Dental anxiety disorder is a common dental emotional state, which refers to the unique anxiety, tension or psychological fear of patients facing dental treatment, which can lead to increased sensitivity to dental treatment, decreased pain tolerance, emotional stress, delayed follow-up and many other problems, affecting the overall physical and mental health.
Severe dental anxiety, i.e., dental phobia, can even produce an extreme, irrational fear of oral visits, causing patients to avoid or refuse to see a doctor, causing the disease to worsen, thus forming a vicious circle, and in severe cases, it can even lead to the death of the patient.
1. Epidemiological investigation of dental anxiety disorders
Anxiety disorder is one of the many mood disorders worldwide and is one of the most common chronic disabling diseases, and dental anxiety is a common phenomenon that affects people of all ages in different countries. Not only does this disease negatively impact the oral health-related quality of life of children and adults, but it can also place a significant burden on society.
It is not difficult to see that dental anxiety is common in different ages and cultures around the world, and the incidence is high, which should be paid close attention to by oral clinicians. However, the reasons for the different incidences of dental anxiety in different countries are still unclear and still need to be further studied and explored by researchers at home and abroad.
2. Assessment of dental anxiety disorders
Dental anxiety is an emotional state of patients, and it is difficult to quantify it strictly. The evaluation of physiological indicators mainly includes: salivary cortisol level, fast or slow heart rate, high or low blood pressure, etc.
The various stress systems are activated by anxiety, the sympathetic nervous system becomes excited, and the hypothalamic-pituitary-adrenal axis becomes more active, resulting in changes such as increased heart rate, accelerated breathing, and increased blood pressure.
Salivary cortisol is one of the important glucocorticoids in humans, which is considered a biological marker of stress and anxiety, and is one of the most objective and simple ways to measure stress and anxiety.
The subjective feeling assessment mainly uses various scales to evaluate the dental anxiety of patients, and both evaluation indicators can effectively reflect the dental anxiety of individuals. Due to the advantages of simple operation, easy access, and patient more willingness to cooperate, subjective scales are widely used in clinical and experimental studies and are more favored.
3. Influencing factors of dental anxiety
1. Gender
Several studies at home and abroad have shown that there is a significant correlation between gender and dental anxiety, and women are more likely to show dental anxiety than men. On the one hand, women are more likely to be affected by emotions than men, and women have a weaker ability to cope with negative events, and also exaggerate emotional discomfort and tension, while men are less good at expressing themselves and hiding their true emotions.
On the other hand, studies have shown that the pain threshold in men is significantly higher than that in women, resulting in differences in pain perception and control between men and women, so men are less sensitive to pain-induced dental anxiety than women and are less likely to show dental anxiety, which is one of the reasons why women are more likely to show dental anxiety.
2. Age
Most studies have shown that dental anxiety decreases with age, and the main reasons for this are as follows: for adult patients, with age, personal life experience and social experience continue to increase, the ability to cope with stress continues to improve, and the understanding of dentistry gradually increases, and the probability of visiting dental care also increases with age, which helps to reduce the degree of dental anxiety in adult patients.
3. Poor dental experience
There are two types of poor dental visits: direct and indirect. Direct adverse dental visits mainly refer to the bad or unpleasant dental visits that an individual has experienced. Indirect adverse dental visits refer to dental anxiety caused by one's own imagination after listening to descriptions from family members, friends or colleagues, and obtaining dental visits through other channels such as the media.
Studies have found that dental visit experience plays an important role in the occurrence of dental anxiety. There was a significant correlation between the most negative dental experience and increased dental fear in adolescents, while there was no significant negative correlation between positive dental experience and increased dental fear. The dental experience did not appear to be associated with the onset of dental anxiety in adults, and they found that people who had never seen a dentist had higher levels of dental anxiety.
The reasons for the differences in the results of the above studies may be caused by the different methods used and the selection of study subjects, or it may be due to the different adverse medical experiences of the study subjects, which have an inconsistent impact on patients, and the sample size needs to be expanded for further research.
4. Self-evaluation of oral health
Self-evaluation of oral health is an important factor affecting the degree of dental anxiety, and studies have shown that patients who feel poor oral health have significantly higher levels of dental anxiety than those who feel good oral health.
The main reasons why people with poor self-rated oral health are more likely to show dental anxiety are as follows: On the one hand, people with poor self-rated oral health are mostly suffering from dental caries, periodontitis, missing teeth, bad mouth and other diseases, and are worried about embarrassment during treatment and have dental anxiety.
On the other hand, people with poor self-rated oral health are more worried about oral diseases, increase the frequency of dental treatment, and are more likely to get information about dental treatment, which may further aggravate their dental anxiety.
5. Other factors
The effects of marital status, different education levels, economic level, and type of tooth extraction on dental anxiety have been reported by different studies at home and abroad.
Analyzing the reasons for the different research results, it is speculated that there are the following two aspects: on the one hand, education level has little effect on patients' cognitive level, and education level may not be a direct factor causing anxiety, and on the other hand, because of the different research subjects, patients from different countries and cultures may be different, which needs to be further explored and studied.
The anxiety level of patients with common loose tooth extraction is the lowest, and the reason may be that loose teeth are more common, while other types of tooth extractions are more professional and difficult, and patients are more likely to have fear of the unknown.
4. Treatment of dental anxiety
1. Medication
As one of the important means to treat and control dental anxiety in patients, medical sedation has been used in clinical practice for a long time. There are two commonly used methods of drug treatment for dental anxiety: (1) oral, nasal or intramuscular sedatives. (2) Continuous inhalation of low-flow laughing gas (also known as nitrous oxide) during treatment.
The advantage of drugs in reducing anxiety levels is that they have a direct effect and are more effective. However, there are inevitably some side effects of drugs on the human body, such as headache, cold and fever, gastrointestinal disorders, increased metabolic burden on the liver and kidney, respiratory arrest and even death.
And some studies have shown that medication may lead to more severe anxiety at the next treatment. Some scholars believe that the use of pharmacological sedation as an adjunct to therapy should improve the treatment algorithm. This includes assessing the patient's degree of dental anxiety, ensuring good communication between the doctor and the patient, conducting a thorough examination of the patient's body before treatment, and using sedative medications appropriately.
2. Psychotherapy: Psychobehavioral intervention
It refers to instructing patients to carry out a series of trainings, so that patients can master the method of consciously regulating their own physiological and psychological activities, and at the same time divert their attention from excessive concentration on bad emotions, and prevent or cut off the vicious circle between emotional disorders and physical symptoms.
In recent years, studies have shown that psychological and behavioral intervention can alleviate patients' dental anxiety to a certain extent, and has gradually become a new research direction in the treatment of dental anxiety. Compared with pharmacological sedation, psychotherapy mainly helps patients reduce anxiety levels through psychological induction techniques, and reduces the potential side effects of analgesics to a certain extent.
While pharmacological sedation can only provide temporary relief, psychotherapy can help patients cope with the anxiety and fear of the dental procedure ahead, and can also make them more autonomous in the face of future dental treatments. There are three main types of psychotherapy methods commonly used: behavior modification therapy, cognitive therapy, and a combination of the two.
3. Physical therapy
Physical therapy methods for dental anxiety include music therapy, aromatherapy, massage therapy, etc. The use of music therapy for the treatment of dental anxiety is a scientific intervention process, which is an interdisciplinary technique integrating medicine, psychology, music, etc., and is currently very popular among scholars at home and abroad.
Music therapy is rich in content, easy to operate, and has been confirmed by scholars at home and abroad for its effect on relieving dental anxiety. Music therapy is rich and easy to implement, and some studies have shown that music has a significant effect on reducing dental anxiety in patients
There may be several reasons why music can relieve dental anxiety: On the one hand, music has a beautiful melody, and the melody helps to adjust the listener's state of mind and improve his nervousness or anxiety. Music, on the other hand, can create a relaxed and pleasant environment for the listener and give a sense of temporary escape from reality, making people feel happy.
Studies have shown that music can inhibit the sympathetic nervous system, leading to a decrease in adrenaline secretion, which allows the body to gradually relax and relieve anxiety. Aromatherapy, also known as aromatherapy, has the advantages of easy operation and low price.
However, lavender or rose essential oils in aromatherapy may cause allergic reactions, dermatitis, pimples, and even respiratory depression. Therefore, in the process of use, the patient's reaction should be strictly observed and adjustments should be made in time.
Massage therapy is one of the traditional Chinese medicine methods. Massage therapy adjusts and controls anxiety by improving the condition of the brain and peripheral microcirculation. This therapy has the advantages of simplicity and low cost of treatment. In conclusion, there are a variety of treatments for dental anxiety with varying effectiveness, each with its own advantages and disadvantages, and clinicians should be cautious when applying them.
V. Conclusion
In recent years, dental diagnosis and treatment technology has continued to improve and improve, but dental anxiety has remained high. The high incidence of dental anxiety in oral outpatients and the wide range of influence can easily cause patients to delay or even avoid medical treatment, thereby aggravating oral diseases and leading to a vicious circle.
At the same time, when patients have dental anxiety, it increases the workload of oral clinicians, increases the pressure on doctors, and even affects the doctors' accurate judgment of patients' conditions. Therefore, the treatment of dental anxiety is still a complex problem that doctors and researchers at home and abroad need to solve urgently.
At present, scholars at home and abroad have paid more and more attention to dental anxiety, and seeking treatment methods for dental anxiety has become the focus of research by scholars at home and abroad.
Although psychotherapy, drug therapy and physical therapy have achieved certain results, how to take corresponding treatment methods for different dental anxiety symptoms in different patients still needs to be further studied and explored, which will also be an important task for our clinicians, and we need to work together.
This is the end of this article, do you know more about dental anxiety after reading it?If you have any questions, you can leave a message in the comment area, and we will discuss together.