For patients needing endodontic treatment, patients experiencing stress and fear in anticipation of their treatments, evoking dental phobia, a common phobia, can leave people panic-stricken and terrified of the dental setting. For those with this condition or dental anxiety, these unrecognizable amounts of fear and apprehension require a significant amount of consideration and care when handling dental visits and treatments. Dental anxiety and dental phobia are highly relevant, and as endodontists, our careers involve more than just handling teeth. Our dental care also revolves around the patient themselves, helping them by understanding their conditions on a deeper level and treating them effectively.
The Origins of Dental Anxiety and Dental Phobia
Dental anxiety is an incredibly common condition, causing feelings of unease, stress, and apprehension, and this condition affects everyone differently. However, dental anxiety does not directly cause postponement of appointments, and dental phobia exists on the more severe spectrum of fears, causing complete feelings of terror in a dental setting leading to avoidance, irrationality, and regular sensations of panic. Both of these conditions create cycles of fear and shame when it comes to dental health, and both of these conditions result from psychological conditioning. When referring to these forms of conditions, they include:
- Direct Conditioning: Direct conditioning refers to the negative or traumatic experience that contributes to the dental anxiety of dental phobia. This form of conditioning directly correlates the experiences of fear and panic with memories associated with previous visits while at the dentist.
- Indirect Conditioning: Indirect conditioning refers to the process of second-hand information influencing a person’s fears and perceptions of their dental experiences. Most often, negative depictions, previous experiences from friends and family, and other outside sources ultimately create a form of indirect conditioning that causes dental anxiety or dental phobia.
One common idea is that patients with these conditions often associated with the dentist are anticipated pain. For younger patients with these conditions, they can experience higher levels of pain because of the anticipation versus experienced pain in comparison to older adults. Another aspect of this is their greater vulnerability to negative emotions and thought patterns that could worsen the effects of these conditions and even lead to physical reactions to these associated fears. These physical reactions, including higher heart rates, stress levels, and higher blood pressure, can occur before and during the appointment. Through this combination of both physical and psychological effects, it results in avoidance, one of the biggest problems often faced in the dental industry when it comes to caring for patients’ oral health.
With these conditions in mind, it’s essential to understand these sensitivities with dental treatments and take a considerable amount of effort to work with the patient’s fears and anxieties in order to create a more compassionate and positive experience. For endodontists, this aspect of care is particularly important, as complex tooth cases can often be encountered with these conditions and ultimately affect how appointments move forward.
How Endodontists Help Patients With Dental Phobia
When endodontists are faced with patients who have some form of dental anxiety or dental phobia, this often results in their treatments needing to be tailored to their patient’s needs. However, customizing this experience involves a complete set of protocols and techniques to be able to assess their medical history and provide management clinically. In cases where these conditions are present, management techniques can help provide some form of intervention before and during appointments, which include:
- Building Reputation: Patients needing ease and peace of mind related to their conditions can be relieved by providing qualifications and establishing a friendly, professional relationship.
- Desensitizing Scenarios: During appointments, working with desensitization techniques can help during stressful moments and reduce the effects of dental anxiety.
- Soothing Techniques: Other methods can include music, videos, and even virtual reality headsets to reduce stress and provide distractions for the patients during treatment.
- Autonomy and Control: Reassuring patients by providing them with a sense of control can help ease their moments of fear and potential panic during treatments.
- Increasing Information: Most of all, explaining the procedures used, giving their patients descriptive details related to their pain and methods, and other pieces of information can help remove these fears over time.
However, for those with severe dental phobia, patients under these conditions can also opt for other medical interventions and treatment methods that won’t exasperate the problem. These medical interventions can also be combined with the previously mentioned to create a more integrated approach to patient care, which include:
- Oral Conscious Sedation: Administering medications such as propofol and midazolam can help provide patients with a more relaxed state and help soothe feelings of fear associated with their dental care.
- Nitrous Oxide: This mixture of gases can help relieve the psychological effects of dental phobia and help provide patients with ease of mind.
- Anxiolytics: Some other medications, such as benzodiazepines, can provide anxiety relief and can be administered with IV sedation or taken before a procedure.
- General Anesthesia: Medications such as oxycodone and hydromorphone and can be used as general anesthesia to assist patients and relieve any potential pain during endodontic procedures.
All of these treatments can provide solutions for patients with dental anxiety or dental phobia, and with the goal in mind of helping patients overcome their fears, these methods can provide a sense of relief and comfort during their experience. However, while these solutions can be provided during the moment, the long-term complications of patients with these conditions need to be made more aware of to solve these issues better.
How We Work To Understand These Fears
It’s important to recognize that with each patient comes their own individualized treatment. Individualized treatment matters as it helps assess and further understand the cycles and mindsets that ultimately create these conditions in the first place. The natures of these fears occur as a cycle of dental phobias, oral neglect, and poor dental health and can create more complex endodontic issues for these patients. With this in mind, it takes a comprehensive approach that combines therapeutic care with professional dentistry is what will help patients address these fears more effectively and give them control over their dental care.
