MANAGEMENT OF DENTAL ANXIETY / SEDATION DENTISTRY
Dental anxiety is not well-defined but can be taken to mean fear of all aspects of dentistry, from routine scaling to injections and dental surgery.
Mild dental anxiety can manifest as sweaty palms, racing pulse, a dry mouth, or a churning stomach when in the dental setting.
You may also have difficulty sleeping the night before the dental appointment.
Some patients may also faint when under extreme stress and the strain of “trying to keep it in” during dental treatment.
Severe dental anxiety (dental phobia) is linked with intense feelings of anxiety which are too overwhelming to cope with . Dental phobia affects about 10% of the population and may result in complete avoidance of dental care.
Dental phobics may see their physician instead of a dentist, in the hope of managing acute dental pain with painkillers and antibiotics.
You may delay seeking dental treatment except when in severe or chronic pain. You may only seek treatment when persuaded by a friend or relative.
You may miss dental appointments or have not attended a dentist in years.
Dental anxiety can produce unpleasant physical symptoms as a result of the stress (fight-or-flight) response. This can trigger a medical event (heart attack, stroke, epileptic fit or asthma attack) if you have a medical condition (high blood pressure, epilepsy or asthma) that is worsened by stress.
The anticipation building up to the dental appointment can be extremely potent, especially if you are left waiting for your appointment to begin.
In the dental chair, you may feel completely helpless or vulnerable.
The sights, sounds and smells of the dental environment may trigger unpleasant memories of previous dental experiences. Some patients may gag during the dental examination or during treatment and you may feel extremely embarrassed.
Dental anxiety may affect how you think about dentistry. You may tend to catastrophize (imagining the worst possible outcome of a procedure will happen). You may also believe that the dental team perceives you as being silly, stupid or weak as a result of your anxiety. You may worry about being stigmatised and this embarrassment can be a powerful motivator for avoiding dentistry.
Outside of the dental practice, dental anxiety affects many other aspects of life.
Some patients may avoid smiling because they are self-conscious or embarrassed about their smile.
You may avoid hard foods (if there is a painful tooth to chew on or if you have a reduced ability to chew as a result of missing teeth) and cold foods (because of sensitivity).
You may become hyper-aware of your oral hygiene routine and change toothbrushes regularly, use mouthwash or develop a very elaborate routine in an effort to avoid dentistry.
Self-medicating acute dental pain in order to avoid a dental procedure is common.
You may experience mood changes (becoming more irritable) when you have a dental appointment coming up.
Untreated dental disease that causes severe pain may cause you to miss work or personal commitments.
Dental anxiety is usually triggered by past negative dental experiences (usually in childhood).
Occasionally, incidents portrayed by family, friends or the media can trigger dental anxiety in a person with no previous history of traumatic dental experience. This is known as vicarious learning.
Other possible triggers include a near-drowning experience or a history of sexual abuse.
Studies have shown that 10-20% of the population suffer from severe dental anxiety.
Women are more than twice as likely to be more affected by dental anxiety compared to men.
With time, psychological techniques and sedation, most of our anxious patients can successfully manage to receive dentistry in a positive way.
We use neck pillows, dark glasses, noise-cancelling headphones, blankets and aromatherapy to dampen negative physical stimuli.
Painless and effective local anaesthesia is the foundation for successful pain control.
We have found that open and upfront discussion about the procedure(s) that are being planned, as well as potential risks and complications can help patients feel better-informed and prepared.
For very anxious patients or patients who require procedures that are more extensive or have a long duration (for example, wisdom tooth surgery or root canal treatment), we can arrange for sedation.
We offer 4 different methods of sedation:
General Anaesthesia in an operating theatre for patients who require extensive surgical procedures and for very anxious young children.