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Do dentists treat people with extreme dental fear (phobia) differently?

In a study recently published in the British Dental Journal, researchers from King’s College London set out to test whether the presence of dental phobia modifies the proposed care plan for a patient, compared to a similar non-phobic patient.

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Dental phobia

Over 50% of the British public claim they are anxious about a visit to the dentist, but almost 12% have such high levels of anxiety, it is classed as a phobia. Those with dental phobia will often avoid a visit to the dentist, unless in an emergency situation.

Avoiding a visit to the dentist can exasperate the situation; those with dental phobia commonly have poorer oral health and higher rates of tooth decay. The oral health of those who do manage to 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. 

In a study recently published in the British Dental Journal, researchers from King’s College London set out to test whether the presence of dental phobia modifies the proposed care plan for a patient, compared to a similar non-phobic patient. As patients with dental phobia commonly have poorer oral health, the team from the Faculty of Dentistry, Oral & Craniofacial Sciences wanted to know if dentists take the patients’ phobia into consideration when preparing a care plan.

To answer these questions the research team devised a study inviting 79 UK based dental practitioners to create a care (treatment) plan for an ‘imaginary’ patient that had simple, or complex treatment needs. Each case had the option of a dental phobic patient and a non-dental phobic patient. Dependent variables included frequency of care planning elements, including periodontal treatment, prevention, restorations, root canal treatment, extractions and provision of crowns, bridges and prostheses.

The results found that dentists offered a more complex treatment plan for the complex conditions. The treatment plans were influenced by patients’ dental needs and not the presence or absence of dental phobia. This shows that while practicing dentists’ attitudes towards patients with dental phobia are not a barrier for receiving the best possible dental care, it is still important to consider patients’ anxiety and its management in the treatment 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.– Lead of the study Dr Ellie Heidari from King’s College London

“Another important component in their care would be to address dental phobia by providing them with an opportunity to access Cognitive Behavioural Therapy. This is a therapy that has been proven to be very successful,” she adds.

Professor Tim Newton, Professor of Psychology as Applied to Dentistry at King’s College London commented: “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. 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 Behaviour Therapy.”

'The impact of dental phobia on care planning: A vignette study’ by Heidari E, Andiappan M, Newton JT, Banerjee A, was published in the British Dental Journal on 26 April 2019.  


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