Dental Anxiety Associates with Pain During Dental Procedures

It is well known by dentists that some patients experience dental anxiety, with some patients have worse dental anxiety than others. In a review article titled “Dental Anxiety Is Considerably Associated With Pain Experience During Dental Procedures,” by Mike T. John, appearing in J Evid Base Dent Pract, 2013, issue 13, pp. 29-30, the issue of dental anxiety in dental patients is explored.

The study reviews a study titled “Predictors of pain associated with routine procedures performed in general dental practice,” by Tickle M, Milsom K, Crawford FI, and Aggarwal VR, in Community Dent Oral Epidemiol, 2012 Aug;40(4):343-50. In the original study 508 patients who visit 38 different dentists in England participate. Dental anxiety was measured with the Corah Dental Anxiety Scale which resulted in a score between 4 and 20. This score was grouped into 4 different variables representing anxiety. The dental patients were asked to rate their intensity of pain on a scale of 0 to 10 during the procedure, after the procedure, and later after the procedure (not immediate). The researchers performed logistic regression and found that very anxious patients had a fivefold increased odds of experiencing pain during the dental procedure compared to patients who had no dental anxiety.

The reviewer (John) states that due to effective anesthesia most patients do not experience pain during dental procedures. In addition, the study (Tickle and et. al), found that 3.4% of the patients used in the analysis had very high dental anxiety. This is lower than what has been found in previous studies. Hence this study seems to show that pain and dental anxiety are intertwined. Hence if one has a high dental anxiety they may have reluctance to take proper care of their oral health. This could also lead to more days taken off work and frustration.

Hence the reviewer suggests that dentists are aware that dental anxiety exists on a continuum. He suggests that patients with less dental anxiety can be treated by dentists and given coping strategies and pharmaceutical interventions. Of course more complex cases of dental anxiety can be managed by other healthcare professionals. It is hence important that patients who have dental anxiety and especially more serious dental anxiety explore their options and talk to their dentist about it before any procedures occur. One option for patients with more severe dental anxiety is to talk with an online psychologist. Patients should understand that if they need dental care it is in their best interest to practice coping strategies to minimize their anxiety and ability to experience pain during any procedures.

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