Treatment of Dental Anxiety once the crucial assessment of dental anxiety has been completed specific techniques can be identified that target the individual’s specific anxiety issues.
Control Techniques: Behavioural
A fear of loss of control is a common issue identified in anxiety assessment. Factors contributing to control issues are patient position during dental treatment. Dental treatment is accomplished with a patient in a supine position with the dental team above and over the patient. Any claustrophobic tendencies; the sense of being out of control and vulnerable plus the inability to communicate due to dental treatment often results in an overwhelming sense of loss of control. Simple hand signals are an integral part of any dental treatment. A simple signal of raising the left hand is an agreed signal bet. The dentist and patient that everything needs to stop and the dentist will then identify with the patient what the problem is and correct it immediately before treatment re-commences. Dental team members are experts at communicating with patients even with the restrictions of rubber dam, or local anaesthetic.
Control Techniques: Informational
The assessment of an individual’s dental anxiety may reveal the need for lots of information during dental treatment to decrease dental anxiety (MONITOR-type) or the need for minimal information during dental treatment(BLUNTER-type) as too much information only causes increased dental anxiety. Monitor-type individuals with dental anxiety are calmed by knowing exactly what is going on; what procedures are being performed; the sensations they can anticipate and the anticipated time frame remaining in dental treatment.
Blunter- type individuals with dental anxiety are calmed by no details, no specifics of ongoing dental treatment, or the need for minimal information during dental treatment. Information, explanations and dental information only raises their anxiety levels.
It is crucial to identify an individual’s specific type in order to control the type of information correctly.
Coping strategies form the basic building blocks of treatment of dental anxiety.
Relaxation Breathing / Muscle Relaxation
A very simple, basic strategy that can be enormously helpful. A simple, short lesson with the patient teaching the techniques of relaxation breathing and muscle relaxation using a tense and release technique will allow the patient to identify and control the initial symptoms of anxiety and control and minimize anxiety before it becomes the over whelming highly elevated anxiety that is often impossible to control. This simple technique is highly effective and can be used by the patient in a number of difficult applications.
An additional coping strategy that is often used by a dentist to refocus the patient. Patients who focus intently on the specific components of dental treatment and anticipate negative outcomes or sensations will experience difficulties. Refocusing a patients attention on other aspects, sensations will prevent the “tense” “red alert” body state that results in exaggerated reactions to minor sensations.
Control Techniques: Cognitive
A patient’s belief about the dental experience is often a self-fulfilling prophecy. Many patients are unable to control the incessant “voice in their Head” that repeats negative beliefs eg. “This is going to hurt” “I can’t do this” “this is going to be sore” “This is horrible” “I can’t bear this”. The continuous playing of these beliefs can completely undermine a patients’ ability to cope with dental treatment. The first step is to identify specifically what is being repeated and then use a strategy that works for that individual to stop the message. Examples of strategies are visualizing large stop signs, or hand positions that interrupt the thought.