Hey everyone, I'm Prateek, a dentist and specialty doctor and in this video we're
going to be looking at various ways of managing anxious dental patients. If you
want to see similar educational content to this make sure to subscribe to the channel.
Within my day-to-day job, I carry out intravenous sedation and I deal with lots of anxious patients.
Through this experience I've picked up lots of general hints and tips that I can then apply
to my work in practice to help manage anxious patients more effectively and dental anxiety
is extremely common it is fed through various ways which we'll look at in this video.
Now there are many ways of managing an anxious patient these include pharmacological methods
but in this video I'm going to go through some relatively easy changes that you can make within
your day-to-day practice to help manage patients chair side. I must emphasise that this video isn't
a comprehensive list of anxiety management methods however it's looking at some very simple things
that you can start implementing in day-to-day work. Dental anxiety and anxiety in general stems from a
variety of causes. It may be that a patient has had a past experience that's affected their feelings
towards dental treatment. It could be that the patient has heard stories from other people so for
example a lot of children are quite anxious and it may be because their parents have told them horror
stories about going to the dentist. But effective management of an anxious patient is so important.
If you poorly manage an anxious patient, you could end up strengthening or reinforcing their existing
anxiety and this isn't something that we want to do because then it may reduce their ability
to attend for dental treatment and reduce their access to dental care which ultimately is going
to affect their general health. In contrast, if you effectively and appropriately manage an
anxious patient, you may end up reducing their anxiety and they may feel far more comfortable
coming to the dentist. The added difficulty is that anxious patients don't often present to a dentist
until they have a problem and often when they do present it's usually with symptoms that require
quite invasive treatment and so it becomes a bit of a vicious circle and their anxiety gets
strengthened. So let's start looking through some of the ways we can manage anxiety. One of the big
sources of anxiety for patients is the fear of the unknown when they go to a dentist and that
loss of control that they have and a big way of managing this is building trust with a patient.
Trust can be built in several ways. It can be built in your general management of the patient, how
you communicate with them. You can also do simple things by providing written or verbal information
of what is going to be done at appointment before the appointment happens. So for example if
a patient's coming for a checkup and they need a filling doing, providing them with the information
about that filling at the check-up appointment rather than surprising them with it at the actual
treatment appointment this then means the patient can go home, they can digest the information, they
can ask you questions and they can come to the next appointment more prepared. Another really
big way that you can gain trust from a patient and give them some control back is basic stop
signals. So I commonly will tell my patients even before I start doing anything that if they have
any problems or if they just want to break or they want to ask a question, just to pop their hand up
and immediately I will stop what I'm doing. I also reinforce this as I'm going through the procedure
because this constantly tells the patient, constantly reminds the patient that they
actually have some control in what is happening. Another big aspect to managing an anxious patient
is acknowledging and understanding their anxiety - so being empathetic. It's really important that you
develop your chairside manner so that you spend time to speak to the patient, to listen to their
anxiety and to try and understand it a bit better. In this simple act, you also go back and you build
trust and rapport with the patient because the patient thinks that you care about them and you
care about their anxiety. Another thing that I personally like to do is when a patient is
anxious, I like to ask them what is their source of anxiety and what makes them anxious at the dentist.
This does two things. The first one is that it shows the patient that I care about their anxiety
and I'm acknowledging their anxiety but the second thing that it does is it gives me information
about their anxiety that may provide me with some direction that we can go to help manage the
anxiety and reduce it for them. So for example in the hospital I commonly get referrals of anxious
patients and when I ask them what they're anxious about, a lot of them say that they're scared of
pain and so what I do in response to this is I try and reassure them that I don't want them to be in
pain and that once I give the anaesthetic, I always check and triple check that the anaesthetic has
worked. If it hasn't they can tell me and they've got control over what is happening and through this
method a lot of this anxiety about a fear of pain is removed. As well as acknowledging the anxiety,
it's important to provide reassurance to an anxious patient. So when patients are referred to
the hospital, for example, a lot of them I will tell them that I do this day in day out or I tell them
that we have anxious patients all the time coming through the hospital and therefore we're very good
at managing them. All of these things reassure the patient and helps build a bit more trust in what
we're doing. Again linking back to the control and providing reassurance, always remind the patient
they can ask you a question at any time. This will help reassure them that if they do have concerns,
if they're worried about something, they can raise it with you in terms of when you're communicating
with a patient. Just general body language is really important having a good friendly manner,
facing the patient, making eye contact, all of these are really important because the patient feels
you're engaging with them and you're understanding their concerns. Now to just touch on some very
simple techniques that we can use to try and help manage anxiety. Distraction is a very common way.
When patients are having anaesthetic, sometimes I will tell them to wiggle their toes or listen to
the music or have a TV on. All of these will help distract the patient from what is happening. Even
while giving anaesthetic sometimes, if you can move patients lip whilst you're doing the anaesthetic
that will distract them from what you're doing. Another very common technique used with children
is the tell, show, do technique. So this is where you would tell the child what you're doing you
will reassure them. So for example if you're going to do a fissure sealant on a child you might put some
acid etch on the glove. You might then paint on some sealant and this will just show them the
materials that you're going to use, the equipment that you're going to use. This goes back to the
idea of the fear of the unknown. By showing them what you're going to do you can hopefully reduce
this fear. Leading on from this modelling is also another technique. More commonly used with children
but can be used with adults as well and this is essentially where you carry out a procedure
on someone else the patient knows for example it may be their brother, their sister and they
are able to observe exactly what is happening and this again may reassure them that actually there's
nothing to worry about. Desensitisation is another important technique and this is where we gradually
expose a patient to aspects of the dental surgery or the dental practice and by gradual exposure
the patient ideally should become more and more comfortable being in that environment and this
desensitisation is of varying degrees. So it could be as simple as the patient just coming in so
for example with children and just sitting in the dental chair in one appointment and that's enough.
The following appointment could just be they sit in the chair and they open their mouth and you
gradually build them up by doing this. Finally some very simple things that you can consider for work.
First one is with anxious patients identifying them and then sticking to time keeping to time
in your diary. If you feel that this is going to be quite difficult if a patient is in the middle
of the day, try scheduling an anxious patient first thing in the morning or first thing in
the afternoon and this means they're not waiting around they're not waiting for their anxiety to
build. It's also really important to have a calming environment so soft colours soft music within the
surgery. Making sure you work well with your nurse so that you both have calming soothing tones.
In some situations your patient may feel more comfortable talking to the nurse about certain
things rather than the dentist because their fear comes from the dentist. If this is the case, work
with that and allow your nurse to engage in what's happening. It's also nice to have pleasant smells,
calming light. So for example when I carry out intravenous sedation I'll often turn off all the
ceiling lights and just have the dental light on. This darkens the environment it makes it far more
comfortable for a patient and then we usually have some light acoustic music in the background and
that eases the patient down even more. We've looked at lots of techniques that you can use to help
manage anxious patients more effectively. I think the biggest takeaways are that you need to address
the patient's anxiety, don't hide away from it acknowledge it discuss it with them and then find
what works best for them. By managing an anxious patient properly we can entirely change their
perception of dentistry. It's really important that we spend time on these patients. If you found this
video useful, please make sure to like, comment and subscribe - until the next video, take care!