Fear and its Management

1. NAVODAYA DENTAL COLLEGE
DEPARTMENT OF PEDODONTICS
STAFF NAME – Dr NAVEEN KUMAR
Professor
TOPIC NAME –Fear and its management

2. What is
fear?
• Fear is the result of endless desires,
when the desire are not fulfilled people
worry & fear.
• Fear is felt by almost everyone from time
to time, but one must know how to deal
with it.

3. Development of fear
1. At birth
• This is a primary response acquired soon after birth
such as startle response; however , the new born is
unaware of the stimulus.
• With age he starts becoming aware of fear-producing
stimuli and can adjust to the isolated experience by
resorting to flight if he cannot solve the problem.
2. Pre-schooler
• Fear of animals or being left alone or abandoned
3. Early schooler
• Fear of the dark, staying alone
4. Late schooler
• By age of 9,fear of bodily injury may be present
5. Adolescent
• Fear of social rejection

4. Fear of dental situation
1.Innate fear:-
• Fear without stimuli or previous experience
Dependent on vulnerability of the individual
2.Objective fear:-
• Acquired objectively or those produced by direct
stimulation of sense organ but not parental origin
• Eg: previous unpleasant contact with dentistry,
uniforms worn by dentist
3.Subjective fear:-
• Based on feelings and attitudes suggested to the child
by others without the child personally experiencing
them

5. Fear Evoking Dental Stimuli
• Anesthetic administration locally by injection
• Extraction
• Sound of drill
Factors causing dental fear
• Fear of pain or its anticipation
• Lack of trust or fear of betrayal
• Fear of loss of control
• Fear of unknown
• Fear of intrusion

6. Management of Fear
Various behavior management strategies includes:-
• Pre appointment approaches
• Communications
• Euphemisms
• Time structuring
• Distraction
• Guided imagery
• Parent in the operatory
• Desensitization
• Modeling
• Tell Show Do
• Pharmacological management

7. Reality approach for managing a fearful child in dental
clinic:-
• The patient is granted the reality of his symptoms or
complaints
• The patient’s anxiety or fear requires a thorough
exploration of the symptoms and complaints
• A positive statement of assurance at some stage is
mandatory
• The dentist states that he or she does not know all the
answers to the patient’s problems

8. Fear Assessments
The Children’s Dental Fear Picture Test -
CDFP(Klingberg, 1994)
It consists of three different subtests
• The Dental sitting pictures (CDFP-DS)
• The pointing pictures (CDFP-PP)
• A sentence completion task (CDFP-SC)

9. Basic obstacles of
fear
• Fear & worry
• Lack of confidence
• Lack of persistence
• Failure to take
action

10. Fear &
worry

11. Lack of
confidence

12. Lack of
persistence

13. Failure to take
action

14. We cannot except a fearful
person to do better jobs or
responsible jobs

15. Positive think can kill the
fear