Successful Treatment of Fearful Dental Patients

Did you know that up to 40% of people have some level of dental anxiety? Thankfully, advancements in sedation have allowed for easier treatment of fearful patients, and many dentists now use nitrous oxide (laughing gas) and oral or intravenous drugs in their offices. But the dental professionals at Tufts School of Dental Medicine, which happens to be the alma mater of our very own Dr. Luis Sanchez, believe that drugs aren’t the the only solution.

“Many dentists focus primarily on pharmacologic treatments, such as the short-term use of sedatives, but there are many nonpharmacologic, behavioral approaches that I believe are underutilized in the dental setting,” said Ellen Patterson, director of interprofessional education at Tufts School of Dental Medicine. The school actually offers a course, “Introduction to the Dental Patient,” where Patterson, a health communications specialist and former psychiatrist, works with students to learn to manage fearful patients.

In a recent article from Tufts Dental Medicine, the magazine of the Tufts University Dental Alumni Association, Patterson and other Tufts faculty and alumni gave their best advice for treating anxious patients. Here are some of their key tips:

Build rapport.

Building a trusting relationship is crucial making an empathetic connection with a patient a must. “I think it really has to do more with the practitioner’s decision to take the time and energy to create a patient-centered environment that respects and honors each patient’s needs rather than any innate talent.”

Understand the source of fear.

There are three basic categories of nervousness surrounding the dentist. Dental fear is the most common and is relatively mild and manageable. Dental anxiety is worse, and patients may not be able to handle their fear on their own. When a patient is not just anxious, but instead panic-stricken, it’s classified as dental phobia.

There are three situations that are most common in provoking fear: when the dentist appears rushed or insensitive, when the dentist doesn’t talk to the patient about what is to be done, and when the dentist fails to pay attention to a patient’s needs or goals.

A dentist can gently explore a patient’s dental history and anxiety triggers by asking open-ended questions. Is it the sound of the drill that causes fear? Does the thought of a needle piercing the gums induce anxiety?

“If somebody’s anxious in the chair, there’s got to be a reason for it,” said Susan Cushing, author of Have No Fear of the Dental Chair. “We just need to take the time.”

Be an active listener.

Iqbal Singh, a professor of preclinical studies, recommends taking the time to talk with an anxious patient before jumping into an exam.

“I have to listen to them, rather than me talking to them,” he said.

This gives the patient the opportunity to talk about their experiences and how they’ve led to their dental fear. Making time to engage leads to a trusting relationship and more loyal patients.

Honesty is always the best policy.

While telling a patient, “This won’t hurt at all,” might seem harmless, for some, trust in the dentist is at stake if there actually is some discomfort. Cushing recommends making promises you can keep. “I promise to do my best not to hurt you. But there may be a pinch or things that are uncomfortable, and I need you to help me make it easy for you.”

Be aware of nonverbal cues.

Some of the most fearful patients are hesitant to talk about their anxiety.

“It is not unusual for some people – men as well as women – who pride themselves on being tough to want to maintain that image in spite of their fears,” said Anthony Silvestri Jr., a clinical professor at the dental school. “If I see a rugged-looking patient sitting in my air-conditioned operatory with beads of sweat emanating from the upper-lip, I have a pretty good idea what lies behind that sweat.”

Body language can give important clues. Pacing the waiting room, frequently getting up from the seat, and white-knuckling the arms of the chair are all signs to look for. If these signs, or similar ones, are present, an opportunity to compassionately explore the situation presents itself. This can also lead to a chance to build a sense of trust with a patient.

Explain as you go.

Many dentists have found success with the tell-show-do method. First tell the patient what the procedure will involve. Then show them the tools and materials involved before finally doing the procedure. For some, the “show” may include handling the tools to get a better feel for them before they are used in their mouth.

Other tips include giving patients a sense of control, neutralizing sensory overload, taking baby steps, practicing flexibility, and consulting with a psychiatrist. For more on these suggestions, visit the original article, here.

Our mission at Miami Dental Sedation Spa is to eliminate dental fear through the professional, cheerful and caring treatment of our patients. We strive to meet the physical and emotional needs of all of patients by providing a  personal, comprehensive, professional and relaxing experience. Contacting us is your first step toward anxiety-free dental health. We hope to hear from you soon!

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