DENTAL ANXIETY
In the eyes of many peoples, dentistry has the reputation of being anything but pleasurable. This may not be unfounded. The media have always used dentistry as an image for pain and as a comparison to an unpleasant event. We continuously hear these illustrations by comedians, in commercials and in the movies. Another contributor to this reputation is that years ago, pain control in medicine and dentistry was not nearly as profound as it is today. Many people in their fifties and older recall painful visits to the dentist. Other reasons for dentistry being looked at as an unpleasant event may revolve around the loss of control that one may feel while in the dental chair and that the mouth is a sensitive and intimate place for a person who is almost a stranger to be poking around.
A study done by Locker at the University of Toronto and published in January of 1999 classified 16.4% of patients as suffering from dental anxiety. Other studies have put this number as high as 21%. Numerous studies have compiled lists of the most anxiety-producing events in our lives and dental treatment is a regular on these lists. It is interesting that those who are generally anxious have an increased risk of suffering from dental phobia and that people who are dental phobic, avoid dental treatment and therefore have a higher degree of dental disease. Good dental health results in part from regular check-up and hygiene visits. The longer these visits are put off, the more plaque and tartar build up on our teeth and this results in more bacteria living around our teeth and gums. This leads to tooth decay (cavities) and gum disease (gingivitis and/or periodontitis).
So what can dentists do today to minimize dental phobia? There are a whole range of stress reduction techniques, some which require special training, and others that do not. Simple traits such as compassion and empathy and techniques of practice such as minimizing waiting, going slowly and explaining the unknown will go a long way in alleviating anxiety. There are dental offices that offer distractions such as television, music and even virtual reality glasses. Anything to take one's mind to a place other than the present. A few dentists even practice hypnosis. Some people have fears so deep that more is needed to allow them to even enter a dental office. This is where pharmacology comes in handy. Many dentists will prescribe an oral sedative to be taken half an hour before the appointment. An alternative to this is to use a mixture of nitrous oxide and oxygen gases (known as laughing gas) as a sedative. Both of these alternatives are usually best suited for the mildly anxious patient and will likely not alleviate a moderate or severe phobia. People who have a higher level of anxiety will require a deeper sedative technique to help them through their appointment. To perform these sedative techniques, there are specially trained dentists throughout Canada and the United States. When carried out by trained individuals, intravenous sedation is a very safe and effective means for anxiety relief during dental treatment. If you are dental phobic, ask your dentist to refer you to a dental anaesthesiologist or simply look in the Yellow Pages.
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