Dental anxiety, fear and phobia

When I qualified from New Cross Hospital, my clinical training had been solely with school-aged children. As all dental therapists in those days, I went to work in the Community Dental Service (CDS) where I continued to treat children, some of whom were very young or anxious. Eventually the role of Community Dentistry changed and encompassed adults with special needs. Those ‘special needs’ were not restricted to disabilities or patients with complex medical histories but included those patients who because of anxiety, fear or phobia could not receive treatment in General Dental Practice.

Nowadays, the CDS is known as the Salaried Primary Care Dental Service (SPCDS) and accepts patients only on referral. The dentist assesses the patient and dependent on treatment needs; either refers to a dental therapist for acclimatisation, confidence building and treatment using traditional behaviour management techniques or treats with relative analgesia, intravenous sedation or general anaesthetic. The type of patients seen has also changed to include more adults with anxiety and other special needs. A few years ago it became apparent to me that if I could not manage anxious patients using traditional psychological approaches, many would ultimately receive intravenous sedation (not suitable for needle phobics or children) or inhalation sedation (not suitable for very young children) or general anaesthesia. I felt that another option was needed. I began to research and then to train in neuro linguistic programming and hypnosis in order to manage dental anxiety, fear and phobia without the need for pharmaceutical intervention.