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Features / April 13, 2021

Treating dental phobic patients

by Niall Neeson

Niall Neeson explains why ensuring access to dentistry for those who need it the most will reap rewards – for you and your patients.

Dental phobia is a massive deal for those people affected by it. It can have an impact on a lot more than oral health. It can filter into overall wellbeing, confidence and mental health, too.

For some patients, completing a course of dental treatment can be life-changing. In my opinion, that’s the most satisfying work we do. That is what sends me home in the evening with a smile on my face.

Unfortunately, the provision of dentistry doesn’t always lend itself to supporting people with dental anxiety. Time is money and the many constraints we face as a business and healthcare profession are not exactly conducive to building rapport and trust.

The benefits

I’m keen to highlight the positive in the benefits we can gain from investing in this group of patients.

Firstly, this is the most loyal group of patients you will ever have. Once you’ve won them over, they are going nowhere else. Not only that, but they’ll also send a lot of their friends and family your way, too.

Secondly, let’s remember that dental fear is associated with neglect. Helping and caring for them also usually involves quite a substantial course of treatment. From a business perspective, this can work in a practice setting.

The additional time and attention required at the beginning is very much an investment and one that will pay dividends. Job satisfaction, happy patients, more referrals and happy practice owners. What’s not to love?

Open and honest

Patients who are dental phobic have usually lost trust. If we can earn that trust back, then often everything else falls into place very quickly. It is here where open and honest communication is key.

We have to listen to their story. The first time we meet a dental phobic patient, they are usually telling us what has happened before and what they don’t want to happen again. This is incredibly valuable information.

Equally, it’s important for us to communicate to them that they have been heard.

Effective communication is what allows us to build rapport, trust and control. Regardless of what technology or sedation options I have at my disposal, if I haven’t earned these three things, I might never get close enough to even cannulate them for sedation.

Working with patients

All too often, we hear of how people were made to feel powerless in the chair. Working with our patients gives them that all-important control back.

If we invite opinion and let patients know that ‘they’re your teeth, it’s your money and it’s entirely your choice’, then they respond well to this.

The dentolegal experts at Dental Protection often speak about ‘shared decision making’. For me, this is a fantastic approach.

We must communicate all the options to empower patients to make an informed decision about their oral health. We have to work with patients to find bespoke solutions.

Dental fear, anxiety or phobia is a unique experience and patients arrive in the chair from a different background, with different contributing factors and triggers, and with different priorities and goals.

At Boyne Dental, as part of our ‘Dental Fear Solutions’ service, we email a questionnaire to each new patient. As well as dental anxiety scales, it includes open questions, such as ‘what are your goals?’ and ‘how can we help you?’ to ascertain their specific priorities. It helps us work together in mapping out the right pathway for them.

Innovative solutions

Some patients love the idea of using IV sedation and getting the treatment completed without remembering it. Others may have mental health difficulties contributing to their dental anxiety/phobia – in their case, cognitive behavioural therapy (CBT) may be the right solution for them.

Many others just want to be able to achieve treatment in the chair simply using comfortable, effective local anaesthetic, such as The Wand, a game-changing piece of kit that has elevated my treatment of nervous patients.

The computerised delivery of the local anaesthetic solution is a modern alternative to traditional syringes. It looks like a pen and is held like a pen, which makes it a non-threatening experience for patients.

Crucially, it also improves the effectiveness and predictability of my numbing. What some dentists may not realise is that The Wand opens up alternative local anaesthetic techniques that I simply can’t otherwise use.

The STA technique

The STA intraligamentary technique is capable of anaesthetising any tooth without the need for an infiltration or a block and that is powerful.

Technically, we can even avoid an ‘injection’ in a sense, ie we can actually numb the tooth up without piercing the mucosa, simply placing The Wand down the side of the tooth like a perio probe using the STA technique.

By investing in innovative solutions, it sends the message that dentistry has progressed and that we can offer them a dental experience that feels different to before. This is a massive step forward, allowing us to reduce the triggers, reduce their fight or flight response and it can contribute to retraining their overall perception of dentistry to something much more positive.

Ideally, as a healthcare profession, we should be investing time and consideration to every one of our patients because, at our core, we want to care for people.

However, sometimes our busy minds can be swept away by the day-to-day frenzy of general practice. We can forget that some patients will require more from us than others.

As dentists, we have the power to change the perception of anxious patients. If we achieve this, we can not only improve their dental health but their overall quality of life.

To achieve successful outcomes, we need to dedicate the time and energy into building trust with this patient group. There are plenty of benefits to be enjoyed by everyone in the long run.

This article first appeared in Irish Dentistry magazine. You can read the latest issue here.