Strategies Used by The Dentists in Addressing The Behavior of Patients in Managing Dental Anxiety

BALAYAN SENIOR HIGH SCHOOL
Caloocan, Balayan Batangas

Science Technology Engineering and Mathematics
(STEM)
STRATEGIES USED BY THE DENTISTS IN
ADDRESSING THE BEHAVIOR OF PATIENTS IN
MANAGING DENTAL ANXIETY
STEM 12 – Epifanio De Los Santos
Group 12
Dacallos, Trina L.
Mendoza, Shaina Irish Jade D.
Pasiona, Kasandra Marienn
Perez, Kim Rosselle D.
Sanchez, Lorraine Grace
Dr. Ma. Rhoda E. Panganiban Phd
Research Adviser
1
(STEM)
CHAPTER I
INTRODUCTION
Dental Anxiety is a significant factor that contributes to the avoidance of
dental care. According to Better Health Channel (2021), dental anxiety is defined as
fear, anxiety, or tension related to a dental environment -or it could be simply
correlated to the fear of going to the dentist. Dental anxiety is common among
people. As said by Beaton et al. (2014), there are several causes as to why people
are frightened of dentists such as an individual aetiological factor. Patients that suffer
from dental anxiety are afraid that something frighteningly bad will happen during
dental treatment, thus, avoiding going to the dentist. When such behavior occurs it
ultimately results in bad oral health. Oftentimes, dentists encounter difficulties when
dealing with a patient who has dental anxiety. The behavior of a patient suffering
from dental anxiety when triggered by a stimulus varies from one person to person.
Dental Anxiety manifest physical, cognitive, emotional, and behavioral responses in
people. It also has different levels, varying from mild to extreme levels that have
distinct types of appropriate approaches depending on the severity of the dental
anxiety of the patient. It is necessary to identify dentally anxious patients effectively
and to treat them appropriately. According to Hamzah et al. (2014), numerous
strategies of managing dental anxiety in pediatric patients were deemed effective,
including verbal and nonverbal communication, desensitization to dental settings and
procedures, positive reinforcement, parental presence and support, and many more.
Therefore, developing appropriate evidence-based treatments to be given such
patients is essential.
2
(STEM)
Dental anxiety is a major complication for both patient and dentist. This
apprehension leads patients to postpone or cancel dental visits or avoid treatment
entirely. It is confirmed that anxious patients have more decayed, missing and less
filled teeth in comparison to no anxious patient. Their poorer oral health status can
have negative effect on their social life. Furthermore, treating anxious patients might
take more time; it is hard to manage them during the procedure and they are often
unsatisfied with their treatment. Anxiety can affect patient/dentist relationship and
result in misdiagnosis. Dentists claim that such patients are important sources of
stress that can compromise their practice.
Dental anxiety is prevalent worldwide and not limited to a population or
country. Depending on the population and the measurement technique, 2.5-20%
people endure high dental anxiety. Many studies ascertain that dental anxiety is more
common in women. In addition, it has reported that anxiety subsides with age. Some
studies claim that patients with higher education experience less anxiety during
dental procedures. A study indicated that previous traumatic experience is a
significant commencing factor in dental anxiety and fear.
The basic feeling of anxiety is perceived differently and individually by every
person. The different ways to deal with this anxiety are as vast and varied as the
subsequent reactions. In response to anxiety-provoking objects or situations, there
are controlled as well as uncontrolled actions or behaviors of patients. It should be
emphasized that anxiety is normal, considering the perspective of evolution and is
usually perceived as negative. However, developing a phobia out of an anxiety
makes the patient often respond with an avoiding strategy, avoiding the dentist. The
transition to this pathological condition is fluent.
3
(STEM)
Anxieties and their disorders are one of the most frequent psychological
illnesses. Dental anxiety for patients who are suffering from an anxiety disorder is
ranked in second place, with 21%, behind. A study from 2019 aimed to show a
relationship between dental anxiety and general psychological distress. It suggested
that there is more psychological distress among patients below the age of 46 and
women. Additionally, patients with dental anxiety have more destroyed teeth and
worse dental hygiene than other patients. It is, therefore, advised to figure out a
suitable treatment of patients with dental anxiety to prevent bad oral health. One can
conclude that dentists need to be prepared for encounters with patients with dental
anxiety and to act appropriately to reduce the anxiety.
In accordance to the Professional Regulatory Board of Dentistry is
empowered to prescribe and/or adopt a Code of ethics and a Code of Dental Practice
for the practice of dentistry, dental hygiene, and dental technology (Sec. 6. Powers
and Functions of the Board, Art II of R.A No. 9484, known as the Philippine Dental
Act 2007"). Duty to the Community; states that the primary duty of the dentists,
dental hygienists, and dental technologist's primary duty of serving the public is
accomplished by giving his/her professional service to the best of his/her capabilities
in accordance with established standards if care and by conducting himself/herself in
a manner befitting a professional of high esteem. The dentist, dental hygienists, and
dental technology must make their discoveries, inventions, or works that are helpful
in preserving or improving health available in the interest of the public's health,
subject to governmental regulatory legislation. The community shall have access to
the dentist's, dental hygienists, and dental technologist's skills, knowledge, and
4
(STEM)
experiences, particularly in the field of specialty, in all efforts to promote the dental
health of the general public.
This study will be accomplished just near the hometown and where it is
convenient for the researchers to conduct this study. The main participant of this
research study are the dentists and dental professionals within the Province of
Batangas in the Municipalities of Balayan, Calaca, and Lemery to access or identify
the strategies used by the dental professionals in addressing the behavior of patients
in managing dental anxiety.
Behavioral phenomena, as shaped by psychological traits, which also refers
to the perceptible physical, social, and mental activity of an individual is called so for
the reason that its complexity is rather beyond the scope of scientific explanation,
yet. With that, due to the fact that personality types vary from person to person,
different emotions, behavior, and tendencies are manifested as well. And as
complications arise, the decision making and natural instinct of people to resolve
them comes about as well. It is normal for an individual to experience anxiety or
uneasiness, especially with a dental setting, since it is influenced by genetics, as they
can also be innate or learned. That being the case, dental professionals would
anticipate the presence of dental anxiety in their respective clinics, and would adapt
and develop ways and strategies to address these situations in order for the dental
procedures to take place properly and effectively. But these variety of strategies are
not always guaranteed to work because again, the behavior of people, especially
children are still that of an enigma. Consequently, the ultimate aim of this study is to
know whether certain strategies indeed have an effect on the change in behavior of
patients, whether it is also on the positive or negative side as in some cases, actions
5
(STEM)
which are intended to ease patients rather provoke even stronger emotions, and
finally, if these strategies affect the patients' mental stability and alleviate the anxiety
patients suffer from; moreover how the effectiveness of taking action eliminates
dental anxiety altogether over time.
Statement of the Problem
This study aims to have an extensive perception on the strategies used by the
dentists in managing the behavior of patients with dental anxiety
Specifically, this study seeks to answer the following questions:
1. What are the strategies used by the dentist in addressing dental anxiety in
terms of:
1.1 Psychological
1.2 Pharmacological
2. What are the ways of the dentists in managing the dental anxiety of the
patients in terms of:
2.1 Verbal
2.2 Non-verbal
2.3 Sedation Medication
3. Is there a significant relationship between the strategies used and the ways of
managing the dental anxiety of the patients?
Hypothesis
Ho: There is no significant relationship between the strategies used by the
dentists and managing dental anxiety.
6
(STEM)
Significance of the Study
This study will be undertaken to determine the strategies used by the dental
professionals in addressing the behavior of patients in managing dental anxiety. The
researchers expect that this research study will benefit the following groups:
For the Dentist. The study will benefit them by being of help in seeking ways
to manage dental anxiety. Moreover, this will provide them practice accumulated
from other professionals on the same field.
For the Parents. The study will benefit them by giving them assurance that
there are indeed strategies and action being taken by dentists and dental
professionals who look out for their children’s health physically and mentally.
Moreover, this study will also provide suggestions as to how they will be able to put
their children at ease themselves.
For the Researchers. This study will be an accompany for researchers to
discover more things that are reliable and credible to further understand the topic.
Furthermore, this study will allow them to be successful.
For the Future Researchers. This study will help them as this can be used as
reference for future studies and could be used as a guide for them to avoid errors in
research and to make the necessary adjustments that will be suggested by the
findings of the study.
7
(STEM)
For the Future Dentists. This study will help them to be more prepared by
knowing the preparation and success experiences of the dentists. In addition, there is
a massive possibility that their product will succeed because this research study.
Scope and Limitations
This study will focus on the strategies used by the dental professionals in
addressing the behavior of patients in managing dental anxiety. The primary
respondents of this research study comprise the dentists and dental professionals of
District 1 within the province of Batangas. This study will be conducted in Balayan
Senior High School from February 2023 – June 2023. The respondents will be
confined only to and will not explore beyond the said constituent local governments
of District 1 representatives from Batangas.
8
(STEM)
CHAPTER II
Review and Related Literature
1. Strategies in managing dental anxiety among patients.
Newton et al. (2012) dental anxiety and fear are common and potentially
problematic, both for the patient and for the dental team in managing such patients.
Furthermore, dental fear still presents a major barrier to the uptake of dental
treatment. This article will take as its premise an assumption that anxiety manifests at
different levels and that consequently management of dental anxiety involves both
assessment and proportionate intervention. Methods for undertaking both
assessment and management are outlined.
Dental Anxiety is an adaptive emotional response to potentially threatening or
dangerous situations; moderated by the sympathetic nervous system. Dental anxiety
is common and presents before, during or after dental treatment. Consequently,
extensive distress leads to avoidance of dental treatment and multiple failed
appointments, impacting both oral and general health. Dental anxiety can generate a
variety of negative consequences for both the dentist and the patient. The
physiological response includes an increase in heart rate, blood pressure, respiratory
rate, and cardiac output (Hoffman et al., 2022)
Verbal
Communication is essential for a good working relationship that results in
effective clinical treatment between the dental practitioner and the patient (Armfield &
9
(STEM)
Heaton, 2013). It was revealed that patients who feel positive regarding their dentists'
communication had better outcomes in terms of satisfaction and decreased fear than
those who felt negatively about their dentists' communication.
According to Apple (2019), checking on the patient verbally before, during,
and after the dental procedure is an excellent way to build a compassionate,
empathic attitude. The tell-show-do strategy is an efficient way to do this. The
technique's "tell" component entails verbal explanations of the general method as
well as connected actions along the way. The "show" involves demonstrations of the
visual, auditory, olfactory, and tactile components of the process for the patient. The
"do" element of the technique is the execution of the dental process—without
straying from the roadmap provided out in "tell" and "show."
Nonverbal
As stated by Hoffman et al. (2022) evidence‐based strategies are essential
for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioral
strategies can modify the patient's experience through a minimally invasive approach
with nil or negligible side effects, depending on patient characteristics, anxiety level
and clinical situations. These therapies involve muscle relaxation, guided imagery,
physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction
and desensitization. Pharmacological intervention utilizes either relative analgesia
(nitrous oxide), conscious intravenous sedation or oral sedation, which can have
undesirable side effects, risks and contraindications. These modalities increase the
cost and availability of dental treatment.
10
(STEM)
According to Armfield and Heaton (2013), early dental fear research focused
on dentist attributes linked to patient satisfaction and anxiety reduction. It was shown
that patient satisfaction was correlated to the relationship patients had with their
dentists. Patients' satisfaction with care was influenced by dentists' friendliness and
ability to provide moral support. Patients were most worried about their dentists'
specific remarks regarding pain prevention when it came to lowering anxiety. In
interviews with dentally phobic patients, it was discovered that dentists'
understanding and acceptance of patients' wants and fears was more essential than
their technical skill.
Sedation Medication
According to McMaster and Garisto (2012), sedation can be an effective
approach to reduce a patient's tension and anxiety during dental treatment, allowing
for more comfortable procedure. Individuals who have mild to moderate anxiety or
fear will respond effectively to modest to moderate levels of conscious sedation. A
low level of drowsiness can be easily accomplished by administering a sedative
substance (most typically benzodiazepines), nitrous oxide with oxygen, or a
combination of both. Moderate sedation can be achieved by combining various
sedative medications with or without nitrous oxide and oxygen, or by administering a
sedative substance parenterally.
General anesthesia is significant to the execution of excellent dental
treatment for some patients (Mady and Geren, 2020). It's employed in more
extensive procedures. The patient will experience no discomfort and will have no
recollection of the treatment. It is a great alternative for patients who are really
anxious. It is applicable if dental treatment is more advanced or complex, for persons
11
(STEM)
who have excessive anxiety about dental care, or in the event of special care where
patients are unable to cooperate with ordinary care.
2. Ways of the dentists in managing dental anxiety among
patients.
Dental anxiety and phobia result in avoidance of dental care. It is a frequently
encountered problem in dental offices. Formulating acceptable evidence-based
therapies for such patients is essential, or else they can be a considerable source of
stress for the dentist. These patients need to be identified at the earliest opportunity
and their concerns addressed. Broadly, dental anxiety can be managed by
psychotherapeutic interventions, pharmacological interventions, or a combination of
both, depending on the level of dental anxiety, patient characteristics, and clinical
situations (Appuktan D, 2016).
According to Bruce Lieberthal (2018), DDS, director of Product Management
for Henry Schein Practice Solutions, avoiding dental care is a result of dental anxiety
and phobia. At dental offices, it is a problem that is regularly encountered. Such
patients must be given appropriate evidence-based treatments in order to avoid
becoming a significant source of stress for the dentist. These patients must be
located as soon as possible, and their issues must be treated. The initial interaction
between the dentist and the patient can show the presence of anxiety, fear, and
phobia. In such cases, subjective assessment through interviews and self-reporting
on fear and anxiety scales, as well as objective evaluation of blood pressure, pulse
rate, pulse oximetry, finger temperature, and galvanic skin response, can significantly
12
(STEM)
aid in the diagnosis and allow for the classification of these people as mildly,
moderately, or severely anxious or dental phobic.
Psychological
According to Jiang (2019), there are several psychological approaches to
ease dental anxiety. Relaxation techniques such as concentrated breathing and
meditation can effectively lower the heart rate and relax a patient. Incorporating
distractions to the dental chair is useful for many people. Headphones for music or
podcasts are one example, as is a stress ball that may be squeezed with the hands
to relieve tension throughout the operation. Cognitive behavioral therapy is another
strategy that seeks to improve both negative thoughts and behaviors.
Psychotherapeutic interventions are either behaviorally or cognitively oriented
(Appuktan D, 2016). Behavior-modification therapies aim to change unacceptable
behaviors through learning, and involve muscle relaxation and relaxation breathing,
along with guided imagery and physiological monitoring using biofeedback, hypnosis,
acupuncture, distraction, positive reinforcement, stop-signaling, and exposure-based
treatments, such as systematic desensitization, “tell-show-do”, and modeling.
Cognitive strategies aim to alter and restructure the content of negative cognitions
and enhance control over the negative thoughts. Cognitive behavior therapy is a
combination of behavior therapy and cognitive therapy, and is currently the most
accepted and successful psychological treatment for anxiety and phobia.
Pharmacological
Pharmacologically, these patients can be managed using either sedation or
general anesthesia. According to Appuktan D (2016), in certain situations, where the
13
(STEM)
patient is not able to respond to and cooperate well with psychotherapeutic
interventions, is not willing to undergo these types of treatment, or is considered
dental-phobic, pharmacological therapies such as sedation or general anesthesia
should be sought.
There are multiple drugs that a dentist can use to assist lessen patients’
anxiety, including various levels of ‘sedation (Jiang, 2019). A dentist might prescribe
anti-anxiety medication, such as diazepam, to take one hour before a planned dental
appointment. A dentist may also advise patients to use conscious sedation, such as
nitrous oxide, to help patients relax. Patients will retain control over their physical
processes, and this medicine will only be administered during the treatment.
Furthermore, general anesthesia, which puts patients to sleep, may be advised for
more invasive jaw procedures, or for individuals with distinctive requirements or
significant anxiety that makes ordinary treatment impossible.
3. Significant difference between the strategies used ad how
dentists manage dental anxiety
According to Kheir et al. (2020), “Within the limitation of this study, we concluded that
the patient–dentist relationship had a significant impact on dental anxiety. If these are
taken into consideration, contributions to improvements in the delivery and standards
of oral health care for dentally anxious patients in this region can be achieved.”
Dental fear and anxiety can have a severe influence on patients' dental health
as well as their general health. Most patients are nervous before going to the dentist,
and the coronavirus epidemic has heightened their worries. Dental hygienists play an
14
(STEM)
important role in recognizing patients with dental anxiety and executing successful
treatment plans for worried patients (Hoerler and Hunter, 2021).
Theoretical Framework
Figure 1: Theoretical Framework
This section represents the theory that will serve as the foundation for this
study
With reference to the theory of Seligman et al., due to the fact that it is only
natural for an. individual to have feelings caused by certain unpleasant
circumstances wherein they provoke discomfort and fear among people, dental
anxiety has been proven to be very much prevalent from way back in time until, and
especially now. It also has been reconstituted by them that dental anxiety proves that
it has indeed much complexity and is multifactorial. With that theory, they presented
these said factors through two diagrams; A – Onset of dental anxiety, and B –
Maintenance of dental anxiety—which both aim to explain the occurrence of dental
anxiety in that of a deeper way.
15
(STEM)
According to their study, one of their primary points is the interrelation of
dental anxiety and age, focusing more on youth, as it is also stated that dental fear is
rather developmentally normative. When fear gives way to more serious state namely
dental anxiety or dental phobia, it results to significant distress and avoidance;
therefore, the management is not that only of monotherapy, as they also said that
with most cases, youth with dental anxiety which tend to refuse treatment even when
experiencing significant pain could be alleviated with appropriate care. Since in
reference to studies with insight as evidence, most suggest that most adults with
dental anxiety typically emerged their fear during childhood.
As they have undergone extensive research, it has been inferred that there
are complex set of factors that results to the development of significant dental
anxiety, and moreover the maintenance of it. The factors were demonstrated in a
way that it could be interpreted that they run through a cycle and an integrated
cognitive-behavioral model which incorporates influences and results all circling
around the concept of the occurrence of dental anxiety, with negative and positive
outcomes, all depending on the approach, assessment, and management.
Subsequent to the analysis and assessment will the professionals then formulate a
proper and appropriate treatment plan. As early as possible, dental anxiety is very
much encouraged to be diminished and eliminated, otherwise resulting health
problems and is associated with lower quality of life due to refusing and avoidance.
Conceptual Framework
INPUT PROCESS OUTPUT
Factors that trigger The significant
dental anxiety of difference between
patients the strategies used

Survey questionnaire
by the dentists16and
The strategies used
the change in
by the dentist that
affect the behavior of

(STEM)
Definition of Figure 2: Conceptual Framework

Terms
The following terms or phrases pertain to these respective definitions. The
following words were defined conceptually and operationally.
Dentists. persons who are skilled in and licensed to practice the prevention,
diagnosis, and treatment of diseases, injuries, and malformations of the teeth, jaws,
and mouth and who makes and inserts false teeth (Merriam Webster Dictionary). In
this study, they referred as professionals trained in the diagnosis, prevention, and
treatment of diseases and problems affecting the teeth and gums, including the
replacement of missing teeth through extraction and repair.
Dental Anxiety. fear, anxiety, or stress associated with a dental setting (Better
Health Channel). In this study, it is often described as a vicious cycle where
avoidance of dental care, poor oral health, and psychosocial effects are common
17
(STEM)
features, often escalating over time. In addition, it is a normal emotional reaction to
one or more specific threatening stimuli in the dental situation
Nonverbal. Not using words, or not relating to the use of words (Cambridge
Dictionary). In this study, it refers to various ways that a patient is tended to but
without the involvement of spoken words such as body language or facial
expressions
Strategies. a long-range plan for achieving something or reaching a goal, or the skill
of making such plans (Cambridge Dictionary). In this study, it is referred to as a
careful plan or method for achieving a particular goal usually over a long period of
time; a plan that is intended to achieve a particular purpose
Pharmacological. the science or drugs including their origin, composition,
pharmacokinetics, therapeutic use, and toxicology (Merriam Webster). In this study, it
refers to a method where the dentist provides medications, primarily drugs to treat
dental anxiety and behavioral difficulties.
Psychological. directed toward the will or toward the mind specifically in its conative
function (Merriam Webster). In this study, it refers to an approach in that of which the
patient with dental anxiety will be given various kinds of treatments to improve and
reduce anxiety symptoms, in which the mental and emotional state of a person are
the central points.
Verbal. consisting of or in the form of words (Dictionary.com). In this study, it refers
to a strategy in which the dentists use to ease patients’ anxiety in the form of words
or spoken
Synthesis
18
(STEM)
These are the several relations among the review of related literature and our
research study — theses relations are critical in supporting and providing evidences
for our study. According to several studies, they have shown significant links between
the strategies used by dentist in addressing the behavior of patients in managing
dental anxiety and the idea which is presented by Newton et al. (2012) dental anxiety
and fear are common and potentially problematic. both for the patient and for the
dental team in managing such patients. The study of Apple (2019) states that,
checking on the patient verbally before, during, and after the dental procedure is an
excellent way to build a compassionate, emphatic attitude, was also the same as the
studies of (Hoffman et al., 2022), (Lieherthal 2018), (Armfield and Heaton (2013) who
states that early dental fear research focused on dentist attributes linked to patient
satisfaction and anxiety reduction, it was discovered that dentists’ understanding and
acceptance of patients’ wants and fears was more essential than their technical skill.
Moreover, there are also studies that claim to have another point of view
about the study, based on McMaster and Garisto (2012), sedation can be an
effective approach to reduce a patient’s tension and anxiety during dental treatment,
allowing for more comfortable procedure. General anesthesia is significant to the
execution of excellent dental treatment for some patients (Mady and Geren, 2020), in
which it supported by the studies of (Jiang, 2019) and (Appuktan D, 2016), who
claims that these patients need to be identified at the earliest opportunity and their
concerns addressed. Broadly, dental anxiety can be managed by psychotherapeutic
interventions, pharmacological inventions, or a combination of both, depending on
the level of dental anxiety, patient characteristics, and clinical situations.
19
(STEM)
CHAPTER III
This chapter presents and explains the procedures which the researchers
used in conducting this study. These procedures involved research design,
20
(STEM)
respondents of the study, data gathering instruments, data gathering procedure, and
statistical treatments.
Research Design
The purpose of this study is to have a deeper understanding about the
strategies used by the dentists in managing dental anxiety among patients. This
study focuses on determining the ways of the dentists in managing the dental anxiety
of the patients in terms of psychological and pharmacological. It aims to know the
strategies used by the dentists in addressing dental anxiety among patients of verbal,
nonverbal, and medicinal approaches.
In conducting this study, a descriptive research design is applied. According
to Voxco (2021), a descriptive research design is a type of research design that
seeks to systematically gather data to characterize a phenomenon, circumstance, or
population. The goal of a descriptive research design is to draw and classify a
phenomenon (Nassaji, 2015) and to elaborate individuals, events, or situations by
observing them in nature (Siedlecki, 2020). This research design was applied
because this method is used to investigate and comprehend the significance that
individuals or groups attribute to a social or human situation (Creswell, 2014).
Respondents of the Study
21
(STEM)
The respondents of this study will be the licensed dentists of District 1 within
the Province of Batangas. With a total population of (30) licensed dentists working in
their respective dental clinics and offices that will be conducted at the municipality of
Balayan, Batangas in the year 2023. According to Business Research Methodology,
purposive sampling is a method where the researcher uses his or her discretion to
select individuals from the population to participate in the study hence the
consideration for this sampling method to be the one of use to the researchers.
Subsequent to this method, when the subset of respondents has been selected, the
collection of the required data shall be what follows.
Data Gathering Instrument
The research instrument used by the researchers is the survey questionnaire,
focusing on the strategies used by the dentists in addressing the behavior of patients
in managing dental anxiety. According to the World Health Organization, a
questionnaire is the most prevalent method of gathering primary data. A
questionnaire allows for the collection of data in a standardized manner, ensuring
that the data is internally consistent and coherent for analysis (Roopa & Rani, 2012).
The researchers also opted for a survey questionnaire as the method for gathering
data as it is convenient for them. The questionnaires can be distributed simply by e-
mail, mail, or the Internet. Nowadays, online surveys are the most widely known
method for collecting data from target respondents. Furthermore, survey
questionnaires are best suited for research studies because they stimulate all
participants systematically.
22
(STEM)
Data Gathering Procedure
First, the researchers developed a plan to hand out survey questionnaires to
the selected respondents to collect the data needed for their research study. They
listed possible questions for the writing of their questionnaire. The researchers
structured an outline for the making of their self-made questionnaire. Then after, the
researchers constructed the questionnaire. After finalizing the questionnaire, the
researchers printed out a sample for validation.
In the validation process of this study, copies of the questionnaire were given
to the teacher assigned for the validating process. The questionnaire will be validated
by Mrs. Rhoda E. Panganiban order to guarantee the quality of the questions.
Teachers with experience in the field of educational research would be urged to give
their professional judgment about the questionnaire's content. The questions were
formulated in simple language for clarity and ease of understanding.
After determining the validity and reliability of the data collection method and
whether the made questions were appropriate for the study, the researchers will
hand out the questionnaire to the selected respondents. The questionnaires will be
directly administered to the chosen set of respondents. The respondents will then
complete the survey questionnaire. The respondents' corresponding answers to the
questions will be kept private following the agreement of the respondents and the
researchers.
The printed survey questionnaire that was provided to the respondents will be
checked by the researcher in order to gather data. The researchers will total up all
the data once they have collected it all. Following the distribution of questionnaires,
23
(STEM)
the researchers will ensure that all necessary information is accurately written. The
data will be examined and interpreted by the researcher, who will then deliver their
findings.
Statistical Treatments
After the researchers were able to examine and organize the acquired data in
order to answer the questions of the study, these statistical methods were used.
MEAN. It is the simple mathematical average of a set of two or more numbers. A
mean helps you to assess a set of numbers by telling you the average, helping to
contextualize each data point.
STANDARD DEVIATION. It is a statistic that measures the dispersion of a dataset
relative to its mean and is calculated as the square root of the variance. The standard
deviation is calculated as the square root of variance by determining each data
point's deviation relative to the mean.
FREQUENCY. It is the number of times an event or observation happened in an
experiment or study. It can also be defined simply as a count of a certain event.
WEIGHTED MEAN. The weighted mean is a type of mean that is calculated by
multiplying the weight (or probability) associated with a particular event or outcome
with its associated quantitative outcome and then summing all the products together.
PERCENTAGE. It is a special type of proportion where the ratio is multiplied by a
constant, 100, so that the ratio is expressed per 100.
24
(STEM)
PEARSON’S R. measure the strength and direction of the linear relationship of two
variable and of the association between interval and ordinal variables (Baraceros,
2016)
To further understand this study, after gathering the necessary data through
survey questionnaires, the collected data will then be evaluated using Pearson’s r.
The researchers will use this technique to further determine and understand the
significant differences between strategies used by the dentists and managing dental
anxiety. With the help of this technique, the researcher will come up with the most
relevant results.
25
(STEM)
References
Apple, A. (2019).
https://www.dentistryiq.com/dental-hygiene/article/14038381/effective-
ways-to-treat-patients-with-dental-anxiety
Appukuttan DP. Strategies to manage patients with dental anxiety and dental
phobia: literature review. Clin Cosmet Investig Dent. 2016 Mar 10;8:35-
50. doi: 10.2147/CCIDE.S63626. PMID: 27022303; PMCID:
PMC4790493.
Armfield, J. and Heaton, L. (2013), Management of fear and anxiety in the
dental clinic: a review. Aust Dent J, 58: 390-407.
https://doi.org/10.1111/adj.12118
Baraceros, E.L. (2016). Practical Research 2. Rex Book Store, 856 Nicanor
Reyes, Sr. St. C. M. Recto Avenue, Manila, Philippines.
Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist?
Observations and explanations. Med Princ Pract. 2014;23(4):295-301.
doi: 10.1159/000357223. Epub 2013 Dec 20. PMID: 24356305;
PMCID: PMC5586885.
Definition of dentist. (2023). In Merriam-Webster Dictionary.
https://www.merriam-webster.com/dictionary/dentist
Definition of pharmacology. (2023). In Merriam-Webster Dictionary.
https://www.merriam-webster.com/dictionary/pharmacology
26
(STEM)
Definition of psychological. (2023). In Merriam-Webster Dictionary.
https://www.merriam-webster.com/dictionary/psychological
Definition of verbal. (n.d.). In www.dictionary.com.
https://www.dictionary.com/browse/verbal
Department of Health & Human Services. (n.d.). Dental anxiety and phobia.
Better Health Channel.
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/
dental-anxiety-and-phobia#:~:text=Dental%20anxiety%20is%20fear
%2C%20anxiety,general%20can%20trigger%20dental%20anxiety.
Hamzah HS, Gao X, Yung Yiu CK, McGrath C, King NM. Managing dental
fear and anxiety in pediatric patients: A qualitative study from the
public's perspective. Pediatr Dent. 2014 Jan-Feb;36(1):29-33. PMID:
24717706.
Hoerler, S. and Hunter, S. (2021, June 25). Managing Dental Anxiety.
Dimensions of Dental Hygiene | Magazine.
https://dimensionsofdentalhygiene.com/article/manage-dental-anxiety/
Hoffmann, B., Erwood, K., Ncomanzi, S., Fischer, V., O'Brien, D. and Lee, A.
(2022), Management strategies for adult patients with dental anxiety in
the dental clinic: a systematic review. Aust Dent J, 67: S3-S13.
https://doi.org/10.1111/adj.12926
Jiang, T. (2019). Coping with dental anxiety: Drills, Needles, and Pain.
Harvard Health. https://www.health.harvard.edu/blog/drills-needles-
and-pain-oh-my-coping-with-dental-anxiety-2019121818475
27
(STEM)
Kheir OO, Ziada HM, Abubakr NH, Abdel-Rahman ME, Fadl SM, Ibrahim YE.
Patient-dentist relationship and dental anxiety among young Sudanese
adult patients. Int Dent J. 2019 Feb;69(1):35-43. doi:
10.1111/idj.12409. Epub 2018 Jul 11. PMID: 29992551; PMCID:
PMC9378979.
Laura D. Seligman, Joseph D. Hovey, Karina Chacon, Thomas H. Ollendick.
Dental anxiety: An understudied problem in youth. Clinical Psychology
Review, Volume 55, 2017, Pages 25-40, ISSN 0272-7358,
https://doi.org/10.1016/j.cpr.2017.04.004.
(https://www.sciencedirect.com/science/article/pii/S0272735816302331
Lieberthal, B. (2018). Oral Helath in America: Advances and Challenges.
Advancing the nation's oral health through research and innovation |
National Institute of Dental and Craniofacial
Research. https://www.nidcr.nih.gov/sites/default/files/2021-12/Oral-
Health-in-America-Advances-and-Challenges.pdf
Mady, Z. and Geren, J. (2021, August 5). General Anesthesia Dentist
Alexandria - Dental General Anesthesia Arlington VA | Center for
Dental Anesthesia.
https://snoozedentistry.net/sedation-dentistry/general-anesthesia-
alexandria-va/
28
(STEM)
McMaster, R. and Garisto, G. (2012). Practical Considerations for Treating
the Anxious Dental Patient - Oral Health Group.
https://www.oralhealthgroup.com/features/practical-considerations-for-
treating-the-anxious-dental-patient/
Nassaji, H. (2015). Qualitative and Descriptive Research: Data Type versus
Data Analysis. Language Teaching Research, 19, 129-132.
https://doi.org/10.1177/1362168815572747
non-verbal. (2023). https://dictionary.cambridge.org/us/dictionary/english/non-
verbal
Professional Regulation Board. (2008). Professional Regulation Board: Code
of Ethics for Dentists, Dental Hygienist, and Dental Technologists.
Roopa, S & Menta Satya, Rani. (2012). Questionnaire Designing for a Survey.
Journal of Indian Orthodontic Society. 46. 273-277.
10.1177/0974909820120509S.
Siedlecki, Sandra. (2020). Understanding Descriptive Research Designs and
Methods. Clinical nurse specialist CNS. 34. 8-12.
10.1097/NUR.0000000000000493.
strategy. (2023).
https://dictionary.cambridge.org/us/dictionary/english/strategy
Voxco. (2021, September 29). Descriptive Research Design - Voxco. Voxco.
https://www.voxco.com/blog/descriptive-research-design/#:~:text=Desc
29
(STEM)
riptive%20research%20design%20is%20a,problem%20rather%20than
%20the%20why.
STRATEGIES USED BY THE DENTISTS IN ADDRESSING
THE BEHAVIOR OF PATENTS IN MANAGING DENTAL
ANXIETY
SURVEY QUESTIONNAIRE
Dear Respondents,
A pleasant day! As a requisite for our academic subject: Inquiries,
Investigation & Immersion, we are conducting a research study with the title:
STRATEGIES USED BY THE DENTISTS IN ADDRESSING THE BEHAVIOR OF
PATIENTS IN MANAGING DENTAL ANXIETY. In this regard, we have deemed you
suitable to be our respondents as this survey form is only limited to dentists of District
1 within the province of Batangas. This study will be conducted in Balayan Senior
High School from February 2023 – June 2023.
We would like to request your cooperation by kindly accomplishing this
questionnaire as your response plays a significant part in order to gather the data
and information needed in this study. We are hoping for your immediate response
and that the questions are to be answered with full honesty and sincerity. Do know
that by submitting your response, you are giving the researchers the approval of
storing, analyzing, and processing of the personal information that you have
30
(STEM)
provided. As the researchers, it is rest assured that your privacy and the shared
information will be kept confidentially. Thank you!
-The Researchers
Part I. Strategies Used by the Dentist in Addressing Dental Anxiety Among
Patients
Directions: Kindly answer the questions truthfully by providing honest information
and choosing what seems most accurate based on personal experience.
4 - Strongly Agree 2 - Disagree
3 - Agree 1 - Strongly Disagree
Verbal SA A D SD
1. I usually use verbal encouragement as it is very
effective in easing my patients' anxiety.
2. I have good communication skills as they are vital
in order to create a comfortable and good patient–
dentist relationship.
3. I try to initiate conversations with my patients
before, during, and after dental procedures as
much as possible.
Nonverbal SA A D SD
1. A dentist’s understanding and acceptance of
31
(STEM)
patients' desires and fears is helpful in easing
dental anxiety.
2. Promoting relaxation techniques such as
concentrated breathing and meditation aids in
calming an anxious patient.
3. Using physiological monitoring systems such as
pulse oximeter help in recognizing and relieving
dental anxiety.
Sedation Medication SA A D SD
1. Laughing gas (Nitrous oxide) makes it easier for
dentist to treat a patient with moderate level of
anxiety.
2. Mild dental anxiety is easily soothed with the use of
sedative substance (most typically
benzodiazepines)
3. General anesthesia is the safest option to utilize
when treating a patient with severe dental anxiety.
Part II. Prevalence of Dental Anxiety
Addressing Dental Anxiety among Patients SA A D SD
32
(STEM)
1. Dental anxiety is very common in my
workplace.
2. I usually have a hard time addressing the
dental anxiety of my patients.
3. Dental anxiety is hard to get used to over
time.
4. There are technological advances that have
made dentistry less painful and less
uncomfortable, however dental anxiety is still
a widespread problem that persist
nonetheless, especially in my dental clinic.
5. I have more patients with dental anxiety than
those without.
Psychological/Behavioral SA A D SD
1. The difficulty of behavioral management
between adult and pediatric patients are
relatively the same.
2. I provide certain tools that would serve as
distraction, such as stress balls, fidget
33
(STEM)
spinner, etc.
3. Considering the psychological age of the
patient in the diagnosis of behavior problems
and treatment planning
4. Trust building is crucial for the management
of dental anxiety.
5. Most of the time, my patients would undergo
dental procedures even if they have
moderate to severe dental anxiety.
Pharmacological SA A D SD
1. There are fewer cases where there is an
unnecessary use of drugs and medication
with procedures that do not require them
2. Sometimes, I use general anesthesia as a
pain killer to ease the throbbing feeling of the
patient.
3. I often use OTC drug to manage the dental
anxiety of the patient.
34
(STEM)
35

Strategies Used by The Dentists in Addressing The Behavior of Patients in Managing Dental Anxiety

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Strategies Used by The Dentists in Addressing The Behavior of Patients in Managing Dental Anxiety

Uploaded by

Copyright:

Available Formats

BALAYAN SENIOR HIGH SCHOOL

Caloocan, Balayan Batangas

STRATEGIES USED BY THE DENTISTS IN

ADDRESSING THE BEHAVIOR OF PATIENTS IN

MANAGING DENTAL ANXIETY

STEM 12 – Epifanio De Los Santos

Mendoza, Shaina Irish Jade D.

Pasiona, Kasandra Marienn

Perez, Kim Rosselle D.

Sanchez, Lorraine Grace

Dr. Ma. Rhoda E. Panganiban Phd

Dental Anxiety is a significant factor that contributes to the avoidance of

fear, anxiety, or tension related to a dental environment -or it could be simply

Dental Anxiety manifest physical, cognitive, emotional, and behavioral responses in

distinct types of appropriate approaches depending on the severity of the dental

anxiety of the patient. It is necessary to identify dentally anxious patients effectively

and to treat them appropriately. According to Hamzah et al. (2014), numerous

strategies of managing dental anxiety in pediatric patients were deemed effective,

including verbal and nonverbal communication, desensitization to dental settings and

Therefore, developing appropriate evidence-based treatments to be given such

apprehension leads patients to postpone or cancel dental visits or avoid treatment

stress that can compromise their practice.

Dental anxiety is prevalent worldwide and not limited to a population or

country. Depending on the population and the measurement technique, 2.5-20%

dental procedures. A study indicated that previous traumatic experience is a

significant commencing factor in dental anxiety and fear.

The basic feeling of anxiety is perceived differently and individually by every

subsequent reactions. In response to anxiety-provoking objects or situations, there

are controlled as well as uncontrolled actions or behaviors of patients. It should be

emphasized that anxiety is normal, considering the perspective of evolution and is

usually perceived as negative. However, developing a phobia out of an anxiety

transition to this pathological condition is fluent.

relationship between dental anxiety and general psychological distress. It suggested

anxiety and to act appropriately to reduce the anxiety.

In accordance to the Professional Regulatory Board of Dentistry is

accomplished by giving his/her professional service to the best of his/her capabilities

in accordance with established standards if care and by conducting himself/herself in

in preserving or improving health available in the interest of the public's health,

subject to governmental regulatory legislation. The community shall have access to

health of the general public.

Batangas in the Municipalities of Balayan, Calaca, and Lemery to access or identify

in managing dental anxiety.

Behavioral phenomena, as shaped by psychological traits, which also refers

different emotions, behavior, and tendencies are manifested as well. And as

them comes about as well. It is normal for an individual to experience anxiety or

uneasiness, especially with a dental setting, since it is influenced by genetics, as they

dental anxiety altogether over time.

Statement of the Problem

dentists in managing the behavior of patients with dental anxiety

Specifically, this study seeks to answer the following questions:

patients in terms of:

2.3 Sedation Medication

managing the dental anxiety of the patients?

Ho: There is no significant relationship between the strategies used by the

dentists and managing dental anxiety.

Significance of the Study

professionals in addressing the behavior of patients in managing dental anxiety. The

from other professionals on the same field.

their children at ease themselves.

For the Researchers. This study will be an accompany for researchers to

Furthermore, this study will allow them to be successful.

findings of the study.