How Can You Turn Dental Fears Into a Productive Dentist-Patient Relationship?      

DATE: Dec 20, 2018
AUTHOR: Natalie Bradley BDS DCSD MFDS RCSEd 

Patients who suffer from a dental fear or dental phobia may avoid going to the dentist. The resulting sporadic attendance and difficulty trusting dental staff may lead to untreated dental problems. Forging a strong dentist-patient relationship with a fearful or phobic patient can be challenging, but it's worth the time and effort to make sure every patient has access to care.

How Can Dentists Establish Trust?

Many of us have mild to intense fears about objects or situations, which is perfectly normal. In order to address dental fear, dentists need to recognize the problem, acknowledge it and take it seriously. Treating someone with dental fear requires more sensitivity than treating someone who is simply nervous. Dismissing a patient's fear will discourage them from seeking treatment and make it difficult to form a trusting dentist-patient relationship.

If you discover one of your patients is anxious or fearful, find out more about their apprehension. Ask if there are specific aspects of dental appointments that make them particularly anxious, such as needles or drills. Do not rush an apprehensive patient. Their appointments may be longer than average, but letting conversations and procedures progress at a pace they can handle is essential to helping patients overcome their trepidation.

How Can You Help Your Patients Overcome Their Fear?

What steps can be carried out to reduce patients' fears? The steps will differ depending on the patient. Some treatment adjustments I've made to help patients cope include:

  • Finding out if they want to know all the details of what is going on, or if they can't bear to hear a procedure described. You can tailor your approach accordingly.
  • Using the tell-show-do method to describe procedures: Tell the patient what you are about to do, show them the tools and supplies involved and proceed only when they understand. For patients with a fear of the unknown, explaining exactly what will happen may help them stay calm.
  • Adopting behavior management techniques, such as breathing exercises, to help them relax. Listening to music during treatment may help some patients tune out the noises of dental equipment. Establish a stop signal like waving a hand so the patient can feel in control during treatment.
  • Offering to allow a patient's friend or relative to remain in the room to support them during appointments.

Get your whole dental team on board to help out! Your practice staff should all be aware of patient fears and how to address them. A friendly face at the reception desk or an assistant holding a patient's hand can work wonders.

How Should You Address a Fear of Pain or Instruments?

For specific fears, you may need to develop specific adaptations. You could address a fear of needles, for example, by using a topical anesthetic before injecting a local anesthetic, and positioning your body so that the patient does not see the needle as you are going to give the injection. Manual excavation of a carious lesion could be a welcome solution for a patient with a fear of drilling.

Patients with a fear of pain may also be suffering from dentin sensitivity. Some patients can't cope with the sensation of ultrasonic scaling instruments, particularly if they have gingival recession. I often use hand scalers in these cases. You can also recommend an at-home switch to a toothpaste like Colgate Sensitive Complete Protection that provides 24/7 sensitivity protection with continued use.

When Does a Fear Become a Phobia?

Dental fears verge on phobias when they begin to inhibit a person's ability to seek treatment. According to the U.K. mental health organization Mind, "A phobia is a type of anxiety disorder. It is an extreme form of fear or anxiety triggered ... even when there is no danger." The trigger for a phobia could be an item, like snakes or spiders, or a situation, like going to the dentist. A person with a phobia may feel overwhelmed simply by talking or thinking about their fear.

A fear becomes a phobia if:

  • The fear is out of proportion to the danger.
  • It lasts for longer than six months.
  • It has a significant impact on how you live your day-to-day life.

Extremely phobic patients may need special accommodations or medication to be able to undergo treatment. Not all phobias can be conquered, and some patients might need more help than a dentist can provide. If you notice that a patient's phobia is causing them to avoid care, offer to refer them to a mental health professional or doctor.

Ultimately, if you can help a person overcome their dental fear or phobia, you can empower them to pursue whole mouth health for life. Take the time to ask your patients about their concerns and show that you are worthy of their trust.