Lesson 10

DENTAL PHOBIA

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Read the text carefully. Pay attention to words in the bold print

Dental phobia is the serious, often paralyzing fear of seeking dental care. This fear can lead to development of many serious dental problems in patients. Besideschronically infected gums and teeth which can affect overall health, the ability tochew and digest can be seriously impaired. Without healthy gums and teeth, speech can be affected as well. All of these can lead to serious limitations in patient’s social and business environments. The key to good oral health isprevention – stopping problems before they arise. Unfortunately, people who suffer from dental anxiety often fail to visit the dentist for routine care. When they finally do go, often a small preventable problem has turned into a problem which will requiremajor intervention.

People with dental phobia have an awareness that the fear is totally irrational but are unable to do much to change this. They usually go to the dentist only when forced to do so by extreme pain. Other signs of dental phobia include: trouble sleeping the night before the dental exam, feelings of nervousness that escalatewhile in the dental office waiting room, crying or feeling physically ill at the very thought of visiting the dentist, intense uneasiness when objects are placed in mouth during the dental appointment or sudden breathing difficulties. There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include fear of pain, injections or anesthetic side effects, orembarrassment and loss of personal space.

Sedation dentistry may be an option for patients who have a fear of dentist. The most common type of sedation dentistry is oral sedation, where a pill is taken prior to the appointment. Depending on the amount of dental work being performed, the dosage will vary by patient. A friend or family member should drive the patient to and from the dental office as he/he is unable to operate machinery. During the visit, the patient is able to respond, but usually has little or no memory of the visit. Oral sedation works great for patients who wish to combine procedures and minimize the amount of dental office visits.

Additional option is an IV sedation. This process typically involves the intravenousadministration of a sedative by means of an injection directly into the bloodstreamof the patient. IV sedation dentistry is a more effective method than other forms of sedation such as pill sedation or gas inhalation. IV sedation doesn’t really put the patient to sleep, they are fully conscious throughout the procedure, they will be completely relaxed and their mind will be at ease and they will remember little or nothing regarding the procedure afterwards.

There’s also the option of nitrous oxide (laughing gas) or halcyon, another numbing substance that is inhaled. Patients are in a relaxed but conscious state of mind, and many experience a temporary euphoric effect. Many patients prefer the inhalation option, due to the lack of serious health risks.

Additional options for the treatment of dental anxiety include cognitive behavioral therapy, hypnotherapy, positive visualization, deep breathing, and other relaxation techniques for those who suffer from extreme phobic reactions. The patient should discuss the best option for them with their dentist.

GLOSSARY
administration – podawanie leku 
amount – ilość 
anxiety – niepokój, obawa 
to arise – powstać, pojawić się, wyniknąć 
as well – również 
awareness – świadomość czegoś 
to be at ease – zrelaksowany, wyluzowany 
besides – oprócz, poza 
bloodstream – krwiobieg 
to chew – żuć 
cognitive – poznawczy 
to combine – połączyć, złączyć 
conscious – świadomy 
to digest – trawić 
embarrassment – zakłopotanie, skrępowanie 
to escalate – nasilać się, powiększać się
euphoric – w stanie euforii
impaired – osłabiony, pogorszony
inhalation – wdychanie
injection – zastrzyk
paralyzing – paraliżujący
to place – umieszczać, wkładać
prevention – zapobieganie, profilaktyka
prior – przed
regarding – odnośnie
to require – wymagać
sedation – uspokojenie polekowe
to seek – szukać
side effect – działanie uboczne
to turn into – zmienić się
visualization – wizualizacja, wyobrażanie sobie

Complete the sentences with words from GLOSSARY section

1. ‘After IV sedation you will not fall asleep. You will be ___________ and aware of everything I do.’
2. In oral sedation a patient takes the sedative tablet _________ to dental procedure.
3. ___________ oral sedation we may also distinguish IV sedation and sedation with the use of halcyon. 
4. Nitrous oxide is administered in a form of ____________. 
5. ‘I know that you have a fear of dental procedures, that is why I recommend sedation which will help you to _____ more ____ _______ during the next visit.’
6. IV sedation __________ administration of the medicine directly into the __________.
7. ‘ Your fear of dentist is so high that I strongly recommend to _________ professional help’.
8. There are some possible _________ _________ associated with a use of anesthesia.

Use the words in brackets to write answers to your patient’s questions

QUESTION 1: ‘Will I experience any side effects if I decide to use laughing gas during the dental procedure?’ 
ANSWER: (nausea / sense of being “drunk”/ confusion)
………………………………………………………………………………………………………………………………………………………………………………………………
QUESTION 2: ‘Is IV sedation a safe choice for me?’
ANSWER: (perform evaluation / hypertension, kidney disease, drug allergies / make decision)
………………………………………………………………………………………………………………………………………………………………………………………………
QUESTION 3: ‘ How should the oral sedative be used?’
ANSWER: ( depend on drug / always / prior to the visit)
………………………………………………………………………………………………………………………………………………………………………………………………
QUESTION 4: ‘ I heard I’d feel drowsy after taking the oral sedative. Will I be able to drive back home?’
ANSWER: (No / drowsy and tired / someone / drive back home)
………………………………………………………………………………………………………………………………………………………………………………………………
QUESTION 5: ‘ How can I help my child to overcome the dental phobia?’
ANSWER: (inform about dentist visit / not say something will be painful / no rewards)
………………………………………………………………………………………………………………………………………………………………………………………………

Complete this short text about dental anxiety in children with the words from the table

demonstrate ease firm
 
complex describe

 behavior

Dentists often will use different techniques to 1)_________ children's fears. For example they may talk in friendly voice which could become 2)__________if necessary. The dentist should use simple words to 3)___________ procedures and sometimes may even 4)____________ the procedure on a doll or another person. Dentists often will tell stories to draw child’s attention away from the procedure. Praise and compliments should be given if a child is o his/her good 5)____________. In more 6)___________ cases, sedation may be used as well. The two most common types of sedation that might be used in children are nitrous oxide or an oral sedative such as Valium.

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