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Course Syllabus
Anxious or Phobic Patients - Best Treatment Practices
Contact Hours: 6
Price: $54.00
Published: October 2009
Pages: 33
Course Description
Many patients only visit the dentist for emergency situations or when the pain of a dental problem becomes so severe that they can't stand it anymore. Why don't these people seek treatment when they first notice the symptoms? Why aren't they scheduling routine maintenance visits?
Some people can't face dental treatment because it terrifies them. They would rather live with the pain or poor esthetics caused by lack of dental care. A study by Dr. Scott in 1984 shows that dental fear effects up to 80% of the United States population to some degree. A recent epidemiological study by Milgrom (1988) reported that 20% of the population of Seattle exhibited so much dental fear that they avoided the dental office. By extrapolating this data it can be assumed that 47 million Americans have fear of dental treatment.
Though the option of referral for IV sedation or general anesthesia is certainly popular, does this really help the patient overcome their fears? Many experts agree that medication for sedation will only propagate the cycle of emergency treatment and avoidance of routine care. (Kroeger 1988) This eventually leads to further breakdown of the existing dentition.
Dental professionals report that anxious patients are difficult to manage and treat. Treatment of an anxious patient can take up to 20% more appointment time (Jepsen 1992). The anxious patient is more likely to be late and three times more likely than any other patient to not show up for their appointment at all (Mendola 1991). Many dental professionals experience feelings of frustration or inadequacy leading to increased stress when treating anxious patients (Glassman 1993). This segment of the population can become a source of new patients for a dental office that is willing to take the time to treat the patient's anxiety as well as their dentition.
Definitions
Fear is a learned reaction characterized by physiological symptoms such as faster heart rate, nausea, sweating, muscular tension, and increased respiration. The response is initiated by a real or imagined threat to one's safety. When questioned, the patient will readily identify the specific source of fear. The patient poises in a fight or flight stance ready to either escape the stimulus or stand and defeat it.
Anxiety is a different type of disturbed emotional state. Usually associated with dangerous or unpredictable situations, the physiological symptoms include sweating, increased heart rate, pounding chest, dry mouth, diarrhea, muscle tension, and hyperventilation. There is a sense of impending doom. When the patient is questioned about the stimulus, the source is not easily identifiable. New experiences are usually met with some apprehension. New experiences combined with uncertainty and expectations of pain can cause anxiety in many people.
Phobia is an irrational fear reaction. It is excessive, persistent, and exaggerated. The physiological reactions are the same as for anxiety, but the phobic state is beyond conscious control. Reason or explanation cannot comfort the phobic. A dental phobic feels as though no one understands his or her problem. They are usually embarrassed and ashamed of their fears. They are concerned that they are mentally unstable.
Pain is an anatomical and physiological reaction to a stimulus. The thoughts and emotions of the patient influence it. Previous experiences, expectations, and distractions also affect the perception of pain. The physiological and emotional symptoms are very similar to those of anxiety. Often they occur at the same time.
Course Objectives
Upon completion of this course, the student should be able to:
- Define fear, anxiety, phobia, and pain. Describe how they are related.
- List some of the methods of assessment of dental fear or phobia.
- Describe the physiological reactions to fear stimuli.
- List common reasons for patient's fear of dentistry.
- List some current methods used by dentists to reduce the anxiety of their patients.
- Describe the role of the dental staff in reducing patient anxiety.
- List actions that experts recommend avoiding in order to reduce patient anxiety.
- Describe ways of teaching the patient to relax during dental treatment.
- Describe some current methods of anesthesia.
- List the conditions when is it appropriate to refer the patient to a mental health professional or a dental fears treatment clinic associated with a dental school.
About the Author
Mary Oeding, R.D.H., M Ed.
Mary Oeding has a Bachelor’s Degree in Dental Hygiene and practiced in California for over 13 years. Mrs.
Oeding completed a Master’s Degree Program specializing in Educational Research and Scholarly Writing.
She has done extensive research on California Law and has written dental continuing education classes for
over 10 years.
Testimonial"Thank you. I've got my certificate in my hands!!! You'll see me again ... way before my deadlines ... Much love and Many Blessings." Dale. |
Questions
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Call: 800-522-1207
