Dental Care Anxiety and Fear Part I

Study Notes

Stress refers to physiological or psychological strain caused by adverse stimuli, which can be physical, mental, or emotional.
Coping is the individual's emotional and physical response to stress.
Types of stress include physical (trauma, pollution), psychological (emotional stress), psychosocial (relationships), and psycho-spiritual (value crises).

Chronic and acute stress can weaken the immune system, leading to increased susceptibility to diseases.
Prolonged stress may cause hormonal imbalances, further disrupting immune functioning.

Anxiety is a cognitive emotional response anticipating future threats, often accompanied by muscle tension or avoidant behavior.
Fear is a direct reaction to immediate threats, activating the fight or flight response.
Phobia is an intense, persistent fear leading to avoidance of specific situations or activities.

Dental anxiety is an emotional response tied to dental experiences, with children exhibiting higher anxiety levels than adults.
Women report higher levels of dental anxiety compared to men.

Causes include previous painful dental experiences, heightened sensitivity to pain, social learning, cognitive misperceptions, and worries about control or danger.

Self-reported measures: Questionnaires such as Corah’s Dental Anxiety Scale, Modified Dental Anxiety Scale, and Dental Fear Survey assess dental fear.
Physiological measures: Indicators include perspiration, increased heart rate, altered gastric activity, changes in respiration, and muscle tension.
Behavioral measures: Observed through body language, speech, and appointment cancellations.

Introduce patients to the clinic using the TELL-SHOW-DO technique, explaining procedures step-by-step.
Ensure a quiet and relaxed dental environment to ease anxiety.
Patients should be able to signal for treatment to stop, introducing new procedures gradually.
Praise positive behavior while avoiding criticism of undesirable behavior.

Stimulus Control: Keep needles and syringes out of sight during treatment.
Social Praise: Recognize and reinforce patients' coping behaviors during treatment.
Behavioral Control: Allow patient decision-making throughout the dental experience.
Exposure Therapy: Gradually acclimate patients to the dental setting through multiple visits.
Systematic Desensitization: Shift perceptions of fear-inducing stimuli through positive conditioning.

Combining modeling and relaxation techniques yields a success rate of around 78%.
Providing time for patients to acclimate to the dental environment is beneficial before treatment begins.