Acta Scientific Clinical Case Reports

Letter to EditorVolume 2 Issue 6

Dentophobia - An Overview and Management

Haritma Nigam1* and Manisha Parpiyani2

1Assistant Professor, Department of Oral Medicine and Radiology, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India
2Intern, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India

*Corresponding Author: Haritma Nigam, Assistant Professor, Department of Oral Medicine and Radiology, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India.

Received: April 19, 2021; Published: May 24, 2021

Citation: Haritma Nigam and Manisha Parpiyani. “Dentophobia - An Overview and Management”. Acta Scientific Clinical Case Reports 2.6 (2021): 35-37.

Abstract

  Dentophobia i.e. dental fear may result into reduced dental care services and we deal with this in our dental offices very often. It is one of the commonest problem which we come across in our dental offices. Henceforward, for such patients appropriate proven rehabilitations should be implemented which can be benefitted for both patients and dentist. The current literature gives an insight view regarding such patients and their management.

Keywords: Dental Fear; Stress; Dentophobia

Introduction

Dentophobia (dental fear) is a “unique phobia with special psychosomatic components that impact on the dental health of the odontophobic persons” [1].

  In our dental practice, procedures involving needles arouse most fear and invasive procedures like subgingival scaling, deep probing, fillings, extractions and root canal are associated with more pain therefore apprehensive patients do not visit the dentist. Such carelessness eventually come out as a bad consequences like poor oral health, dental caries, poor periodontal status therefore more of missed out teeth [2,3].

Henceforth, objective of a dentist should be at diminishing the anxiety and fear as a result of which patients should be positively driven for upcoming dental visits.

The current literature gives an insight overview of the etiology of dental anxiety, approaches to recognize and manage dentophobic entities in dental office.

  Causative factors: Dental fear is considered to be multifactorial in origin.10Some commonest factors may include previous negative or traumatic experience, especially in childhood, indirect learning from anxious family members, provoked by sensory triggers such as sights of needles, noises of drilling, fear of pain, blood-injury, mercury poisoning and radiation exposure [4,5].

Management of dental anxiety

As the etiology for dental anxiety is multifactorial, there is no single therapy for management:

  • Proper assessment of the patient and distinguishing their source and level of tension.
  • Completely informed about the procedure in a simpler, friendly approach.
  • Give moral help and confirmation during the procedure [6].
  • Avoid negative phrasing [7].

Extra approaches to set up an office climate incorporates:

  • Playing charming music.
  • Walls decorated with relaxing banners and pictures.
  • Waiting room tables with a variety of reading options.

Psychotherapeutic management

    1. Behavior-management techniques: To change unwanted behavior through the process of learning. The strategies involved are:
      1. Relaxation techniques: Stress reaction can be reduced by profound breathing and muscle unwinding when practiced routinely.
      2. Guided symbolism: It is a brain body work out, wherein patients are instructed to build up a psychological picture of a lovely, relaxing up experience that deliberately manages their concentration to accomplish unwinding, accordingly lessening nervousness [8].
  • Biofeedback: It is also a brain-body technique. They use instruments to quantify, intensify, and feedback physiological data to the patient being observed.
  1. Acupuncture: It is a simple, inexpensive treatment modality, wherein the illness is treated by embeddings needles at different points on the body, known as needle therapy points [9].
  2. Distraction: Distraction is a useful technique of diverting the patient’s attention from what may be supposed to be an unpleasant procedure by giving patient a short break, visual and auditory distraction, such as background music, television sets, computer games, and 2-D and 3-D video glasses for watching movies [10].
  3. Enhancing control: Telling the patient what to expect and it includes Tell-show-do technique and modelling [11].
  1. Cognitive therapy: Cognitive treatment strategies center around changing and rebuilding the substance of negative perceptions and improve command over the negative contemplations by support, adjusting assumptions, interruption [12].
  1. Pharmacological management: Use of sedation and anesthesia- both local and general, and should be used only in cases where the patients are not able to respond and cooperate well with psychotherapeutic interventions [13].
    1. Conscious sedation: Oral sedation is often used for the management of mild-to-moderate anxiety Example: Benzodiazepines.
    2. Anesthesia
      1. General anesthesia: General sedation is a medication-initiated loss of consciousness during which patients are not arousable, even by excruciating incitement.
      2. Local anesthesia: It induces the absence of sensation in a specific part of the body, causing local insensitivity to pain.
  • Computer-controlled local anesthetic delivery: It alleviates anxiety in needle-phobic. It is a computer-controlled dental injection i.e. computer controls the flow rate of the local anesthesia as traditional syringe appears more dangerous, aggressive and threatening than plastic handpiece [14].
  1. Electronic dental anesthesia: The technique is noninvasive, safe, and well accepted by the patient. In view of the gate control hypothesis of pain it is utilized to create dental sedation by utilizing the guideline of transcutaneous electric nerve incitement [15].

Conclusion

  Dentophobia can obstruct dental care services. The dental specialist ought to speak with the patient and recognize their main origin of fear, with adjuvant utilization of fear scales to empower classification and afterward treatment appropriately. In mild and moderate phobic patients can be oftenly overseen utilizing mental intercessions, and infrequently anxiolytic medications or cognizant sedation might be vital whereas in life-threatening phobic patients most every now and again require joined administration draws near.

Bibliography

  1. Moore R and Birn H. “[Phenomenon of dental fear]”. Tandlaegebladet2 (1990): 34-41.
  2. Van Wijk AJ and Hoogstraten J. “The Fear of Dental Pain questionnaire: construction and validity”. European Journal of Oral Sciences 1 (2003): 12-18.
  3. Seeman K and Molin C. “Psychopathology, feelings of confinement and helplessness in the dental chair, and the relationship to the dentist in patients with disproportionate dental anxiety (DDA)”. Acta Psychiatrica Scandinavica 2 (1976): 81-91.
  4. Oosterink FM., et al. “What are people afraid of during dental treatment? Anxiety-provoking capacity of 67 stimuli characteristic of the dental setting”. European Journal of Oral Sciences 1 (2008): 44-51.
  5. Walsh LJ. “Anxiety prevention: implementing the 4 S principle in conservative dentistry”. Auxiliary5 (2007): 24-26.
  6. Botto RW. “Chairside techniques for reducing dental fear”. In: Mostofsky DI, Forgione AG, Giddon DB, editors. Behavioral Dentistry. Oxford: Blackwell (2006): 115-125.
  7. Corah NL. “Dental anxiety: assessment, reduction and increasing patient satisfaction”. Dental Clinics of North America 4 (1988): 779-790.
  8. Hofmann SG., et al. “The effect of mindfulnessbased therapy on anxiety and depression: a meta-analytic review”. Journal of Consulting and Clinical Psychology 2 (2010): 169-183.
  9. Ernst E and Pittler MH. “The effectiveness of acupuncture in treating acute dental pain: a systemic review”. British Dental Journal 9 (1998): 443-472.
  10. American Academy of Pediatric Dentistry. “Special issue: Proceedings of the conference on behavior management for the pediatric dental patient”. Paediatric Dentistry 2 (2004): 110-183.
  11. Allen KD., et al. “Evaluation of behavior management technology dissemination in pediatric dentistry”. Paediatric Dentistry 2 (1990): 79-82.
  12. Dumitrache MA., et al. “Efficiency of cognitive technique in reducing dental anxiety”. Procedia - Social and Behavioral Sciences 149 (2014): 302-306.
  13. Folayan MO., et al. “Seminars on controversial issues. A review of the pharmacological approach to the management of dental anxiety in children”. International Journal of Paediatric Dentistry 5 (2002): 347-354.
  14. Heaton LJ., et al. “Computerized dental injection fear treatment: a randomized clinical trial”. Journal of Dental Research 7 (2013): S37-S42.
  15. Yap AU and Henry CW. “Electronic and local anesthesia: a clinical comparison for operative procedures”. Quintessence International 8 (1996): 549-553.

Copyright: © 2021 Haritma Nigam and Manisha Parpiyani. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



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