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Dental anxiety? Let’s tackle this

Diana Woodward examines how we can help patients with the age-old problem

A 35-year-old female attended the practice, recommended all teeth to be taken out and to have a set of dentures instead. She indicated that she hadn’t seen a dentist for 20 years and she had not used a toothbrush for the same time interval. She said: ‘The last time I saw a dentist he was trying to squash that air mask on my face.’ She scored 25 (the highest score) on the Modified Dental Anxiety Scale (MDAS). An examination revealed very poor dental status with pocket depth of more than 5mm and teeth mobility ranging from grade 1 to grade 3, no dental fillings or missing teeth but four decayed teeth. A brief, relaxing discussion was undertaken and the patient agreed to have some treatment done. She had supra and sub gingival scaling under audio distraction and was given all control on when she would like treatment to start and stop (perceived control). Treatment was very successful and the patient was very co-operative. Dental health education was given and the importance of oral hygiene was reinforced. On several appointments, her dental status has improved and would have partial dentures constructed once her periodontal status is stabilised. After three months of the first appointment her MDAS score dropped to 14.

Survey

According to a report from the Adult Dental Health Survey carried out in 2009 by the NHS Information Centre for health and social care  in England and published in 2011,   just over half of adults (51%) who had ever been to a dentist had an MDAS score of between 5 and 9, indicating low/no dental anxiety. Over a third of adults (36%) had an MDAS score of between 10 and 18 indicating moderate dental anxiety, and a further 12% had a score of 19 or more, which suggests extreme dental anxiety. The prevalence of dental anxiety was higher in women and lower socioeconomic groups. Twenty percent of the patients were not satisfied with their most recent dental visit and showed the longest gaps in dental appointments and hence had the highest scores on MDAS. Discussion

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