Iatrosedation: a holistic tool in the armamentarium of anxiety control

Identifying the causes of dental anxiety by taking a history and carrying out investigations for patients attending for any type of dental procedure, can be time consuming. Common causative factors of dental anxiety can be previous adverse dental experiences, age, temperament or socioeconomic factors. These factors can lead to patients falling into a cycle of dental avoidance and greater treatment need with attendance for symptomatic relief only. Treatment using pharmacological methods such as conscious sedation or general anaesthesia can help overcome these obstacles, however, although a successful treatment outcome may result, how is the patient to gain trust and overcome their anxiety or fear, if they do not learn from the experience? In 1967 Nathan Friedman described a method he termed 'Iatrosedation' consisting of two components, the interview and the clinical encounter. His method relies on the communication skills and behaviour of the practitioner to identify the causes of anxiety or fear and then to provide a bespoke approach to help overcome them. The result can be that the patient not only has successful treatment, but also learns and gains confidence from their experience, as well as gains increased faith in their practitioner.