Pain and anxiety in dental care

Pain and anxiety management is a very important part of many medical procedures, such as those that take place in dentistry and pediatric dentistry.

Dental anxiety and phobia is a reality

Carrying out dental treatment in children or adults who are anxious, phobic or in a situation of disability continues to be a difficult task, sometimes even impossible for the dental professional. Such patients are often perceived as difficult and disruptive, causing the dental practice to run late, angering other patients, and increasing occupational stress for the dentist.

Fear of the dentist is a problem with negative implications for the physical health and quality of life of those who present it. Dental patients who experience a higher level of anxiety will tend to have a greater pain response. The quality of treatments and the humanization of healthcare depend to a certain extent on the way in which professionals are prepared to manage pain and anxiety with their patients.

40 % of Canadians

Worry about the potential pain and discomfort that they may encounter during regular hygiene appointments or more complex dental work.1,2

The role of fear and anxiety in dental care

The fear of going to the dentist may lead many people to ignore the need for regular check-ups. The pathologies that could be detected at an early stage are neglected and the patients end up going to the clinic when pain prevents them from carrying out their normal life. Given the advanced nature of the case, the dental treatment patients will have to receive is often more complex, long and expensive.

Knowing how to properly treat a patient who is afraid of the dentist is a skill that every dentist should master. The ability to manage fear and anxiety can help patients in the long term, avoiding the need for long or complex dental treatments.

Pharmacologic management

Sedation can be an effective way to calm a patient’s stress and anxiety during dental work and can make the procedure more comfortable for everyone involved.

Patients who experience mild to moderate fear or anxiety will do well with mild to moderate conscious sedation. Benzodiazepines, nitrous oxide with oxygen, or a combination of the two can all be easily administered orally to produce a minimal level of sedation. The administration of several sedative drugs, either alone or in combination with nitrous oxide and oxygen, or the parenteral administration of a sedative drug, can both result in moderate sedation.

Treatment delivered under deep sedation or general anaesthesia would be more appropriate for patients with a significant fear or phobia. In these situations, the dentistry will be performed while the patient is sedated due to a drug. This treatment will be carried out safely and successfully if you work with a qualified medical or dental anesthesiologist.

References

1 Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23(4):295-301. doi: 10.1159/000357223. Epub 2013 Dec 20. PMID: 24356305; PMCID: PMC5586885.

2 Hensley  L. (2019, August 24). Why some people are afraid of the dentist. Global News.

McMaster R, Garisto G. (2012, February 1). Practical Considerations for Treating the Anxious Dental Patient. Oral Health.

 

 

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