Putting dental phobic patients at ease


RelaxedIn this article, Alex Mungo explores some of the clinical and non-clinical ways of dealing with patients with dental phobias.

Dentophobia is a common affliction. Research from the British Dental Association (BDA) suggests that 25% of patients suffer some form of dental anxiety before visiting the dentist. Of this number, 12% suffer from extreme dental phobia, which can be so severe that it prevents them seeking treatment at all.

Practising dentists and their teams encounter dental phobias on a very regular basis, but often are not equipped to put patients at ease or offer guidance on overcoming dental phobias.

How are you?

With busy schedules to keep, many dental professionals jump straight in with: ‘How are your teeth, any problems?’.

This type of opening salvo can often put patients on edge – they feel like they are having an examination. Spending a few minutes asking after patients’ wellbeing and engaging in relaxed chit chat helps humanise ourselves and can instantly relax patients.

Guiding patients through your check-up routine or treatment is a good way to keep them engaged and relaxed. You can often identify which parts of the treatment are likely to make patients anxious by talking to them and carefully watching their facial expressions.

Dental anxieties can have a number of root causes, including fear of drills, needles, gagging and even embarrassment.

If you can identify the underlying causes, then you will find it easier to put patients at ease. It’s also a good idea to have breaks during parts of treatment to allow patients to relax.

Relaxation techniques

Many patients can benefit from using relaxation techniques during treatment.

An easy technique to use with nervous patients is controlled breathing exercises. Controlled breathing regulates the heart rate, reduces anxiety and refocuses the brain away from your work.

The NHS recommends deep breathing exercises in the treatment of stress, anxiety and panic.

There is a myriad of different controlled breathing exercises, but this one is simple and easy to follow:

  • Breathe in through the nostrils for a slow count of three
  • Exhale through the nostrils for a slow count of three.

This exercise not only helps relax patients but it also draws their focus away from the mouth and towards the nostrils and the repetitive action of inhaling
and exhaling.

Therapy treatments

If the above techniques do not help your patients to relax, then the chances are that they have a deeply ingrained phobia that will require specialist treatment techniques or therapy.

Severe dental anxiety is common enough that there are a now a number of specialists that can treat it in the UK. However, the majority of therapists are equipped to deal with dental phobias and the NHS can refer patients to therapy sessions for dental phobias.

Sedation techniques

If therapy doesn’t work, sedation techniques will need to be utilised to relax patients. However, this should only be considered as a last resort, as it is not cost effective and it doesn’t cure the underlying problems that cause the phobia.

There are two types of commonly used dental sedation:

  • Oral sedation
  • Intravenous sedation.

General anaesthesia can only be carried out in a hospital setting and so cannot be used at dental practices.

Oral sedation involves taking a tablet (such as temazepam) about an hour before the start of dental treatment. The patient will remain awake throughout the procedure; however, it can take the ‘edge’ off the treatment.

Intravenous sedation (often carried out by an anaesthetist) offers a much deeper form of relaxation. It is quick and effective and can be maintained and adjusted throughout treatment.

In order

These are some of the most common ways for dentists and their teams to help patients with dental anxiety and severe dental phobias. Typically, we want to try and work top to bottom through this list in order to try and avoid unnecessary expense and sedation for the patient.

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