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Release: April 11, 2001

Dentistry professor writes textbook chapter on dental anxiety

IOWA CITY, Iowa -- If the sound of a dentist's drill leaves you trembling, you are probably not alone. Avoiding the dentist, however, will not help the situation and could only make things worse for your teeth, according to a University of Iowa College of Dentistry researcher.

"When you ignore routine oral care because of dental anxiety, larger problems develop," said Cindy Marek, Pharm.D., assistant professor (clinical) of oral pathology, radiology and medicine. "In the end, more extensive -- and more expensive -- care is often needed."

Marek wrote about the common fear of visiting the dentist in the upcoming textbook, "Treatment Planning in Dentistry," scheduled for release April 23.

Marek, who co-authored the chapter with Henrietta Logan, professor emeritus in the UI College of Dentistry, said about 25 percent of adults are afraid of visiting the dentist. As a result, 10 percent of these people neglect dental treatment.

Dental anxiety usually develops during childhood after a negative experience, or may be a learned response from family members, most often older siblings, Marek said.

"The patient usually has an underlying fear of pain," she said. "Evidence suggests that when the patient no longer fears pain, dental fear declines."

Marek, who also holds a faculty appointment in the UI College of Pharmacy, said administering anti-anxiety medications prior to and during dental treatment will help manage dental fears and make a patient more comfortable. Oral anxiety medications, which are very safe, are provided to sedate fearful patients, but Marek said drugs alone are not the answer. A patient must find a dentist they are comfortable communicating their fears and concerns with.

"The patient and practitioner can establish hand signals, so that the patient can signal for breaks during the procedure," Marek said. "This way, the patient gains control over the treatment, which can make a lot of difference to any patient."

Once the rapport with the practitioner is established and there are positive experiences, the anxiety will subside, Marek said.

"After a few positive experiences, these fears can be overcome," she said. "It is essentially a relearning experience."

The UI College of Dentistry curriculum teaches students how to deal with anxious or fearful patients, since it is so common, Marek said.

"There is more emphasis on this topic now, since fear keeps so many people from visiting their dentists," she said.

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