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Australian Dental Journal Dec 2013People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by... (Review)
Review
People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.
Topics: Adult; Child; Dental Anxiety; Dental Care; Dental Clinics; Dentist-Patient Relations; Fear; Humans; Patient Education as Topic
PubMed: 24320894
DOI: 10.1111/adj.12118 -
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 -
Clinical Psychology Review Jul 2017Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with... (Review)
Review
Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward.
Topics: Adolescent; Child; Dental Anxiety; Humans
PubMed: 28478271
DOI: 10.1016/j.cpr.2017.04.004 -
Journal of Dental Research Feb 2017Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain... (Meta-Analysis)
Meta-Analysis Review
Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain related to dental procedures. However, conclusions from individual studies may be limited by the treatment procedures that patients received, the tools used to assess DA, or the treatment stages when anxiety or pain was assessed. It is unclear whether DA, at the study level, accounts for the variance in pretreatment SA. The impact of DA and SA on pain at different treatment stages has not been systematically investigated. To address these questions, we present novel meta-analytical evidence from 35 articles (encompassing 47 clinical groups) that investigated DA in a clinical group. Subgroup analyses revealed that the studies of surgical and nonsurgical procedures did not significantly differ in either DA or pretreatment SA. Furthermore, metaregressions revealed DA as a significant predictor that explained the variance in SA assessed before and during treatment but not after treatment. The findings suggest that patient DA has a significant impact on patient SA. Metaregressions revealed DA as a significant predictor that explained the variance in expected pain, pain during treatment and posttreatment pain. In contrast, pretreatment SA was a significant predictor that explained the variance in expected pain. The findings reveal that DA has a consistent impact on pain through the entire period of dental treatment. Altogether, the findings highlight the role of DA as an overall indicator for anxiety and pain, across different types of dental procedures or treatment stages. We conclude that anxiety should be assessed as a critical step not only in anxiety management for high-DA patients, but also in pain control for all dental patients.
Topics: Dental Anxiety; Dental Care; Dentistry, Operative; Humans; Pain; Pain Management
PubMed: 28106507
DOI: 10.1177/0022034516678168 -
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 -
Folia Medica Apr 2021Dental fear and anxiety are psychological reactions that interfere significantly with daily life. They are problems suffered by many patients worldwide that remain a... (Review)
Review
Dental fear and anxiety are psychological reactions that interfere significantly with daily life. They are problems suffered by many patients worldwide that remain a significant challenge to providing adequate dental care. The multifactorial etiology of children's dental fear and anxiety identifies the influence of many different risk factors in its development.The aim of this review article is to analyse the scientific literature regarding the different factors associated with dental fear and anxiety in children. Our review of the literature presents a critical analysis of the contributing factors in dental environment that have been investigated in the literature and provides an insight into the possible explanations on the influence of these factors in pediatric patients.Being familiar with these factors would facilitate behaviour management in anxious children. The findings of the literature review give grounds to undertake studies investigating the influence of contributing factors in all pediatric age subgroups.
Topics: Child; Child Behavior; Dental Anxiety; Humans; Risk Factors
PubMed: 33932006
DOI: 10.3897/folmed.63.e54763 -
International Journal of Paediatric... Nov 2007The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental... (Review)
Review
OBJECTIVES
The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental behaviour management problems (DBMP) in children and adolescents, and their relationships to age, sex, general anxiety, temperament, and general behavioural problems.
METHODS
A broad search of the PubMed database was performed using three combinations of search terms.
RESULTS
A large proportion of the identified articles could not be used for the review owing to inadequate endpoints, measures or poor study design. Thirty-two papers of acceptable quality were identified and reviewed. The prevalence of both DFA and DBMP were estimated to 9%, with a decrease in prevalence with age. DFA/DBMP were more frequent in girls. DFA/DBMP were related to general fear and both internalizing and externalizing behavioural problems, although these relationships were not clear-cut. Temperament was related to both DFA and DBMP but with different temperamental characteristics, while general behavioural problems mainly correlated with DBMP.
CONCLUSIONS
DFA/DBMP are common, and several psychological factors are associated with the development of these problems. In order to better understand these relationships, a number of issues concerning design of research and measurement of DFA/DBMP have to be dealt with.
Topics: Adolescent; Adolescent Behavior; Age Factors; Behavior Control; Child; Child Behavior; Child Behavior Disorders; Dental Anxiety; Dental Care; Female; Humans; Male; Prevalence; Sex Factors
PubMed: 17935593
DOI: 10.1111/j.1365-263X.2007.00872.x -
Journal of Oral Science Oct 2021The aim of this study was to assess the effectiveness of laser acupuncture and intravascular laser irradiation of blood (ILIB) for managing anxiety in pediatric... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to assess the effectiveness of laser acupuncture and intravascular laser irradiation of blood (ILIB) for managing anxiety in pediatric dentistry. Eighty-four children recruited at a university dental clinic were randomly assigned to three groups: the Sham group (n = 27) underwent sham laser irradiation of three acupuncture points, the ILIB group (n = 25) underwent 10 min of ILIB, and the laser acupuncture group (LAC, n = 32) underwent 40 s of laser acupuncture over points VG20 (Baihui), PC6 (Neiguan), and the Oppression Point. The results suggest that ILIB and laser acupuncture are feasible alternatives for managing dental anxiety in children.
Topics: Acupuncture Points; Acupuncture Therapy; Child; Dental Anxiety; Humans; Lasers
PubMed: 34408110
DOI: 10.2334/josnusd.21-0025 -
SAAD Digest Jan 2015Dental anxiety is well documented within dental literature, and is a condition with which dentists and dental care professionals alike will be familiar. Its consequences... (Review)
Review
Dental anxiety is well documented within dental literature, and is a condition with which dentists and dental care professionals alike will be familiar. Its consequences may extend beyond dental implications alone, but can also have the potential to affect a patient's quality of life. It is important that as a dental profession we are aware of the methods which can be used to manage various forms of dental anxiety, and to refer to specialist services as appropriate. This paper focusses on detailing both the evidence-based behavioural and pharmacological strategies that may be employed for both dentally anxious adults and children.
Topics: Anesthesia, Dental; Conscious Sedation; Dental Anxiety; Dental Care; Dentist-Patient Relations; Humans; Oral Health; Quality of Life
PubMed: 25895236
DOI: No ID Found -
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