Fig. 2.9 Is your patient just a mouthful of instruments? (With thanks to David
Myers and kind permission of Eden Bianchi Press.)
Fig. 2.10 Make sure you offer your patient a definite farewell. (With thanks to
David Myers and kind permission of Eden Bianchi Press.)2.5 ANXIOUS AND UNCOOPERATIVE CHILDREN
Dental anxiety should concern us as a profession because it not only prevents many
potential patients from seeking care but it also causes stress to the dentists
undertaking dental treatment. Indeed one of the major sources of stress for general
dental practitioners is 'coping with difficult patients' (Fig. 2.11). Dentists do not want
to be considered as people who inflict unnecessary anxiety on the general public.
However, anxiety and dental care seem to be locked in the general folklore of many
countries. In order to understand why, it is helpful to consider 'what is the nature of
anxiety'.
Many definitions of anxiety have been suggested and it is a somewhat daunting task
to reconcile them. However, it would seem sensible to consider the comments of Kent
(see Kent and Blinkhorn 1991) who reported that anxiety is 'a vague unpleasant
feeling accompanied by a premonition that something undesirable is going to happen'.
In other words it relates to how people feel⎯a subjective definition. Another point of
view is that anxiety manifests itself in behaviour. If, for example, a person is anxious,
then she/he will act in a particular manner. A person will avoid visiting the dentist.
Thus, anxiety should be seen as a multi- factorial problem made up of a number of
different components, all of which can exert an effect.
Anxiety must also be seen as a continuum with fear⎯it is almost impossible to
separate the two in much of the research undertaken in the field of dentistry, where
the two words are used interchangeably. One could consider that anxiety is more a
general feeling of discomfort, while fear is a strong reaction to a specific event.
Nevertheless it is counterproductive to search for elusive definitions as both fear and
anxiety are associated with dental visiting and treatment.