Fear and anxiety in dentistry

Fear and anxiety in dentistry

The advancement of technology coupled with new scientific discoveries has allowed the evolution and progress of dentistry. So much so that dentistry in these last decades has undergone great improvements in each of its areas. Gone is traumatic, mutilating and aggressive dentistry, to give way to dentistry based on prevention and conservation, which tries to be minimally invasive.

It is important to publicize this change in the vision of the dentist, because many fears and anxieties on the part of patients derive from the hostile history that dentistry has had worldwide.

So much so, that panic, anxiety, stress, fear, fear, anguish, are just some of the adjectives that patients can use to rate the visit to the dentist.

It should be noted that fear is an involuntary emotion, regulated by the amygdala (limbic system organ located below the brain) that allows humans and other mammals to adapt to situations that pose a threat to integrity or interests personal On the other hand, anxiety is a generalized response of hyperactivation of the central nervous system that implies a disproportionate use of physical and mental energy, without such effort being necessary or beneficial for people.

All individuals have felt fear or anxiety on several occasions, but when they occur on a recurring basis and are accompanied by significant chronic discomfort under specific circumstances, it is important to take measures to solve it.

The etiology or causes associated with anxiety before the dentist can be multiple and varied, including:

  • The direct association established between dentistry and pain
  • The fear of the unknown
  • Ignorance about health issues
  • Previous unpleasant or traumatic experience
  • Unfounded fears by family or friends
  • Association fears, for example, people who fear doctors and therefore also dentists
  • Own behavior and thoughts inherent to each person
  • Fear linked to the cost of treatment, that is, is associated with the scarcity of economic resources to be able to afford the work

It is essential to promote prevention and stimulate education in health issues, in this way the patient goes to the consultation for control and not for pain. The efforts of the dentist and the patient must focus on eradicating old and outdated paradigms that do not provide benefits for the integral health of the population.

In this way, all suggestions or recommendations are aimed at eradicating or mediating the agents causing the fear or anxiety that the person presents. Therefore, one or more of the options mentioned below can be indicated:

  • Direct, constant, fluid communication between the patient and the professional reduces anxiety levels, prepares the patient for treatment by conditioning their response, avoids future inconveniences, clarifies doubts or questions and builds confidence (Psychoeducation).
  • Avoid threatening children to go to the dentist or doctor for inappropriate behaviors or attitudes, because the child considers the dentist as a punishment or sanction.
  • In certain cases, the professional may indicate the consumption of certain natural medicines (chamomile, linden, etc.) to produce a relaxing effect on the patient
  • Psychological care prior to dental consultation
  • Training in progressive relaxation (breathing and neuromuscular modulation).
  • Music therapy (Use of selected sounds to generate a state of emotional tranquility).
  • Aromatherapy (Use of selected aromas and smells to generate a state of emotional tranquility)
  • Systematic desensitization: progressively reduce unpleasant emotions around dental practice through controlled exposure to the stimuli of the consultation environment.
  • Operative or instrumental conditioning: present stimuli that are reinforcing or pleasing to the person at the time of meeting with the dentist.
  • Prevention and family education about oral health

The professional must also collaborate in this regard and offer a less threatening, calm and peaceful working environment. In addition, you should offer an adaptive dental consultation (systematic desensitization therapy) for both children and adults if necessary. You can also use techniques, such as: hypnosis, sedation and use of nitrous oxide; Starting the treatment with simple and painless procedures to leave the most uncomfortable for the end, in this way the professional earns the patient’s confidence and the dental treatment becomes more fluid.

Currently, there are modern methods and techniques aimed at eradicating fears and managing stressful situations (systematic desensitization, progressive relaxation, psychoeducation, successive approaches, operant or instrumental conditioning, among others that are chosen according to the characteristics of the case). In addition, a multidisciplinary treatment is offered, which includes the active participation of the clinical psychologist, to achieve the proposed goals. Therefore, fear can no longer be an excuse or obstacle to periodically go to the dentist.
The optimistic and proactive attitude of patients is a decisive factor in the success of any treatment in the health field, hence the importance of taking actions in this regard.

Author: Dr. Alejandro Amaíz
Collaborator: Clinical psychologist. Lic. Miguel Ángel Flores.

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