More than 50% of people say they are anxious about dental appointments, but almost 12% have such high levels of anxiety, it can be classed as a phobia, reports the Faculty of Dentistry, Oral & Craniofacial Sciences at King’s College London. Those with dental phobia also often will avoid dental visits unless they face some kind of oral health emergency.
Avoiding these visits can exasperate their situations, as the school reports that those with dental phobia commonly have poorer oral health and higher rates of tooth decay. The oral health of those who do eventually visit the dentist can be so extreme that the only course of action might be to extract the tooth, leaving them with fewer healthy teeth.
Researchers at the school, then, set out to test whether the presence of dental phobia affects the proposed care plan, compared to similar non-phobic patients. As phobic patients commonly have poorer oral health, the researchers wanted to know if dentists take those fears into consideration in preparing a care plan.
The researchers invited 79 dental practitioners to create a treatment plan for an imaginary patient with simple or complex treatment needs. Each case had the option of a phobic and a non-phobic patient. Dependent variables included frequency of care planning elements, such as periodontal treatment, prevention, restorations, root canal treatment, extractions, and provision of crowns, bridges, and prostheses.
The practitioners offered a more complex treatment plan for the complex conditions. The plans were influenced by patients’ dental needs and not the presence or absence of dental phobia. This shows that while dentists’ attitudes towards phobic patients aren’t a barrier for receiving the best possible care, the researchers said, it is still important to consider anxiety and its management in the plan to ensure the best possible care options are available.
“In order to deliver dental care for people with dental phobia, it is important to adapt an approach where prevention of oral diseases and preservation of teeth when possible is provided as part of dental care plans,” said Ellie Heidari, DDS, leader of the study.
“Another important component in their care would be to address dental phobia by providing them with an opportunity to access cognitive behavioral therapy. This is a therapy that has been proven to be very successful,” said Heidari.
“Those with dental phobia are experiencing both the enormous challenges of living with their fear and of having poorer oral health. It is gratifying to see that for the dental team, the presence of a phobia is not perceived to be a barrier to complex restorative or preventive approaches,” said Tim Newton, PhD, professor of psychology as applied to dentistry.
“We hope to be able to ensure that not only do people with dental phobia derive the benefits of good oral health but also overcome their fear through the most effective treatment, cognitive behavior therapy,” Newton said.
The study, “The Impact of Dental Phobia on Care Planning: A Vignette Study,” was published by the British Dental Journal.
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