Management of pain and anxiety

2018 ◽  
Author(s):  
M.T. Hosey ◽  
G.J. Roberts
Keyword(s):  
Dental Treatment ◽  
Dental Anxiety ◽  
Strong Relationship ◽  
Older Children ◽  
Behaviour Management ◽  
General Anxiety ◽  
Anxiety Control ◽  
Operative Care ◽  
Fear And Anxiety ◽  
Good Behaviour

Pain and anxiety are natural physiological and psychological responses. Pain is a direct response to an adverse stimulus that has occurred; anxiety is the unpleasant feeling, the worry that something unpleasant might occur. Pain and anxiety are often intertwined, especially in the dental setting. The best way to manage child dental anxiety is to avoid its occurrence in the first place through prevention of dental disease, good behaviour management, pain-free operative care, and treatment planning that is tailored to the needs and developmental stage of each individual child. These issues are detailed in the previous chapters. This chapter specifically focuses on pharmacological pain and anxiety control and explores the roles of conscious sedation and general anaesthesia (GA) as adjuncts to behaviour management. A child’s perception of pain is subjective and varies widely, particularly with age. Infants up to about 2 years of age are believed to be unable to distinguish between pressure and pain. Older children begin to have some understanding of ‘hurt’ and begin to distinguish it from pressure or ‘a heavy push’. It is not always possible to identify which children are amenable to explanation and will respond by being cooperative when challenged with local anaesthesia (LA) and dental treatment in the form of drilling or extractions. Children over 10 years of age are much more likely to be able to think abstractly and participate more actively in the decision to use LA, sedation, or GA. As children enter their teenage years they are rapidly becoming more and more like adults and are able to determine more directly, sometimes emphatically, whether or not a particular method of pain control will be used. The response is further determined by the child’s coping ability influenced by family values, level of general anxiety and intelligence. There is a strong relationship between the perception of pain experienced and the degree of anxiety perceived by the patient. Painful procedures cause fear and anxiety; fear and anxiety intensify pain. This circle of cause and effect is central to the management of all patients. Good behaviour management reduces anxiety, which in turn reduces the perceived intensity of pain, which further reduces the experience of anxiety.

scholarly journals Association Between Dental Fear and Anxiety and Behavior Amongst Children During Their Dental Visit

2019 ◽  
Vol 12 (2) ◽  
pp. 907-913
Author(s):  
Arshia Ummat ◽  
Sreejeeta Dey ◽  
P. Anupama Nayak ◽  
Nitin Joseph ◽  
Ashwin Rao ◽  
...  
Keyword(s):  
Rating Scale ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Dental Fear ◽  
Dental Visit ◽  
Behaviour Management ◽  
Management Problems ◽  
Child Patient ◽  
Behaviour Rating ◽  
Fear And Anxiety

Dental fear and anxiety (DFA) serves as significant problem in child patient management as it leads to greater prevalence and increased severity of the disease associated with delayed dental visits. Therefore, it is necessary to effectively predict children dental behaviour and identify children at risk of Behaviour Management problems. Study of factors influencing DFA and its association with behaviour in children during first dental visit. The study included 209 children (5-14 years). DFA levels were assessed using 3 standardised questionnaires i.e. Facial Image Scale (FIS), Dental Anxiety Scale (DAS), Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS). The behaviour of the child was then assessed using Frankl’s Behaviour Rating Scale (FBRS). The data were analysed, and a correlation was established between DFA and behaviour using statistical analysis. Presence of DFA according to FIS is 13.4%, according to DAS is 15.2% and according to CFSS-DS is 17.7%. Maximum participants showed positive behaviour (81.8%) according to FBRS. Factors causing maximum Dental anxiety according to DAS was anticipation of treatment (26.30%) and factor which caused maximum dental fear according to CFSS-DS was injections (45.4%). There is association between DFA and behaviour in children during first dental visit. This study will help assess the factors which lead to dental fear and anxiety in children and also find a correlation between dental fear and anxiety and behaviour management problems which can help the Paedodontist to predict various behaviour management problems and to avoid the factors which lead to them before the initiation of the dental treatment. This can lead to a decrease in the fear and anxiety levels of children which will further lead to better treatment and in turn better case management.

scholarly journals The relationship between dental anxiety and other kinds of anxiety: a naturalistic, cross-sectional and comparative study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Juan Valdes-Stauber ◽  
Kevin Hummel
Keyword(s):  
Self Efficacy ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Negative Evaluation ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Dental Surgery ◽  
Positive Correlation ◽  
General Anxiety ◽  
Anxiety Control

Abstract Background Dental anxiety is of public health importance because it leads to postponed dental treatment, which comes with health complications. The present study investigated whether there is a correlation between the degree of dental anxiety and other kinds of anxiety and whether there are prognostic factors for the different kinds of anxiety. Method In the sample (N = 156) from a dental practice in a large German city, 62% of patients received a check-examination and 38% received dental surgery. The target variables were recorded with validated questionnaires: dental anxiety (IDAF-4c+), subclinical anxiety (SubA), anxiety of negative evaluation (SANB-5), current general anxiety (STAI state), loneliness (LS-S) and self-efficacy (GSW-6). The applied statistics were: t-tests for 31 variables, correlation matrix and multivariate and bivariate regression analyses. Results The dental surgery patients displayed more dental anxiety and more dental interventions than the check-examination group. The main result was a positive correlation of all kinds of anxiety with each other, a positive correlation of loneliness and neuroticism with all forms of anxiety and a negative correlation between all forms of anxiety and self-efficacy. Especially dental anxiety is positively associated with other kinds of anxiety. In multivariate regression models only neuroticism is associated with dental anxiety, but feelings of loneliness are positively associated with with the other kinds of anxiety assessed in this study. The higher the self-efficacy, the lower the level of general anxiety. Conclusions In dentistry, anxiety from negative experiences with buccal interventions should be distinguished from anxiety caused by personality traits. Self-efficacy tends to protect against anxiety, while loneliness and neuroticism are direct or indirect risk factors for anxiety in this urban dentistry sample. Dental anxiety seems to be independent from biographical strains but not from neuroticism. In practice, more attention must be paid to anxiety control, self-management and efforts to improve the confidence of patients with emotional lability, less self-confidence and propensity to shame.

scholarly journals Dental fear and anxiety in older children: an association with parental dental anxiety and effective pain coping strategies

2014 ◽  
pp. 515 ◽  
Author(s):  
Livia Puljak ◽  
Anka Coric ◽  
Adriana Banozic ◽  
Miro Klaric ◽  
Katarina Vukojevic
Keyword(s):  
Coping Strategies ◽  
Dental Anxiety ◽  
Dental Fear ◽  
Pain Coping ◽  
Older Children ◽  
Fear And Anxiety

scholarly journals Awareness on Smoking and Alcohol Use and Its Association With Increased Levels of Dental Fear and Anxiety - A Survey Among Dental College Students

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 614-622
Author(s):  
Harini P ◽  
Keerthi Sasanka L ◽  
Jothi Priya A
Keyword(s):  
Oral Health ◽  
Alcohol Use ◽  
Ordinal Data ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Age Groups ◽  
Dental Fear ◽  
Lifestyle Modifications ◽  
Dental Practitioners ◽  
Fear And Anxiety

Lifestyle modifications, work pressure, stress may lead to adverse habits like smoking, drinking and tobacco chewing. These habits may lead to poor oral health. Not only poor oral health may also lead to dental fear and dental anxiety. Self-administered questionnaires were designed based on knowledge, attitude and practice. The questionnaire was distributed through an online platform. The study population included people belonging to the age group of 18-24 age groups. The participants were explained about the purpose of the study in detail. The questions were carefully studied and the participants marked the corresponding answers. The data were collected and statistically analysed using SPSS software. Results were collected as an ordinal data and reported that smoking and alcohol causes increased dental fear which leads to poor oral health and some anxiety management techniques should be employed by dental practitioners to make the procedures in a simple way. For a satisfactory dental treatment and good oral health status, the state of mind of the patient is very important and it is influenced by many factors, including smoking and alcohol use. The aim of the study is to evaluate whether students are aware that the increased level of dental fear and anxiety is associated with smoking and alcohol use.

Dental Anxiety, Fear and Anxiety of Performing Dental Treatments among Dental Students during Clinical Studies

2020 ◽  
Vol 44 (6) ◽  
pp. 407-411
Author(s):  
Sigalit Blumer ◽  
Benjamin Peretz ◽  
Native Yukler ◽  
Sagit Nissan
Keyword(s):  
Dental Treatment ◽  
Dental Anxiety ◽  
Clinical Stage ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Cross Sectional ◽  
Study Population ◽  
Fear And Anxiety ◽  
First Time

Purpose: Dental student’s dental anxiety may negatively affect patient’s attitude towards dental treatment. We evaluated dental anxiety among dental students in different clinical stage of their studies. We assessed the student’s anxiety prior to treating patients. Study design: A cross-sectional study. Fourth to sixth-year dental students completed questionnaires containing: 1) Dental Anxiety Scale (DAS); 2) Dental Fear Survey (DFS); and 3) visual analogue scale questions relating to the student’s anxiety when performing dental treatments in children and adults. Results: 124 dental students completed the questionnaires (mean age, 26.4±3.1 years, 59.7% women). Average DAS in the study population was 7.55±2.15 with similar scores observed across the years. Average DFS score was highest among fourth-year students (1.62±0.65) and lowest among sixth year students (1.36±0.32). DFS scores decreased as the students progressed through the clinical years (p=0.059). The students’ average anxiety scores prior to treating children were significantly higher than the anxiety scores prior to treating adults (3.82±2.42 vs. 2.67±1.9, p<0.001). Fifth-year students had significantly higher anxiety scores prior to treating children and adults compared to fourth and sixth-year students. Conclusion: Dental anxiety among dental students is relatively low and decreases gradually as they progress through the clinical years. Anxiety prior to treating patients, particularly children, is at its highest just before starting to treat patients for the first time. As dental students are future healthcare providers, it is important that they learn techniques to help them manage their own dental anxiety and fear as well as deal with anxiety related to treating patients.

scholarly journals Epidemiological Survey of Dental Fear and Anxiety in Children Living in Transylvania

2014 ◽  
Vol 60 (4) ◽  
pp. 151-156
Author(s):  
Réka Gyergyay ◽  
Melinda Székely ◽  
Krisztina Mártha
Keyword(s):  
Dental Treatment ◽  
Pearson Correlation ◽  
Dental Anxiety ◽  
Epidemiological Survey ◽  
Dental Fear ◽  
T Test ◽  
Cross Sectional ◽  
Dental Practitioners ◽  
Fear And Anxiety ◽  
One Way Anova

Abstract Aims The objectives of the present survey were: 1) a systematic epidemiological investigation of dental fear and anxiety among children living in the central part of Romania and 2) to identify the most fearful aspects of dental care perceived by these children. Methods In this cross-sectional study 406 schoolchildren, 170 males and 263 females, aged 11-18 yearsfrom two cities, Tirgu Mureş and Sfintu Gheorghe were assessed. The subjects’ dental fear was evaluated with the Romanian versions of Corah’s Dental Anxiety Scale (MDAS) and Kleinknecht’s Dental Fear Survey (DFS), the anxiety level with Spielberger`s State and Trait Anxiety Inventory (STAI-S, STAI-T) and their opinion about dentists with Getz’s Dental Beliefs Scale (DBS). Questionnaires were completed anonymously at school. The study was approved by theResearch Ethics Committeeof the University of Medicine and Pharmacy Tirgu Mureş. For statistical analysis t-test, one-way ANOVA and Pearson’s correlation test were used by SPSS/PC statistics v. 17.0. Results The mean (±SD) scores of the surveyed subjects (mean age 15.69±2.06 years) were high: MDAS 10.65 (±4.5), DFS 38.68 (±15.1), DBS 36.93 (±11.9), STAI-S 37.90 (±10.9) and STAI-T 41.04 (±9.9), respectively. There was a strong positive Pearson-correlation between MDAS and DFS scores (r=0.73; p≤0.01) and a somewhat lower correlation between these scales and the general anxiety scores. Except for DBS, statistically significantly higher scores were found in females for every questionnaire (t-test, p≤0.05). The 11-year-old group presented the lowest scores in every case, while the peak was around 14 years. Age was a statistically significant factor only in case of DBS, STAI-S and STAI-T (one-way ANOVA, p<0.05). Drilling and injection were considered the most fearful moments of a dental treatment. Subjects claimed dental practitioners working under time pressure and communication deficiencies. Conclusions Having their special features, our findings were consistent with the local and international data. The subjects claim lack of time and communication deficiencies with the dentists. Identifying the reasons of dental fear and anxiety, might lead to solutions of avoidance or control.

scholarly journals Experience of Intravenous Sedation Increases Incidence of Caries in Patients With Dental Anxiety

2021 ◽  
Author(s):  
Hanako Kawasaki ◽  
Naomi Tanoue ◽  
Terumi Ayuse ◽  
Shinji Kurata ◽  
Ichiro Okayasu ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Dental Anxiety ◽  
Influential Factors ◽  
Treatment Discontinuation ◽  
Study Patient ◽  
Intravenous Sedation ◽  
Duration Of Treatment ◽  
Before And After ◽  
Dmft Index ◽  
Fear And Anxiety

Abstract ObjectivesThe aim of this study was to investigate the factors that influence the decayed, missing due to caries, and filled teeth (DMFT) index of patients with dental anxiety during dental treatment discontinuation.Materials and MethodsA total of 110 patients who complained of fear and anxiety toward dental treatments and who re-visited following treatment discontinuation were enrolled in the study. Patient and dental data considered to be related to caries were digitally collected from medical and dental records. The decayed (D), missing (M), and filled (F) scores, and the DMFT index before and after discontinuation were compared using Wilcoxon signed-rank tests, and the influential factors were evaluated using the Poisson and multiple regression analyses.ResultsThe D score and DMFT index increased significantly during the discontinuation period, and the F score decreased. There was no significant change in the M score. The change in the D score was influenced by the pre-discontinuation D score and the number of experiences of intravenous sedation, and the change in the F score was affected by the duration of treatment discontinuation, the DMFT index before discontinuation, and the number of experiences of intravenous sedation. The increase in the DMFT index was affected by the experience of intravenous sedation, the D and M scores, and the DMFT index before discontinuation.ConclusionDiscontinuation of dental treatment was proven to increase the incidence of caries in patients with dental anxiety.Clinical Relevance: Avoiding treatment discontinuation is crucial, particularly in patients treated using intravenous sedation.

scholarly journals Avaliação e manejo da ansiedade e fobia odontológica: a psicologia na formação do cirurgião-dentista

2020 ◽  
Vol 61 (2) ◽  
pp. 80-94
Author(s):  
Guilherme Borsato Gomes ◽  
Cecília Luiz Pereira Stabile ◽  
Vanessa Santiago Ximenes
Keyword(s):  
Oral Health ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Health Condition ◽  
Traumatic Experiences ◽  
Vicious Cycle ◽  
Delayed Treatment ◽  
Use Of Resources ◽  
Dental Professional ◽  
Fear And Anxiety

Dental fear and anxiety arise from several factors, among them, exposure to previous traumatic experiences with needles, injections and instruments that can cause discomfort. Anxious patients tend to reschedule appointments, avoid treatments and are only available for visits at the dentist when painful symptoms appear, so delayed treatment tends to be more invasive and cause even more emotional damage to the patient, consequently aggravate this feeling and, in turn, create a vicious cycle in which avoiding treatment only makes the oral health condition even worse. It is up to professionals of Dentistry to identify anxiety in patients and make use of resources to manage this anxiety in order to enable an effective dental treatment with less emotional damage to the patient. The aim of this study is to evaluate, by means of a integrative literature review, the importance of the study of Psychology by the dental professional and to expose the techniques for coping with dental anxiety, based on scientific evidences.

scholarly journals Influence of parental anxiety on children’s behaviour during their visits to dental clinic: a short clinical study

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Lakshmi Thribhuvanan ◽  
M. S. Saravanakumar ◽  
G. Anjana
Keyword(s):  
Clinical Study ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Parental Anxiety ◽  
Dental Clinics ◽  
Physiologic Parameters ◽  
Anxiety Levels ◽  
Children’S Behaviour ◽  
Fear And Anxiety ◽  
Children’S Dental Anxiety

Abstract Background Anxiety and fear of dental treatment in children have been recognized as sources of serious health problems. Parents are known to subtly transmit feelings of fear and anxiety to their children Commonly which has influence on children’s dental anxiety are maintenance of general health of the child, past dental history, oral hygiene practices and attitudes in the family towards oral health and high dental anxiety of parents, all of these contributed to sustained and elevated levels of children’s dental anxiety. Aim This study was undertaken to evaluate the influence of parental anxiety on their children during their visit to dental clinics. Objective To determine the relationship between parental anxiety level and that of a child. Methods A short clinical study was performed to assess the influence of parental anxiety on their children during their visit to dental clinics. Twenty subjects were randomly selected and their parents were given the Modified Dental Anxiety Scale Questionnaire (MDAS) and their physiologic parameters were measured during each visit. Similarly, the children’s responses were analyzed using the Facial Image Scale (FIS) and their physiologic parameters were measured. Results The values show a positive correlation (P < 0.05) between the scores (MDAS and FIS) and physiologic parameters (blood pressure and heart rate) of parents and their children. Conclusion The dental anxiety levels in parents influence the anxiety levels in children.

scholarly journals A influência do comportamento parental na adaptação da criança ao atendimento odontológico

2020 ◽  
Vol 11 (2) ◽  
pp. 216
Author(s):  
Roberta Ferreira Silva ◽  
Iza Alves Peixoto
Keyword(s):  
Literature Review ◽  
Dental Care ◽  
Parental Influence ◽  
Dental Treatment ◽  
Parental Behavior ◽  
Dental Anxiety ◽  
Pediatric Dentistry ◽  
The Face ◽  
Anxious Behavior ◽  
Fear And Anxiety

The influence of parental anxiety on children produces aversive stimulus through negative personal reports, sometimes frightening, about traumatic dental treatments, fear produced by parents through verbal threats, in other words, the visit to the dentist cited as a threat, or as form of punishment. This assignment aims to understand, through bibliographical research and literature review, the influence of behavioral patterns of parents or guardians and it’s reflection on the accommodation and adaptation of the child to dental treatment. Thus, the specific objectives are: 1) to understand the influence of parental behavior on the infant patient in the face of dental care; 2) talk about the factors that can impact the levels of anxiety of the infant patient in the face of dental consultation or treatment. The literature review was made based on the search of scientific articles published in national and international journals, such as PubMed, Scielo, BVS, and bibliographic researches. The descriptors used as search parameters were anxiety, behavior, parental influence, pediatric dentistry and treatment.  The articles were selected through the analysis of the summaries, which had as main subject the factors associated with dental anxiety and dental care. It’s expected to understand the external factors that cause fear and anxiety behaviors in the children as a patient, including the family's own anxious behavior and the dysfunctional patterns that affects the evolution of dental treatment, as well as the techniques and methods of reception and accommodation used by professionals  pediatric dentistry, in order to enable the hypothesis for possible interventions.

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