Management of the anxious dental patient

The anxious patient in the dental office reacts with panic and inability to cooperate with necessary treatment. It is the dentist's responsibility to recognize and assuage the patient's anxiety on both psychological and medical levels. The diagnosis, etiology and treatment of anxiety will be investigated and presented as any other disease entity. It is an illness that contributes to dental neglect and subsequent pain, disease and dysfunction. The purpose of this paper is to discuss the recognition and etiology of patient anxiety and to offer treatment solutions and behavior modification techniques. The discussion will include psychological insight as well as the use of anxiolytics and nitrous oxide-oxygen (N2O-O2) sedation to ameliorate the symptoms. Finally, a presentation will be made of the modern application of philosophic dicta of Plato and Aristotle in which the doctor is considered a philosopher who values the concept of self-healing based on the doctor-patient relationship. These techniques and concepts of totality in diagnosis and treatment are applicable today just as they were 17 centuries ago.