20 June 2018
Dental patients with phobia and anxiety may receive reduced treatment
A study from the King’s College London Dental Institute has found that dental patients suffering phobias, who constitute over 11% of the population[i], not only experience poorer oral health, but also may receive only basic dental care. It is understood that greater dental anxiety is associated with more decayed, missing and fewer filled teeth. The study, Survey of treatment policies under conscious sedation at centres dealing with people with high levels of dental anxiety across the United Kingdom by Dr Ellie Heidari, Professor Tim Newton and Professor Avijit Banerjee, finds that 11% of the population may not be receiving the complex care they need.
Phobic patients usually only get simple dental treatment, such as amalgam and tooth coloured filling, scaling and extractions. More complex dental treatments, such as molar endodontic, crowns and bridges and implant replacement of missing teeth, are either never provided or referred to a specialist clinic.
People with dental phobia are more likely to present with advanced disease when they finally visit the dentist; this factor and certain healthcare policies and lack of funding might limit dental treatment options for this group. There is also an inconsistency of provision of conscious sedation (CS) services available for people with dental phobia, which can lead to limited access and difficulty in addressing these patients' needs.
Study recommends psychological therapies such as Cognitive Behavioural Therapy, which have the potential to enable individuals to overcome their dental phobia and attend primary care where they will have access to a fuller range of dental treatments.
Time, training and support for dentists to provide certain aspects of complex care for patients under conscious sedation is also a possible solution.
Survey of treatment policies under conscious sedation at centres dealing with people with high levels of dental anxiety across the United Kingdom by E. Heidari, T. Newton and A. Banerjee, published in the British Dental Journal on Friday 27 April, 2018, https://www.nature.com/articles/sj.bdj.2018.265.