Addressing anxiety and fear in clinical settings : the role of non-pharmacological interventions and digital media representation

Abstract

The study of dental anxiety causes and alleviation methods has been ongoing for a long time. While existing literature focuses on dental-related factors, the understanding of non-dental-related factors remains limited. Furthermore, most anxiety-relieving approaches are not patient-driven. This thesis explores a multidimensional approach to addressing dental anxiety through an in-depth investigation of various interventions and contributing factors that help reduce fear and anxiety during dental procedures. The research utilizes a combination of systematic review and meta-analysis, qualitative evaluations, cross-sectional studies, and randomized clinical trials.

First, a systematic review and meta-analysis were conducted to assess the efficacy of non-pharmacological interventions in alleviating fear and anxiety in patients undergoing third molar extraction under local anesthesia. The review offers a comprehensive synthesis of the existing evidence on diverse interventions, including psychological, behavioral, distraction, and educational strategies, thereby contributing to a more profound understanding of their effectiveness in the context of third molar extraction procedures.

Second, a qualitative assessment of YouTube videos addressing dental fear, anxiety, and phobia was performed to evaluate the quality and content of the available online resources. This analysis identified gaps in public knowledge and understanding, as well as revealed potential opportunities for enhancing dental education and patient support. Furthermore, the study provided insights into the causes of dental fear, anxiety, and phobia, as well as the kinds of situations that trigger fear, based on patient testimonials.

The third part of the thesis involves a cross-sectional study examining the link between dental anxiety and factors extending beyond dental-related concerns, with a specific emphasis on adverse childhood experiences and dental anxiety in adults. This study offers a more comprehensive perspective on dental anxiety, enabling researchers and practitioners to take into account a wider array of influences that play a role in the emergence and persistence of dental anxiety.

The fourth and fifth components of the thesis are randomized clinical trials evaluating the effectiveness of two innovative interventions for reducing dental anxiety: biofeedback instruments and virtual reality (VR). The biofeedback trial assesses the impact of biofeedback devices on anxiety levels in patients undergoing dental extraction with local anesthesia, while the VR trial examines the use of immersive virtual environments in reducing anxiety in patients undergoing minor oral surgery with sedation.

In conclusion, this thesis presents a thorough examination of various approaches to addressing dental anxiety, aiming to improve patient comfort and well-being. The research findings have the potential to inform evidence-based interventions and contribute to the development of more effective strategies for managing dental anxiety in diverse patient populations.