Dental Anxiety – The Importance of the Whole


Dr Henriette Macri-Etienne, BDS, is a dental surgeon with more than 20 years’ experience. She has expertise in holistic dentistry and assisting patients with dental anxiety. She owns Integrated Dental Health practices in Katoomba and Canberra, Australia. She also loves yoga, meditation and deadlifts and exercises in the outdoors when she can!  

Dr Henriette says:

“An unfortunate side-effect of the Coronavirus pandemic has been an increase in anxiety levels world-wide. Adults and children alike have become more anxious as fears about contracting the virus, concerns for family members, “lockdowns” and impacts on people’s social lives, school and work have taken a toll.

This has reminded us just how damaging high anxiety levels can be. 

This is true in my own field of dentistry, as well as in our lives in general. As a dentist and dental practice owner with a particular interest in dental anxiety, I know how prevalent this is and what it can lead to. Avoiding or delaying dental visits can lead to a ‘the vicious cycle of dental fear’, culminating in worsening problems and more significant treatments. 

In Australia, high dental fear affects approximately one in six adults and around one in 10 children and dental phobia affects around 5 per cent of the population.

We all know what it’s like to put something off because we can’t bear the thought of doing it. Even if our rational mind tells us to “just do it”, our emotional brain is louder, preventing us from taking action.

As other medical practitioners do all they can professionally to assist with increased levels of anxiety more generally, I’m proud as a clinician and dental practice owner, to see that many of my colleagues are also stepping up. And, increasingly, I find my own work dedicated to this aspect of dentistry and to encouraging even more of my colleagues to focus on patients’ anxiety as a part of their daily work.  

Anxious patients should know they’re not alone. Rarely a day goes by when I don’t meet someone who has dental fear in some capacity. 

It’s also important to understand that “dental anxiety” is not a simple concept. Its origins can be rooted in unique experiences and entrenched within the body as well as the mind, often triggering physical symptoms.

A person may remember a traumatic dental treatment they had as a child. Someone who has experienced a head and neck injury may fear being traumatised by any treatment close to those areas of their body. For others, the cause may be less obvious, but there can still be a strong stress reaction. Dental anxiety doesn’t always need an explanation, but it doesrequire empathy and compassion, combined with a treatment plan tailored to the individual.”

Moreover, in my own clinical experience, it very often requires a holistic or multidisciplinary approach, encompassing other areas of health and wellbeing. 

If there’s one thing that I’d like for myself and for my colleagues coming from the pandemic, it is that we become even more aware of – and practice – the power of holistic dentistry. Here’s a few tips to remind us of the power inherent in this approach and how we can best harness that to the benefit of patients:

• have in mind that holistic dentistry is about addressing both physical and psychological pain points; 

• remember the importance of empowering patients to make choices by offering as many options as possible (a lack of choice and sense of “control” can exacerbate feelings of fear);

• show some common human kindness – empathy and compassion go a long way;

• think about patients’ comfort and “distractions” from anxiety – the sensation of a warm neck pillow in the dental chair, noise-cancelling headphones, weighted blankets, alliances with allied health practitioners, and a full range of pain management options from lighter sedations to sleep dentistry (or general anaesthetic); and

• a sense the clinician cares about and respects the whole person, not just the hole in the tooth!

Dental fear, like other anxieties, can be a whole-of-body experience. So let’s keep in mind the power of the clinician’s skills and experience and of a human hand on the shoulder – metaphorical and literal.

Media Contact – Dr Henriette Macri-Etienne

Location: Sydney, Australia

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