Dental Anxiety, Case Discussion

Replacing  fear with trust in the therapeutic dental relationship. A patient presented with dental neglect and  a history of dental avoidance stemming from negative past dental experience. He declined any treatment without sedation. After consenting to an exam, he was guided toward therapeutic trust in the professional relationship. An exam with permission statements, retaining full personal control was the first step. After the exam, the  possibility of a cleaning emerged and the hygiene visit retaining full patient  control followed. A consultation emphasizing results and attainable financial goals provided the framework for the next step.  After assurance that the visit would be completely painless and under his total control, the patient now had enough trust  to allow a brief visit with local anesthetic and a restoration. Following this quick  and completely painless procedure, the patient said enthusiastically, I could kiss you, shook my hand instead, and said he was now ready for his root canal without sedation!
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