Several theories have been proposed; however, a 2014 review describes five pathways which relate specifically to development dental fear and anxiety: Cognitive Conditioning, Vicarious, Verbal Threat, Informative, and Parental.
However, there may be a variety of background factors common to all general fear and anxiety conditions that may be at play and affect these more specific pathways.
[8] Informative This indirect pathway relates to fear acquisition through gaining information and becoming bias to the dental environment from dental phobic elders, negative connotations advertised by media (e.g. television, movies), and friends with personal negative experiences.
In essence the verbal threat pathway is the fear induced when an authority figure threatens an individual with a painful experience.
This can be achieved through television or movies, or a physical distraction such as focusing on another body part such as wiggling the toes or fingers.
[6] More recent research indicates that the use of conscious sedation combined appropriate communication techniques may relieve the anxiety in the long-term.
[4] Tell-show-do is a common non-pharmacological practice used to manage behaviour such as dental fear, especially in paediatric dentistry.
[6] The purpose of this intervention is to promote a positive attitude towards dentistry and to build a relationship with the patient to improve compliance.
[4] Cognitive behavioral therapy (CBT) appears to decrease dental fear and improve the frequency people go to the dentist.
[17] CBT for dental anxiety is often performed by psychologists, but the effect has proven to be good also when administered by trained dentists.
It has been suggested that the front of house staff, e.g. receptionist and dental nurses contribute to elicit a better cognitive and emotional experience for anxious patients by showing a positive and caring attitude and by adopting good communication techniques.
There is some small evidence that the waiting areas with soft music playing and dimmer lights and cooler in temperature produces a more calming effect.
[23] Music therapy has shown promising results as a non-invasive method for reducing dental anxiety.
By using music as a therapeutic tool, patients can experience decreased stress levels and improved relaxation during dental procedures.
The major muscles groups include The steps according to Edmund Jacobson are as follows: Desensitisation in dentistry refers to the gradual exposure of a new procedure to the patient in order to calm their anxiety.
It is based on the principle that a patient can overcome their anxiety if they are gradually exposed to the feared stimuli, whether imagined or real, in a controlled and systematic way.
[29] Benzodiazepines, a class of sedative drugs, are commonly used as premedication, in the form of a tablet, to aid anxiety management before dental treatment.
[19] Conscious sedation refers to the use of a single or combination of drugs to help relax and reduce pain during a medical or dental procedure.
There are a range of techniques and drugs that can be used; these need to be tailored to the individual need of the patient taking into account the medical history, the skill and training of the dentist/sedationist and the facilities and equipment available.
Most often this type of sedation is reserved for the developmentally disabled and is provided by an anesthesiologist working in conjunction with a general dentist.