June 14, 2016
A study at the University of Washington has shown that between 5% and 8% of Americans avoid going to the dentist due to fear. Others feel anxiety which causes them to only visit the dentist when absolutely necessary. This is an unhealthy and potentially dangerous trend, but one that every dentist can do his or her part in helping to reverse. By helping patients manage their fear, we can help ensure patients receive the care needed to maintain their dental health.
Understanding the Origins of Dental Phobias
For each individual who is afraid of going to the dentist, there are unique circumstances that cause these fears. Usually, patients have had a traumatic dental experience, such as poor anesthesia during surgery, extreme complications from a procedure, or another painful circumstance. Others are afraid of specific things such as drills or needles.
Others may have an underlying anxiety disorder, which can have a variety of triggers common to dental practices, such as confinement in small rooms, bright lights, loud noises, being touched, or feeling stuck around strangers if they were to have a panic attack.
Some people may have anxiety which stems from abuse. Anxiety is very nuanced and has many different aspects which cannot be solved with a simple solution or suggestion.
Strategies for Avoiding and Preventing Dental Anxiety
It is helpful to know in advance that a patient has a dental phobia, but it is not something people with anxiety are eager to discuss. It can be useful to begin each appointment with a new patient by subtly asking them how they feel about their upcoming appointment. If he tells you he is nervous, or seems uneasy, make sure to be aware of his state and be on the lookout for ways to help him feel at ease. Make sure to tell the patient that any time they are uncomfortable or have a question, they should ask or raise a hand to let you know. That way, they can communicate their needs at any time throughout the appointment.
If you have a patient who seems anxious, you can help by making sure he or she understands what is going on during the procedure, why, and how he or she can expect it to feel, especially with respect to pain or sudden movements. It can be useful to slow down with anxious patients, but others want to get out of the chair as soon as possible. So, ask the patient about what he or she would prefer. For some patients, it is especially helpful to let him or her know when you will need to take out and prepare a syringe so that he can look away to avoid seeing the needle.
It can help to chat with patients to distract them, but make sure not to ask questions that would make them respond while you are working with their teeth. Some may prefer to sit in silence. Try to gauge the patient’s response as you talk.
Make your examination rooms a comfortable environment. If you can avoid shining bright lights into the patient’s eyes or excessively touching his or her face, try to do so, as these small things can have a large effect on anxiety. Many anxious people have fears related to being out of control, so it can help to make the patient feel that if they need to spit or have a drink of water, they can do so if they indicate to you that they need to make an adjustment.
Responding to a Patient Having a Panic Attack
Panic attacks are difficult to understand for those who don’t experience them. Although they are not physically dangerous, they are extremely traumatic for those suffering from them, and many people feel they will have a heart attack or even die during a panic attack.
Never continue a procedure if you suspect the patient is having a panic attack (characterized by rapid breathing, heartbeat, darting eyes, sweating, etc.). First, ask the patient if he wants you to leave the room or stay. Regardless, offer the patient a cup of water and a few minutes to sit and breathe. Remind him that the attack will pass, that they are safe in the room and that nothing physically dangerous is happening to them.
Empathy and compassion, rather than displaying impatience or frustration at the inconvenience, can make all the difference in soothing an anxious patient.