Top tips for the management of the dentally anxious patient in general practice

Dental anxiety is often described as fear or stress triggered by the dental setting. It is estimated to affect more than one-third of the population. Dental anxiety can affect patients in different ways. Signs and symptoms of dental anxiety include (but are not limited to) patients visibly trembling, sweating, reporting sleep loss preceding a dental appointment, shortness of breath, heart palpitations and gastric symptoms such as nausea, vomiting and diarrhoea. Dental anxiety may manifest as late cancellations or even missed dental appointments. Lack of presentation for routine dental care may result in an emergency situation potentially compounding feelings of fear and distress. Avoidance of dental care often results in more significant oral health problems and is linked with a higher number of missing teeth. Socio-economic factors such as low income and living in rural areas have also been linked to higher dental anxiety. For anxious patients, the stresses of both attendance at a dental service as well as the potential sequelae of non-attendance may impact negatively on their mental health. Patients with high levels of dental anxiety have been found to have a higher score on their oral health impact profile, with some patients reporting feelings of self-consciousness and lack of life satisfaction.

It is therefore important for the dental team to have an awareness and understanding of how dental anxiety may present and how to help manage it.