The ongoing impact of dental phobia

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  Posted by: Dental Design      27th January 2019

Innovation, evolution and revolution… whatever your specialty, dentistry is an exciting place to be. Trailblazing technology, ingenious techniques and groundbreaking new materials have helped us find successful, stable solutions to problems that would have seemed impossible in the not-so-distant past. The future looks bright too, as research, product development and quality education is set to continue, taking the profession from strength to strength.

As practitioners, you will be constantly inspired by the sheer scope of possibility in dentistry today. There’s always more that can be done. But it is essential that you never stop looking from the outside in and from the unique perspectives of your patients. With their sleek interiors and extensive menus of treatment options to improve oral health, function and aesthetics, many modern practices have an almost spa-like appearance. But the fact remains that few people actually enjoy going to the dentist.

Dental anxiety is a constant challenge and something that most practitioners will encounter every day. Its impact must never be overlooked. The last Adult Dental Health Survey included statistics on dental anxiety for the first time (it was not assessed in previous versions of the Survey). The Modified Dental Anxiety Scale (MDAS) was the tool used to ascertain levels of anxiety. The MDAS asked people to report on fears associated with anaesthesia, as well as anticipated anxiety in four common scenarios; going to the dentist tomorrow, sitting in a dentist’s waiting room, having a tooth drilled and having a scale and polish.[i]It found that 36 per cent of the adults questioned had a MDAS score between 10 and 18, indicating moderate anxiety, and a further 12 per cent scored 19 or over, indicating extreme dental anxiety.

So, a third of adults reported moderate anxiety; this is an important point and underlines the complexity of the issue. There are different triggers and levels of fear; someone who does not normally get afraid may suddenly feel their bravado vanish if they are told they need endodontic treatment or restorative work. Many patients will have past experiences that instinctively come to the fore if they find themselves facing a process that they believe will be invasive and/or painful. The sound of the drill, the uncomfortable chair and being leaned over by a masked dentist in unsettlingly close proximity – modern spa-like practices don’t stand a chance against powerful memories.

Moderate dental anxiety is a reason to delay or cancel an appointment, or leave the practice without committing to treatment. It’s never going away, either, which is why the profession must endeavourto understand it and look for ways to make every patient’s experience as comfortable and positive as possible.

Where to start? Good communication is essential. This should begin from the minute a patient walks into (or calls up) the practice; every individual should be treated with respect and empathy. All staff must be able to talk with authority and listen carefully, and if they are unable to answer a question, they should refer the patient promptly to someone who can.

It’s about reassuring someone that if they say “yes”, nothing bad is going to happen. In fact, the treatment that you are recommending is the gateway to better oral and general health, and often mental wellbeing too. Being able to restore the integrity of a tooth that is damaged or missing will not only improve mechanical function, but also revive self-esteem. As practitioners, you can allay anxiety by helping patients fully understand the procedure, assure them of your competence and address any concerns so they feel informed, involved and empowered. You can also reassure them that you are committed to using the very best materials designed to allow you to perform these treatments effectively, efficiently and ethically. For example, resin composites have allowed clinicians to place aesthetically pleasing and conservative restorations. COLTENE provides restorative materials that are easy to use and provide a quick, stable treatment process for the anxious patient. The range includes the BRILLIANT EverGlow® for anterior and posterior restorations, and Fill-Up!dual curing bulk fill composite for Class I and Class II cavities.Practitioners need full confidence in their materials giving them a high-quality result; satisfied patients are a practice’s most powerful marketing tool.   

Despite the fantastic developments in dentistry, it’s important to remember that the more things change, the more they stay the same. Many patients will be fearful or anxious, which means that they may say “no” to treatment that could change their life for the better. The profession won’t ever cure dental anxiety, but it can put together the right elements to encourage patients to accept recommendations and give them a positive experience. Exceptional dentistry is based on a foundation of communication, with every patient trusting you to use your skills and experience alongside the very best products for consistently high-quality, long-lasting results.


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[i]Adult Dental Health Survey 2009. The Health and Social Care Information Centre, 2011. Theme 8, Barriers and Access to Care. Link: July 2018).

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