Key Points
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Identifies that individuals who are referred for sedation are highly anxious and fear a range of different dental stimuli.
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Even patients who are referred for restorative dentistry can be anxious.
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Anxious patients are likely to attend for dental care only on an emergency basis.
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Highlights the aspects of dentistry which cause anxiety.
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The drill is more anxiety provoking than dental injections.
Abstract
Objective To assess referrals to sedation, examining dental anxiety and background of patients, and compare these characteristics to those referred to a restorative dentistry clinic.
Design Descriptive, cross sectional survey.
Subjects and methods Subjects were 100 consecutive new patients in sedation and special care and 50 new patients in restorative dentistry at Guy's and St Thomas NHS Foundation Trust. A questionnaire included demographics, self-reported oral health and dental attendance, and dental fear. Information from the patients records was taken: ASA classification, previous sedation or general anaesthesia, alcohol and tobacco use, and medications.
Results The best predictors of referral were dental anxiety level and an irregular attendance. The most important fears were seeing, hearing and feeling the vibrations of the dental drill, and the perception of an accelerated heart rate. Other factors such as general, mental and dental health and alcohol use were related to referral but less important.
Conclusions Referral is consistent with the goal of the sedation clinic to see anxious patients. Referring general practitioners are able to identify these patients.
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Acknowledgements
This research was supported, in part, by a grant from the Society for the Advancement of Anaesthesia in Dentistry (SAAD). We acknowledge the advice of Dr David Craig of the King's College Dental Institute and Emeritus Professor Isaac Marks of the Institute of Psychiatry in carrying out this study and the assistance of the dental nurses in both sedation and restorative clinics. Thanks also to Brian Smith, retired consultant in restorative dentistry.
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Boyle, C., Newton, T. & Milgrom, P. Who is referred for sedation for dentistry and why?. Br Dent J 206, E12 (2009). https://doi.org/10.1038/sj.bdj.2009.251
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DOI: https://doi.org/10.1038/sj.bdj.2009.251
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