Most people don’t look forward to going to the dentist. It’s entirely normal for patients to feel apprehensive about dental procedures, especially those outside of routine preventive care, such as wisdom tooth extractions, root canals, crowns, and other painful dental emergencies.
However, dental phobia is beyond typical apprehension. It is a complex level of fears and symptoms that prevents individuals from visiting the dentist for long periods, even for routine treatment, allowing simple dental work to deteriorate into major procedures.
One study found that 5.5% of Canadians have a high level of fear about going to the dentist, with 49% of this group avoiding dental appointments. Embarrassment, loss of control, and pain are among the greatest fears that nervous patients have, so dentists must use a variety of approaches and strategies to ameliorate these issues.
Communication
Anxious patients are more likely to distrust dentists. They worry about unnecessary work, or that it will be more painful than they have been led to believe and the dentist will be dismissive of their nervousness. Taking the time to get to know your patients, being empathetic, and listening to their misgivings will go a long way in reassuring them that you are on their side.
Address their concerns and talk to your patients honestly and clearly. Fear of the unknown will always provoke anxieties. Therefore, the more information your patients have, the less likely their anxiety levels will ratchet up because of imaginary fears.
Inform your patients about what is going to happen during the procedure. Talk to them about the different anesthesia techniques and reassure them that it is perfectly natural to feel nervous, rather than minimize their anxieties by telling them there is nothing to be afraid of.
Giving Patients Control
Patients are less likely to be fearful if they feel they have some control over the proceedings. Even simply saying to patients that you will begin the treatment on their say-so puts the commencement of treatment in their hands, rather than yours. It is important to create a signal system where patients can raise their hand during treatment if they want you to stop or if they require a break.
For some patients, genuine anxieties may be borne from past trauma. This is where communication at the beginning is key. For example, some patients may have a fear of choking or drowning in their saliva. In these circumstances, it may be that if patients can hold the saliva ejector themselves, they will feel much more control so it will provide them with the reassurance they need to continue with their treatment.
Comfort
Simple changes to the office environment can help patients feel calmer and more relaxed. Make sure the room is at an ambient temperature, and perhaps offer a blanket that can be soothing and comforting.
If patients are uncomfortable or stressed, their body may release stress-inducing chemicals. An aromatherapy diffuser scented with calming essential oils such as lavender, ylang-ylang, or bergamot can induce feelings of tranquility to combat nerves.
Other relaxation strategies include breathing techniques that send a message to the brain to calm down and progressive muscle relaxation, which relaxes the whole body by sequentially tensing and relaxing muscle groups from the head down to the toes. Just a few minutes of going through these techniques with nervous patients while they are in the chair can help to bring their stress levels down.
Distraction Techniques
Distraction techniques may be the wrong phrase, since they don’t aim to distract patients from what you are doing, but rather to help them relax. While talking to your patients about their family, work, hobbies, and other topics is always a good way of getting them to think about something else, it is not possible to have those conversations during treatment.
This is when other distractions are beneficial. It could be something as simple as giving patients a stress ball to squeeze or allowing them to listen to their own music on headphones, which is a useful way of blocking out the noises of drills or other equipment if they make your patients anxious.
Some dental offices now have television screens positioned by the dental chair so patients can zone out to their favorite sitcom instead of being hyper-focused on what you are doing inside their mouth.
Other innovations include massage chairs where patients control the speed, heat, and intensity to provide them with the ultimate in relaxation and distraction from their dental work.
Anesthesia
Sedation is an effective way of helping patients to manage their anxiety during dental work, allowing them to receive the treatment they need without the stress.
Patients with mild to moderate anxiety will usually respond well to minimal sedation that can be administered by a mask with nitrous oxide and oxygen, or with a pill from the Valium family—or a combination of both. Nitrous oxide is easy to control and has the advantage of wearing off quickly once the mask is removed. Patients will not feel groggy and can drive themselves home.
Deep sedation or general anesthesia is an option for patients with significant phobia or fear, rendering them unconscious while the dental work is carried out.
Fear of the Dentist Is Treatable
Dental anxiety and phobias are common. Once recognized in your patient, they can be treated. Providing a calming office environment, training staff to be empathetic, and adopting some or all of these strategies will help to put your patients at ease and help them overcome their fears of going to the dentist.
Dr. Swaida is a passionate and highly experienced dentist in Mississauga, Ontario, Canada. After graduating from the University of Western Ontario and the University of Toronto Faculty of Dentistry, he continued his formal education through multiple courses and mini-residencies in a variety of dental specialties. Dr. Swaida tries to be available for his patients even during his off time, and his number one priority is to make all of his patients feel comfortable and safe when they come to Rockwest Dental Clinic Mississauga. He can be reached at editor@rockwestdental.ca.
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