Psychologic interventions for the anxious dental patient.

This article asserts that pharmacologic usage can be reduced by understanding that pain is composed of somatic, affective, and cognitive elements; the dentist should be assertive in addressing and dealing with the emotional and psychological aspects of the anxious and fearful patient. The dentist can measure levels of anxiety and fear through self-report and records of dental care; an easily administered test of dental anxiety, such as the Dental Anxiety Scale; and a structured interview in a nonoperatory setting. For those patients exhibiting a moderate amount of anxiety, attention to basic aspects of good clinic care should be sufficient. For those patients manifesting a high level of anxiety, a treatment program implemented by a dental clinical assistant is outlined and recommended. The treatment program is intended to increase patient relaxation, positive cognitive coping statements, sensory information, sense of control, and confidence in handling the dental procedures. At any level of anxiety, it is recommended that patients be abundantly praised for any element of success in dealing with the stress of their dental experience. Lastly, for those patients who do not respond to treatment efforts to reduce anxiety, it is recommended that the dentist establish a regular consultation with a psychologist who is an expert in treating dental fear and anxiety.