Advantages and limitations of nonpharmacological techniques Nonpharmacological techniques are frequently very time-
Whereas the effects of pharmacological techniques last only as long as the actual procedure, results of nonpharmacological strategies may benefit the patient for a lifetime. The newly acquired coping skills may eventually allow the patient to face future dental care with confidence. However, for patients whose need for care is too urgent or for individuals who, because of mental or physical disabilities, cannot cooperate, pharmacological intervention may be the appropriate choice. Once their immediate dental needs have been met, it may be possible to provide these patients with ongoing dental care with the help of nonpharmacological techniques alone. breathing, tell-show-do, relaxation techniques, hypnosis, acupuncture and acupressure, and biofeedback. Online support groups may also be of value to some patients. Many of these approaches also work well with pediatric, geriatric, and special needs patients, although some modifications may be required. Other techniques for children include voice control, modeling behavior, and allowing a parent to be present in the operatory. Elderly patients and those with special needs may require additional behavioral support or physical support as well as increased education about home care. When the appropriate nonpharmacological techniques are routinely incorporated into office procedures, treatment outcomes can be improved. In addition, fearful patients may acquire new coping skills that allow for a less stressful delivery and acceptance of quality dental care. Lineberry, J. (2018). Top 6 methods for managing gagging patients . Spear Education. https://www. speareducation.com/spear-review/2015/09/understanding-and-managing-gagging-patients#:~:text=%20%20%20 1%20One%20of%20the%20most,taking%20nice%2C%20even%20breaths%20in%20and...%20More%20 Lovas, J. G., & Lovas, D. A. (2007). Rapid relaxation: Practical management of preoperative anxiety. Journal of the Canadian Dental Association, 73 (5), 437-440. Lyons, R. A. (2009). Understanding basic behavioral support techniques as an alternative to sedation and anesthesia. Special Care in Dentistry, 29 (1), 39-50. Mark, A. M. (2017). Coping skills for facing dental fears. Journal of the American Dental Association, 148 (2), 130. https://jada.ada.org/article?S0002-8177(16)30966-7/fulltext Matsuoka, H., Chiba, I., Sakano, Y., Toyofuku, A., & Yoshihhiro. A. (2017). Cognitive behavioral therapy for psychosomatic problems in dental settings. BioPsychoSocial Medicine, 11 . Article number: 18. https:// bpsmedicine.biomedcentral.com/articles/10.1186/s13030-017-0102-z#:~:text=Cognitive%20behavioral%20 therapy%20for%20psychosomatic%20problems%20in%20dental,Author%20information.%20...%208 Minja, I. K., & Kahabuka, F. K. (2019). Dental anxiety and its consequences to oral health care attendance and delivery . Intech Open.attendance-and-delivery Moore, T. A. (2016). Dental care for patients with special needs. Journal of Multidisciplinary Care: Decisions in Dentistry. https://decisionsindentistry.com/article/dental-care-patients-special-needs/ National Institute of Mental Health. (2016). Anxiety disorders . https://www.nimh.nih.gov/health/topics/ anxietydisorders/index.shtml Oliver, K., & Manton, D. J. (2015). Contemporary behavior management techniques in clinical pediatric dentistry: Out with the old and in with the new? Journal of Dentistry for Children, 82 (1), 22-28. Oyekunle, O. M., Fulton, J., & Hayes, C. (2016). What is the most effective intervention for the management of dental anxiety among adults? A systematic review of interventions. Journal of Community and Public Health Nursing, 2 (4), 146. Panda, A., Garg, I., & Shah, M. (2015). Children’s preferences concerning ambiance of dental waiting rooms. European Archives of Paediatric Dentistry, 16 (1), 27-33. Pocket Dentistry. (2016). Special needs of anxious and phobic dental patients . https://pocketdentistry.com/special- needs-of-anxious-and-phobic-dental-patients/ Premkumar, K. S., Asfaque, S. J., Sumalatha, S., & Narendran, N. (2019). Effect of aromatherapy on dental anxiety among orthodontic patients: A randomized controlled trial. Cureus, 11 (8), e5306. 10.7759/cureus5306. Ravalia, M. (2017). Can clinical hypnotherapy be used as an adjunct or an alternative to conscious sedation in dentistry? EC Dental Science, 10 (2), 37-45. http://www.ecronicon.com>ecde>pdf>ECDE-10-00330 Riba, H., Al-Zahrani, S., Al-Buqmi, N., & Al-Jundi, A. (2017). A review of behavior evaluation scales in pediatric dentistry and suggested modification to the Frankl Scale. EC Dental Science, 16 (6). http://www.eccronicon. com>ecde>pdf>ECDE-16-00574 Rohmetra, A., Tandon, R., Singh, K., & Jaiswal, A. (2017). Acupressure therapy in orthodontics: A review. 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Journal of the Indiana Society of Pedodontics and Preventive Dentistry, 33 (1), 48-52. https://www.researchgate.net/publication/270657611_RMS_Pictorial_Scale_RMS-PS_An_innovative_scale_for_ the_assessment_of_child%27s_dental_anxiety Singh, H., Bhaskar, D. J., & Rehman, R. (2015). Psychological aspects of odontophobia. International Journal of Oral Health and Medical Research, 1 (6). http://www.ijohmr.com>upload>PsychologicalAspectsofOdontophobia Singh, N. (2019). Providing care to patients with special needs. Dimensions of Dental Hygiene . https:// dimensionsofdentalhygiene.com/article/caring-%e2%80%a8for-patients-with-special-needs/ Special Care Dentistry Association. (2016). SCDA definitions . https://www.scdaonline.org/page/SCDADefinitions Suhani, R. D., Suhani, M. F., & Badea, M. E. (2016). Dental anxiety and fear among a young population with hearing impairment. Clujul Medical, 89 (1), 143-149. http://doi.org/10.15386/cjmed-556 Sweta, V. R., Abhinav, R. O., & Ramesh, A. (2019). Role of virtual reality in pain perception of patients following the administration of local anesthesia. Annals of Maxillofacial Surgery, 9 (1), 110-113. https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC6585215/ Tellez, M., Kinner, D. G., Heimberg, R. G., Lim, S., & Ismail, A. I. (2015). Prevalence and correlates of dental anxiety in patients seeking dental care. Community Dentistry and Oral Epidemiology, 43 (2), 135-142. Venkataramana, M., Pratap, K., Padma, M., Kalyan, S., Reddy, A. A., & Sandhya, P. (2016). Effect of aromatherapy on dental patient anxiety: A randomized controlled trial. Journal of Indian Association of Public Health Dentistry, 14 (2), 131-134. White, A. M., Gibline, L., & Boyd, L. D. (2017). The prevalence of dental anxiety in dental practice settings. Journal of Dental Hygiene, 9 (1). https://pubmed.ncbi.nlm.nih.gov/29118148/ Wiener, R. C. (2015). Dental fear and delayed dental care in Appalachia-West Virginia. Journal of Dental Hygiene, 89 (4), 274-281. Wilson, N. J., Lin, Z., Villarosa, A., Lewis, P., Philcy, P., Sumar, B., & George, A. (2019). Countering the poor oral health of people with intellectual and developmental disability: A scoping literature review. BMC Public Health . https://bmcpublichealth.biomedcentral.com/articles/10.1186/a12889-019-7863-1 Zeren, A. E., Öktem, Z. B., Can, I., Bezgin, T., & Özalp, N. (2016). What to wear when practicing on pediatric dental patients? Journal of Pediatric Dentistry, 4 (2), 37-41.
consuming and require great commitment from the dental team. However, they have many advantages compared with the use of medication, such as: ● Greater safety. ● No patient fear of drug interactions. ● No clinical adverse effects. ● No patient fear of developing a drug habit. ● Patient preference for nonpharmacological strategies. ● In many cases no need for special practitioner training. ● In most cases no need for special equipment or medical setting. ● Enhancement of patient self-esteem. Conclusion Dental fear poses one of the greatest challenges dentists face in their daily practice. It frequently leads to avoidance of dental care, which can result in oral health-related problems and a reduction in patients’ quality of life. Some degree of dental anxiety is almost universal, and for an unfortunate few, dental fear presents an overwhelming problem. It is important that dental practitioners be able to identify anxious patients early. Doing so enables the dentist to employ the appropriate strategies to help improve the likelihood of successful treatment. Numerous nonpharmacological patient behavior guidance strategies are available to help patients overcome their fears. This starts with using the appropriate communication approaches and ensuring a welcoming, calming environment. Common strategies for adults include distraction, guided imagery, focused References Ahmad, N., Yunus, N., & Jafri, Z. (2015). Etiology and management of gag reflex in the prosthodontic clinic: A review. International Journal of Oral Health Dentistry, 1 , 25-28. http://oaji.net/articles/2015/1994-1432969210.pdf Al Atram, A., Singh, S., Bhardwaj, A., & Fadalah, M. K. A. (2016). Evaluation of fear and anxiety associated with instruments and treatment among dental patients. International Journal of Contemporary Medical Research, 3 (9). https://www.ijcmr.com/volume-3-issue-9.html Allison, N. (2015). 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