The Fearful Dental Patient: A Guide to Understanding and Managing helps dental
professionals understand the basics of fear, anxiety and phobias and the role
these emotions play in creating negative behavior within the dental environment.
The text contains a variety of modalities that help identify dental fear and
phobia, as well as chair-side techniques and practical advice aimed at improving
patient cooperation and ensuring treatment compliance.
Chapter topics include the basic origins of patient fear and anxiety, how to indentify dental anxiety and varied approaches to managing fearful patients of any age. Approaches discussed employ behavioral, pharmacological, sedation and even hypnotic techniques, specifying combinations where required. Chapters also include coverage of a wide range of patients, including those with psychiatric comorbidities and special healthcare needs. The entire dental team will greatly benefit from the proven methods and practical guidance presented to better understand and treat fearful dental patients.
- Written by practicing dentists with vast experience treating fearful patients
- Provides practical advice on how to minimize patients' anxiety and build the doctor-patient relationship
- Discusses a variety of management techniques both individually and in conjunction with other strategies
- Includes sample questionnaires for use in practice to assess levels of fear and anxiety—available for download at www.wiley.com/go/weiner
Table of Contents
About the Author.
1 The basic principles of fear, anxiety, and phobia: past and present(Arthur A. Weiner).
- Major etiological models to explain anxiety.
- Behavioral indicators of anxiety.
- Nature of dental anxiety.
- Echelons of expression.
- Timing of dental anxiety.
- Differentiating psychological (exogenous) anxiety from medical (endogenous) anxiety.
- Natural history of endogenous anxiety.
- Causes of phobias.
2 Determinants associated with creating fearful dental patients(Arthur A. Weiner).
- Prevalence of dental fear.
- Direct conditioning.
- The approach–avoidance conflict theory.
- Exploring the literature cataloging the common findings of each of the determinants of dental fear.
- Patient control.
- Gender, age, socioeconomic, life status determinants of dental fear.
- Practitioners’ determinants of dental fear.
- Oral health, quality of life, and the impact of dental anxiety.
3 Factors affecting the psychological collection and identification of the fearful dental patient(Arthur A. Weiner).
- Prerequisite components for enhanced communication skills.
- Establishing a positive patient–dentist relationship.
- Two-way communication.
- Accommodating patient–dentist priority differences.
- The initial patient–dentist consultation.
- Practitioner’s verbal inquiry and collection of past and present history.
4 Chairside management of the fearful dental patient: behavioral modalities and methods (Arthur A. Weiner).
- The concept of the dental practitioner as a “facilitator of change”
- Step-by-step chairside model for fear amelioration in the frightened dental patient.
- Chairside management resulting from patient’s consultation and determinants of fears elicited.
- Doctor–patient relationship and its role in reducing anxiety and gaining treatment acceptance (this section authored by Samuel shames).
- Part 2: alternative behavior modification and treatment modalities.
5 The pharmacological basis of pain and anxiety control(Morton Rosenberg and Michael Thompson).
- Local anesthesia.
6 Hypnosis in dentistry(Michael A. Gow).
- What is hypnosis?
- The hypnosis session.
- Hypnosis in dentistry—”hypnodontics”
- “Informal” hypnotic techniques in day-to-day dental practice.
- An anchoring technique for child dental patients—”the high five anchor”
- Suggested hypnosis societies, training pathways, and contacts for dentists.
7 Management of complicated, high-risk patients with psychiatric comorbidities(Kelly M. Wawrzyniak and Ronald J. Kulich).
- Overview: behavioral science and the complicated patient.
- Posttraumatic stress disorder.
- Major depressive disorder and related mood disorders.
- Chronic pain disorder and related somatoform disorders.
- Personality disorders.
- Substance use disorders.
- Eating disorders.
- General management recommendations.
- References .
8 Understanding and managing the fearful and anxious child(Laura Camacho-Castro).
- What is new in behavior management?
- Birth to 2 years old.
- Two years old.
- Three to 6 years old—the preschool age.
- Six to 12 years old.
- The teenage years—adolescence.
- When does fear or anxiety first develop in children?
- Basic behavior management techniques.
- Should the parent remain in the operatory?
- Pharmacological management of behavior problems.
9 The geriatric patient: psychophysiological factors associated with aging and dental anxiety(Kathryn Ragalis and Arthur A. Weiner).
- Understanding the changes associated with aging.
- Managing the risk factors associated with aging.
10 Fear and anxiety management for the special needs patient(Linda M. Maytan and Gina M. Terenzi).
- Let us meet and evaluate your patients.
- Sensory perception modalities for treatment and communication.
- Alternative modalities for anxiety management.
- Case management presentation.
Dr. Arthur Weiner has been on faculty at the Tufts University School of Dental Medicine since 1968, where he has taught courses on pain control, anxiety management, panic disorders, and behavioral dentistry. He is currently director of the Behavior Science II course at Tufts and a national spokesperson for the Academy General Dentistry on fear and patient management. Dr. Weiner is a guest lecturer at several regional and national conferences. He has also spoken in the past in Australia and France and has published extensively on the subject of fear and anxiety management in numerous journals including Dental Clinics of North America and Acta Scandinavia Psychiatrica.