June 28, 2017

Dealing With Dental Anxiety: 5 Answers From an Expert Dentist

This is an interview with Dr. Warren D. Silvers III, concerning dental anxiety and the treatment he is proposing. Pain is the number one reason for fearing the dentist. Let’s see what Dr. Silvers has to say about sedation dentistry:

Q: What is dental anxiety and/or dental phobia? How common is it?

A: It has been estimated that about 75 percent of all patients experience anxiety in some form. Anxiety levels can be broken up into mild, moderate and severe. Dental-phobic patients fall into the severe category. They account for 5 percent to 10 percent of patients. Phobic patients have fears so great that they generally avoid dental visits (even routine visits) at all costs. This unfortunately has the effect of letting things go until they become intolerable.

Q: What are some of the reasons that people say they are afraid to go to the dentist?

A: Even with the advances in anesthetics, pain is considered by most people as the No. 1 reason for fearing the dentist. Other fears include the sound of the drill, needles and fear of being lectured by the dentist or being presented with a plan of care they can’t afford.

Q: What can patients who have a fear of going to the dentist do to make it easier?

A: All dentists realize that fear of dentistry is a concern for many patients. Most modern dental offices provide a caring and relaxing atmosphere for their patients. Even patients who are not afraid of the dentist can benefit from dental sedation. Often when patients are sedated during dental procedures, more work can be done in a single visit, eliminating the need for return appointments in many cases. Discuss your concerns about anxiety with your dentist. He or she can make recommendations based on your specific needs.

Several pharmacological methods exist today to help alleviate anxiety. Nitrous oxide (or laughing gas) has been around for a long time and is a very safe and effective way of relieving mild to moderate anxiety. It is delivered painlessly through a mask placed over the nose and breathed in by the patient. At the end of treatment the patient breathes oxygen and there are no lingering effects. This is an advantage for many patients as they can drive themselves to and from the appointment.

Oral sedation is another method of relieving moderate anxiety. This is administered by way of pill or liquid. Dentists sometimes prescribe these medications the night before, as well as the day of, so the fearful patient can get a good night’s sleep and not be up all night worrying about the next day’s visit. This method requires someone to drive the patient to and from the office. IV sedation is another method available to relieve moderate to severe anxiety. This technique produces a state of total relaxation and comfort. Some preparation before the appointment may be necessary (for example: not eating from the night before) and you should be sure to have a ride to and from your appointment arranged.

Q: How can you help patients work through their anxiety?

A: The short-term goal of sedation dentistry is to remove the barrier that prevents patients from having dental work completed. However, the long-term goal is to provide an atmosphere where patients can develop a rapport with their dentist so eventually the medication can be weaned away.

Q: How can parents prevent their children from being scared of the dentist?

A: We invite parents to bring their children in as early as they can. The Academy of Pediatric Dentistry suggests that in order to prevent dental problems, your child should be seen when the first tooth appears, or no later than his or her first birthday. We recommend that children accompany their parents for their continuing care visits so they become familiar with the dentist, the office and some of the equipment. Having a rapport with a dentist prior to having dental work done really helps prevent anxiety. Too often a child’s first encounter with a dentist is when there is already a “problem” such as a toothache or trauma.

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Can We Prevent Separation Anxiety On The First Days Of School?


Going to school is usually an exciting and enjoyable event for young children. However, for some it can cause intense fear or panic. The good news is that excessive fears and panic about leaving home/parents and going to school can be successfully treated. How about the first days (I don’t like to refer just to the first day) of school? Can we, as parents, do something to prevent this situation?

Samuel T. Gladding, professor of counseling at Wake Forest University and author of the book “Family Therapy,” says not being well-prepared for the separation makes anxiety worse.

Gladding offers parents tips for how to avoid emotional scenes with children clinging tearfully to them when it is time to say goodbye at the classroom door:

– Role play with the child on leaving and returning before the big day arrives.

– Long before school starts, encourage more social children to include your child in their play and provide reinforcement for getting involved in activities.

– Use pretend exercises. The parent asks the child to pretend how a child Superman or Wonder Woman would act when going to school.

– Introduce the child to teachers and other children in the class to help him feel more secure in the new environment.

– If parents are feeling anxious, avoid communicating this distress to the child. Parents can use the pretend technique, too.

– As a parent, model appropriate first-day behavior and get the child to imitate the model behavior.

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Panic Disorder-Stories Of Hope-Video

In this video, the National Institute of Mental Health present some insteresting stories from people suffering from anxiety and panic disorders. Three real people explain their real experiences with panic attacks. But these are stories of hope, as they have a happy outcome. The first time people experience a panic attack is horrible. They do not know what’s going on, they have a patent physical reaction, and a feeling of having a heart attack or of imminent death.

One of the main problems of panic attacks is the avoidance disorder. Patients suffering from panic attacks tend to avoid the situations in which they suffered the attack. For example, if they were driving, then they avoid driving. So, their world becomes smaller and smaller. They avoid any situation -they think- might trigger a panic attack.

Music Therapy Programs To Reduce Anxiety And Stress In Cancer Patients

Music Therapy and Anxiety

Music therapy is nowadays common in hospital settings as part of integrative medicine programs. It is also a key therapeutic tool used at large cancer centers in the United States. So, it is not surprising that recent research has shown that music of therapy is able to lower anxiety levels in patients with cancer:

Music therapy might help lower anxiety and improve mood in people with cancer, say researchers who analyzed past studies. It’s not entirely clear from those studies what kind of music-related treatment.

It’s not entirely clear from those studies what kind of music-related treatment — going to sessions with a music therapist, or listening to pre-recorded CDs during hospital visits — might help patients most.

But music therapist Debra Burns, from Indiana University-Purdue University Indianapolis, said therapists especially can help patients relax during
stressful treatments and think through their tension.

“We can use the different music interventions to target the in-the-moment symptoms — pain, anxiety. But we can also look at longer-term interventions,”
such as improving communication with family members, said Burns, who was not involved in the review.

For the analysis, creative arts therapist Joke Bradt from Drexel University in Philadelphia and her colleagues reviewed data from 30 past studies that
looked at the effect of music therapy or music listening in close to 2,000 cancer patients.

Compared to patients who only received standard cancer treatment, the combined data from the studies suggested that patients who also had music
treatment rated their anxiety and pain lower and had higher mood scores. In addition, their heart rates were lower by about four beats per minute, on

There was no effect, however, on how patients rated their depression or fatigue.

That’s probably because most of the studies only tested the effect of listening to music in the hospital for a single session, and didn’t give patients much choice about what type of music they listened to, Bradt said.

“If someone’s really depressed, one music listening session is not going to reverse that,” she told Reuters Health.

While there wasn’t enough data to determine if going to a music therapist helped patients more than listening to CDs, Bradt said she suspects that’s the case. With a music therapist, patients are usually involved in making music by singing or playing instruments, she explained, and therapists can design a
treatment program for each particular patient.

“The patient can become an active participant,” she said. “It can be really empowering, and can help patients feel more in control over the situation.”

Burns agreed. Therapists can adapt treatment “as they need to depending on the patient’s needs. It gives you some flexibility and a wider breath of tools,”
she said.

“We cannot forget that making music is a lot of fun as well,” Bradt added.

It can be hard to objectively compare anxiety and depression in patients getting music therapy and those not getting any extra treatment, the authors
explained in the new review, published in the Cochrane Library. That’s because researchers can’t keep music therapy a secret from patients — so if patients
think music therapy will help them, they could feel better just because of that extra optimism and expectation, rather than the because of the therapy itself.

But Bradt said despite that limitation, the potential positive effects of music treatment — especially with a trained music therapist — should be taken
seriously, and that it’s not “just about listening to some music.”

“Certainly it’s not for everybody,” said Burns, who’s on the staff of Indiana University’s Melvin and Bren Simon Cancer Center.

“Somebody at least has to be open to the experience,” she told Reuters Health.

Burns concluded that research should continue to look at what type of music therapy might help different patients at different stages of their cancer

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In my opinion, there are still room for a lot of studies to be done before stating music therapy programs have some benefits regarding anxiety reduction or prevention. In the review we are referencing here, we can conclude, with precaution, that results are promising. I would like to highlight some points here:

  • patients received just one music session
  • it would be very interesting that patients could participate in the selection of the type of music
  • exposure to more “doses” could be interesting to study and see if there are some positive long term effects over anxiety, depression, and stress
  • it is very common for inpatients to bring their own music selections to the hospital, and this variable would be very important to control for in the design and analysis of epidemiological studies aiming to evaluate the effects of music therapy on anxiety.