Programs for the Treatment of Dental Disorders

Abstract

Surveys indicate that 4{%}-10{%} of the adult population avoid dental treatment because of extreme fears, and probably an even larger percentage (up to 25{%}) avoid dental treatment except when they are symptomatic (Ayer {&} Corah, 1984). Extreme dental fears were reported in 23{%} of 14- to 21-year-olds, and there is a continuing reduction in fear with age. Dentists are generally inconsistent in their approach to dealing with anxious patients. Corah (1988) reported that three quarters of the dentists surveyed felt that patient anxiety was the greatest barrier to regular dental care. Very few dentists, however, ask the patient whether he or she is anxious. They are afraid that the question will suggest that there is something to be anxious about. Many dentists admit that they themselves become anxious if they deal with anxious patients. Dentists need to know both how to recognize patient anxiety and what to do about it. The first part of this chapter reviews the etiology of dental anxiety and indicates how it can be measured in child and adult patients. Strategies for reducing patient anxiety are provided in terms of the treatment of patients by psychologists and the education of dentists in behavior management strategies for preventing dental phobia. The second part of the chapter deals with temporomandibular disorder (TMD), a pain syndrome increasingly recognized as being influenced by psychological factors.