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Australian Dental Journal Mar 2022Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and... (Review)
Review
Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and presents before, during or after dental treatment. The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output. Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health. Dental anxiety can generate a variety of negative consequences for both the dentist and the patient. Evidence-based strategies are essential for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioural strategies can modify the patient's experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations. These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction and desensitization. Pharmacological intervention utilizes either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment.
Topics: Adult; Humans; Dental Anxiety; Dental Clinics; Conscious Sedation; Anesthesia; Anesthesia, Dental
PubMed: 35735746
DOI: 10.1111/adj.12926 -
Medicina (Kaunas, Lithuania) Dec 2019Invasive dental procedures can be performed only with local anesthesia; in some cases, it may be useful to combine the administration of drugs to obtain anxiolysis with...
Invasive dental procedures can be performed only with local anesthesia; in some cases, it may be useful to combine the administration of drugs to obtain anxiolysis with local anesthesia. Sedation required level should be individually adjusted to achieve a proper balance between the needs of the patient, the operator, and the safety of the procedure. Surgical time is an important factor for post-operative phases, and this could be greatly increased by whether the patient interrupts the surgeon or if it is not collaborative. In this manuscript some dentistry-used methods to practice conscious sedation have been evaluated. This manuscript could be a useful reading on the current state of conscious sedation in dentistry and an important starting point for future perspectives. Surely the search for safer drugs for our patients could have beneficial effects for them and for the clinicians.
Topics: Administration, Oral; Adult; Ambulatory Care; Anesthesia, Dental; Anesthesia, Local; Anesthetics, Inhalation; Anti-Anxiety Agents; Benzodiazepines; Central Nervous System; Child; Conscious Sedation; Dental Anxiety; Dental Care; Dentistry; Humans; Nitrous Oxide; Operative Time; Postoperative Period; Safety
PubMed: 31817931
DOI: 10.3390/medicina55120778 -
Medicina (Kaunas, Lithuania) Oct 2019Dentistry and oral health are at the heart of the systemic health of humans. Often this branch of medicine is underestimated either due to socioeconomic reasons or due...
Dentistry and oral health are at the heart of the systemic health of humans. Often this branch of medicine is underestimated either due to socioeconomic reasons or due to fear. In fact, in dentistry, there is often a widespread condition of odontophobia among patients. A clinician's knowledge of this condition, and an accompanying understanding of how to successfully manage it, is surely one of the first steps to gaining a patient's trust and maintaining his or her patronage. Being able to manage a dental phobic patient in the best way is the key to successful therapy. Psychological techniques often have to work alongside dentistry in managing these patients. A future perspective concerns precisely the implementation of non-invasive practices such as hypnosis in the management of the latter.
Topics: Dental Anxiety; Dental Care; Fear; Humans; Psychology
PubMed: 31597328
DOI: 10.3390/medicina55100678 -
Brain Sciences Apr 2022Hypnosis is a commonly used therapy option in dentistry and medicine for fear and pain reduction. Nevertheless, it is viewed very critically, as there is still... (Review)
Review
Hypnosis is a commonly used therapy option in dentistry and medicine for fear and pain reduction. Nevertheless, it is viewed very critically, as there is still insufficient evidence for a treatment effect. Specific phobia of dental treatment and dental anxiety are prevalent conditions that can cause an oral health impairment. This paper critically reviews 19 clinical trials aimed at reducing dental anxiety and fear avoidance in adults, published in peer-reviewed journals between 1979 and 2021. The search identified 257 papers; 223 were selected after removing duplicates. A total of 188 articles were excluded after title and abstract evaluation; 35 full text articles were assessed for eligibility. Another 10 papers were discharged after full text evaluation, as these were case reports and questionnaires. Six papers were discharged due to the lack of a comparable scale to measure dental anxiety. The following treatment techniques were reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, self-hypnosis by audio therapy, hypnotherapy, hypnosis, and nitrous oxide sedation. CBT delivered in a variety of formats, including one-session treatment, showed the most evidence for the efficacy of reducing anxiety. A wide heterogeneity of methods allowed only the inclusion of five studies to the performed meta-analysis, showing contrasting results for the application of hypnosis. The main reason for this issue is the great variety in methods used, making a distinct assessment of hypnotic interventions difficult. However, the results of the systematic review are promising in that hypnosis can also be regarded as powerful and successful method for anxiety reduction, while there are also studies with a small or even slightly negative effect. Therefore, further research is needed. Within the limitations of the current study, a more consistent use of methods to examine anxiety for hypnosis research is recommended.
PubMed: 35624907
DOI: 10.3390/brainsci12050521 -
Clinical, Cosmetic and Investigational... 2016Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies... (Review)
Review
Dental anxiety and phobia result in avoidance of dental care. It is a frequently encountered problem in dental offices. Formulating acceptable evidence-based therapies for such patients is essential, or else they can be a considerable source of stress for the dentist. These patients need to be identified at the earliest opportunity and their concerns addressed. The initial interaction between the dentist and the patient can reveal the presence of anxiety, fear, and phobia. In such situations, subjective evaluation by interviews and self-reporting on fear and anxiety scales and objective assessment of blood pressure, pulse rate, pulse oximetry, finger temperature, and galvanic skin response can greatly enhance the diagnosis and enable categorization of these individuals as mildly, moderately, or highly anxious or dental phobics. Broadly, dental anxiety can be managed by psychotherapeutic interventions, pharmacological interventions, or a combination of both, depending on the level of dental anxiety, patient characteristics, and clinical situations. Psychotherapeutic interventions are either behaviorally or cognitively oriented. Pharmacologically, these patients can be managed using either sedation or general anesthesia. Behavior-modification therapies aim to change unacceptable behaviors through learning, and involve muscle relaxation and relaxation breathing, along with guided imagery and physiological monitoring using biofeedback, hypnosis, acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based treatments, such as systematic desensitization, "tell-show-do", and modeling. Cognitive strategies aim to alter and restructure the content of negative cognitions and enhance control over the negative thoughts. Cognitive behavior therapy is a combination of behavior therapy and cognitive therapy, and is currently the most accepted and successful psychological treatment for anxiety and phobia. In certain situations, where the patient is not able to respond to and cooperate well with psychotherapeutic interventions, is not willing to undergo these types of treatment, or is considered dental-phobic, pharmacological therapies such as sedation or general anesthesia should be sought.
PubMed: 27022303
DOI: 10.2147/CCIDE.S63626 -
Indian Journal of Dental Research :... 2018Dental treatment still remains as one of the most anxious visits despite awareness between dentists and patients in building trusting relationships. The fear of dental...
BACKGROUND
Dental treatment still remains as one of the most anxious visits despite awareness between dentists and patients in building trusting relationships. The fear of dental treatment determines the frequency of treatment availed with long-term implications in oral health maintenance.
AIM
This study aims to estimate prevalence, extent, and factors influencing dental anxiety in a sample of the adult population visiting a private dental hospital in Chennai, India.
MATERIALS AND METHODS
The study sample included 300 consecutive outpatients visiting a private dental hospital in Chennai. Any patient aged 18 and above was considered for the study. A structured custom-made questionnaire composed of ten questions was designed to assess the anxiety levels of dental patients. The level of the patient's anxiety was assessed taking into account various factors that could influence their mental state. This included their age, gender, educational qualification, number/frequency of their dental visits, reason for their visit, past dental experiences, and nature of the dental procedure planned. Enquiries about the related time of anxiety manifestations as well as their preferred anxiety reducing protocols were done as part of the study.
STATISTICS
The data analysis was performed using SPSS Version 11.5. Analysis initially was performed with Chi-square test for frequency and reason of visit, with the independent samples t-test used for assessing mean score differences along with Pearson's correlation coefficient.
RESULTS
The study revealed that dental anxiety has a wide prevalence rate encompassing both genders. Distinctive predominance among females (65.2%) and professionals (66.9%) exhibiting a greater degree of anxiety was identified. Pain and extraction have been cited as duress and anxiety inciting procedures (72.6%).
CONCLUSION
This survey has revealed that age, gender, level of education, and procedure along with visit frequency has a direct effect on the patient's state of mind and anxiety.
Topics: Adult; Age Factors; Chi-Square Distribution; Cross-Sectional Studies; Dental Anxiety; Educational Status; Female; Humans; India; Male; Prevalence; Risk Factors; Sex Factors; Surveys and Questionnaires; Tooth Extraction; Toothache; Young Adult
PubMed: 29442080
DOI: 10.4103/ijdr.IJDR_33_17 -
BMC Oral Health Jun 2018Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA...
BACKGROUND
Dental fear and anxiety (DFA) is a major issue affecting children's oral health and clinical management. This study investigates the association between children's DFA and family related factors, including parents' DFA, parenting styles, family structure (nuclear or single-parent family), and presence of siblings.
METHODS
A total of 405 children (9-13 years old) and their parents were recruited from 3 elementary schools in Hong Kong. Child's demographic and family-related information was collected through a questionnaire. Parents' and child's DFA were measured by using the Corah Dental Anxiety Scale (CDAS) and Children Fear Survey Schedule-Dental Subscale (CFSS-DS), respectively. Parenting styles were gauged by using the Parent Authority Questionnaire (PAQ).
RESULTS
DFA was reported by 33.1% of children. The mean (SD) CFSS-DS score was 29.1 (11.0). Children with siblings tended to report DFA (37.0% vs. 24.1%; p = 0.034) and had a higher CFSS-DS score (29.9 vs. 27.4; p = 0.025) as compared with their counterpart. Children from single-parent families had lower CFSS-DS score as compared with children from nuclear families (β = - 9.177; p = 0.029). Subgroup analysis showed a higher CFSS-DS score among boys with siblings (β = 7.130; p = 0.010) as compared with their counterpart; girls' from single-parent families had a lower CFSS-DS score (β = - 13.933; p = 0.015) as compared with girls from nuclear families. Children's DFA was not associated with parents' DFA or parenting styles (p > 0.05).
CONCLUSIONS
Family structure (nuclear or single-parent family) and presence of siblings are significant determinants for children's DFA. Parental DFA and parenting style do not affect children's DFA significantly.
Topics: Adolescent; Child; Dental Anxiety; Family Characteristics; Female; Humans; Male; Only Child; Parent-Child Relations; Parenting; Siblings; Single-Parent Family; Socioeconomic Factors
PubMed: 29866080
DOI: 10.1186/s12903-018-0553-z -
European Journal of Paediatric Dentistry Jun 2017The aim of this paper was to review the published scientific literature to quantify the prevalence and mean score of dental fear/anxiety (DFA) in children/adolescents...
AIM
The aim of this paper was to review the published scientific literature to quantify the prevalence and mean score of dental fear/anxiety (DFA) in children/adolescents and its variation according to several variables.
MATERIALS AND METHODS
Cross- sectional and cohort studies published from 2000 to 2014, that measured DFA in children /adolescents (aged 0-19 years), in the general population, or visiting private or public dental services (general or pediatric) or attending school and kindergarten, were searched, with specific terms, in 3 electronic databases (Medline, Embase, Web Of Science). Primary data, collected with specific questionnaires of demonstrated reliability and/or validity, were extracted.
RESULTS
After screening 743 abstracts and evaluating 164 full-text publications, 36 articles were selected. Dental fear/anxiety prevalence rates were 12.2%, 10.0%, 12.2%,11.0% and 20.0% for the CFSS-DS, DAS, MDAS, DFS, and DFSS-SF scores, respectively. In the studies that used MCDAS Dental fear/prevalence rates varied from 13.3% to 29.3%. In the studies that used CFSS-DS ratings, the prevalence and the mean score of dental fear/anxiety was lower in Northern Europe than the remaining countries, the prevalence decreased with increasing age and the frequency was higher in females than males.
CONCLUSIONS
Dental fear/anxiety is a common problem in children/adolescents worldwide, therefore, new strategies to overcome this relevant children/adolescent condition should be encouraged.
Topics: Adolescent; Child; Child, Preschool; Dental Anxiety; Humans; Infant; Prevalence; Young Adult
PubMed: 28598183
DOI: 10.23804/ejpd.2017.18.02.07 -
European Archives of Paediatric... Feb 2019To review the current literature on the effectiveness of using music as an intervention to reduce dental anxiety in children. (Review)
Review
AIM
To review the current literature on the effectiveness of using music as an intervention to reduce dental anxiety in children.
METHODS
At the University of Leeds, the School of Music and the School of Dentistry collaborated to conduct an online search strategy. The Cochrane Library and Medline databases were used to find the current available evidence.
RESULTS
Systematic reviews and clinical trial studies as well as cohort studies containing pertinent information on the effect of music on anxiety in the clinical setting were reviewed. The literature showed that music can have a biological and psychological impact on emotion and consequently has been used effectively as an aid to moderate anxiety in the clinical setting. With regard to paediatric dentistry, majority of studies were found to support the use of music in reducing dental anxiety in children, however several additional studies showed that music did not significantly reduce the children's dental anxiety. The studies employed a number of methods to measure dental anxiety including the Venham's Picture Test, the Venham's clinical anxiety rating scale and pulse oximetry. They also used a range of music types; some studies allowed for patient self-selection of music whereas others dictated the music the children listened to.
CONCLUSIONS
There is an increasing body of evidence to support the use of music to moderate anxiety within the clinical setting in both medicine and dentistry. However, the current evidence for the effectiveness of using music to reduce dental anxiety in children is inconclusive and of limited quality.
Topics: Child; Child, Preschool; Dental Anxiety; Dental Care for Children; Humans; Music
PubMed: 30374854
DOI: 10.1007/s40368-018-0380-6 -
Stomatologija 2017Authors developed an idea of seven blocks with different psychosocial factors that could correlate with children's dental anxiety and explain its variance. Aim of the...
Authors developed an idea of seven blocks with different psychosocial factors that could correlate with children's dental anxiety and explain its variance. Aim of the study was to evaluate correlation between psychosocial factors and children's dental anxiety. Totally, 240 randomly selected children (mean age M=7.96, SD=2.61, range 4 to 12) and their parents took part in the study. Parents evaluated their own (MDAS) and their children's anxiety (CFSS-DS). Psychosocial factors were evaluated by a large questionnaire, developed for this study. Dental status was fixed and child's behavior in dental setting was evaluated with Frankl's scale. Pearson's correlation of CDA with all variables and stepwise linear regression with the correlating variables within the seven psychosocial factor blocks was performed. Dental experience and attitude factors (crying at dentist and dental treatment with difficulties) as well as Children's personality and behavior factors (general anxiety and children's behavior at dentist) gave the most effect on CDA, totally explaining 56% and 54% of variance, respectively. Children's medical experience and attitude factors (anxiety and caution towards doctors) as well as Parental/information factors (parental dental anxiety, promising prizes before treatment) explained 34% and 31% of CDA variance, respectively. Socio-economic factors (number of children and mother's age) explained 15%, but oral care habits and attitude (brushing as obligation) - 14% of CDA variance. Family distress factors had no correlation with CDA and were excluded of further analysis. Children's dental anxiety variance is at best explained by Child's dental experience and attitude factors and Child's personality and behavior factors.
Topics: Attitude to Health; Child; Child Behavior; Child, Preschool; Dental Anxiety; Dental Care for Children; Family; Fear; Female; Humans; Male; Personality
PubMed: 29339671
DOI: No ID Found