About Dental Anxiety

June 20, 2018

Dental anxiety is an all-too common problem for both adults and children. Dental Anxiety has a high prevalence and it is the primary reason why some people avoid visiting a dentist. For many people, some level of anxiety is a part of a full cycle of a dental appointment experience. A high level of anxiety can lead to avoidance and can in turn result in a negative impact on an individual’s oral health. Sedation can help ease stress and remove the barrier of anxiety for better use of dental care.

Dental Anxiety and Aversive Behaviour

Dental treatment avoidance and appointment cancellations are said to be linked with dental anxiety. Many oral health issues can be prevented or managed as part of a routine oral health maintenance provided by a dentist. People with dental anxiety tend to avoid visiting a dentist out of fear. Generally speaking, a large number of patients who seek emergency dentists in Brisbane are people who experience high levels of dental anxiety and avoid routine dental care and therefore end up with dental infections that can grow into a unbearably painful tooth abscess.

Negative Expectations about Upcoming Dental Care

Anticipation for pain is probably one of the major reasons for dental anxiety. In some cases, the anxiety is psychological, and it is out of proportion with the actual pain. Dental anxiety is the patient’s apprehension that something negative is about to happen if he or she attends his or her dental appointment.

Patients who have a high level of dental anxiety tend to have irregularities in their appointments, they may arrive late, often cancel their treatment appointment or not attend their appointment at all, dentist Brisbane dr. Ellie Nadian says. Modern dentistry provides a wide range of techniques for pain and anxiety management. People should not allow dental anxiety to become a barrier against their oral health. Anxious patients should consult with their dentist and learn how they can control or manage their fear.

Patient anxiety in a dental clinic can be the result of the below reasons or a combination of:

  • Injection
  • Dental Drill
  • Fear of Suffocation
  • Cost of Treatment
  • Feeling of Helplessness
  • Claustrophobia (fear of being in closed spaces)

Dentists deal with patient anxiety on a daily basis. Some dentists are experts in the management of dental anxiety. When you go to a dentist for the first time, you most likely fill out a patient registration form also known as medical history form. This form often includes a question about dental anxiety. If you find yourself anxious in the dental office, make a note of that in your medical history form before the appointment and talk to your dentist to see what your options are.

Conscious Sedation with Nitrous Oxide / Oxygen Administration

Nitrous oxide / Oxygen combination is a medical gas that has been used in dentistry for more than 175 years. It can induce a state that allows a dental patient to better tolerate unpleasant procedures. When used appropriately and administered by trained professionals, it is a safe and effective sedation solution for many people. You should consult with a professional dentist to see if your medical circumstances allow you to use this gas for dental treatments.

  • Prior to administration of nitrous oxide, your dentist will assess your medical conditions including but not limited to:
  • Compromised airway (due to cold, allergies, congestion)
  • Adverse drug reaction
  • Current medication
  • Pregnancy status
  • Diseases and disorders

Pain Relief during Dental Treatment

Nitrous oxide is also known as happy gas, laughing gas and sweet air. It is virtually an odourless gas with a slightly sweet smell. The name “laughing gas” is chosen for Nitrous oxide because of the euphoria it creates when inhaling it. Laughing gas has a very quick uptake and is absorbed rapidly. Likewise, it is quickly exerted from the lungs as well.

Dentists may recommend laughing gas administration for the following types of patients:

  • Obstreperous (noisy and difficult to control)
  • When gag reflex interferes with dental work
  • When undergoing a long dental procedure
  • When profound local anaesthesia cannot be obtained

Laughing gas can provide relief from moderate pain. It cannot provide relief for significant pain though.

Your dentist will provide you with information and explain risks associated with administration of laughing gas in dental treatment. Laughing gas has been used safely in dental clinics for around 175 years but like all other types of anaesthesia there are risks associated with this gas. You should provide your dentist with all required information for your dentist to be able to assess your risks. Laughing gas has an excellent safety record and most people do not experience negative side effects after administration, however, a small number of people do.

Adverse effects of laughing gas inhalation

When administered by trained dentists to suitable patients, adverse effects of laughing gas on patients are rare. Some negative effects include:

Nausea, Vomiting and Nitrous Oxide

After administration of laughing gas in dental procedures a small percent of the population may experience nausea and vomiting. this is more likely to happen:

  • After Long Administration
  • Fluctuations in Gas Levels
  • Increased concentration of Nitrous Oxide

For patients undergoing laughing gas administration for dental procedures, fasting is not required. A light meal may be consumed within the two (2) hours prior to gas administration.

Diffusion Hypoxia and Nitrous Oxide

Rapid release of nitrous oxide from blood into alveoli (the many tiny air sacs of the lungs which allow for rapid gaseous exchange) can dilute the concentration of oxygen. Dilution of oxygen may lead to disorientation and headache. To minimise this effect, your dentist may administer oxygen after nitrous oxide gas valve is closed.

Dental Phobia

Dental phobia is a severe form of dental anxiety. It is associated with more extreme dental anxiety than usual and previous traumatizing dental experience is probably a major reason for dental phobia. Patient with dental phobia can experience:

  • Sweating
  • Stomach cramp
  • Muscle tension
  • Fast Heart Beat
  • Accelerated Breathing

Several studies have shown that laughing gas can be effective sedation for patients with dental phobia. Don’t let your dental phobia or anxiety create a barrier between you and the smile you deserve. Dentistry has a lot to offer talk to your dentist and be sure that they can find a way to improve your oral health which is an important part of your overall health.

About the Author 

Dr. Ellie Nadian from Pure Dentistry is a dentist in Brisbane Southside. Tel: 0733434869, address: 11/1932-1974 Logan Rd, Upper Mt Gravatt, QLD 4122 


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