psychotherapeutic (cognitive-behavioral therapy); offered to all patients.
    • Flow Chart for Management:

      • Assessment of level of anxiety.
      • Interventions are proportionate to the level of anxiety.
    • Memory Reconstruction: Help patients recall positive aspects and how they have managed in the past, including use of positive images and reminders.

    • Environmental Change: Using smells (like lavender), soothing music, and positive imagery promotes relaxation.

    • Provision of preparatory information: Patients with moderate anxiety benefit from information on; procedure, expected sensations, and ways to manage anxiety, tailored to patients' needs.

    • CBT: Combines behavioral and cognitive strategies for modifying maladaptive beliefs and behaviors. It includes gradual exposure to fearful situations over repeated sessions.

    • Referral to Specialists: Patients experiencing high anxiety, or complex dental care or medical conditions.

    • Services at the RNENT&EDH (Royal National ENT and Eastman Dental Hospitals):

      • Referrals for patients with anxiety;
      • Clinical psychologists, facial pain service, and pain management.
    • NHS Dental Psychology Service:

    • Referral, Psychological assessment, CBT, gag-reflex management, conditions like orofacial pain, suitability assessments, and collaboration with dental practitioners.

    Summary

    • Information is grouped from definitions, prevalence, impact, signs, measurement methods and management strategies.

    References

    • A number of academic articles, studies, and resources were consulted for the information included in this presentation.

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    Anxiety in Dental Care PDF

    Description

    This quiz explores the various aspects of dental anxiety, including its definitions, prevalence, and impacts. Students will learn to recognize signs of anxiety, assess its origins, and outline effective management strategies. Prepare to enhance your understanding of how anxiety affects dental care and patient experiences.

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