Stress in Dental Patients Undergoing Routine Procedures

A method was devised to record graphically the stress that patients experience during rou-tine dental procedures. Heart rate was used as the indicator and the variations in it showed which parts of the treatment provoked the maximum stress reactions. This pilot study in-dicated that by using this method it is possible to study specific dental problems and methods for treating them. Dentists are well aware of the variations that exist in the way their patients react to routine dental treatment. Few patients enjoy under-going dental treatment; however, the vast ma-jority of patients are capable of sufficient self-control that enables them to accept treatment without undue signs of stress. There is a sur-prisingly large group in which the stress is more obvious, manifesting itself by habits such as fidgeting, watching every move the operator makes, perspiring, excess salivating, etc. Many patients volunteer information and express fear of certain procedures such as injections or use of the drill. In extreme cases, this may result in a downright refusal to accept that particular procedure.' The stress is made up of psychological and physiological components. By physiological stress is meant the reaction to physical inter-ference with the body's tissues, such as injection or cavity cutting. The psychological component is mostly if not entirely a question of antici-pation.2 This will occur when a patient be-comes aware of the dental procedure about to happen and either by previous experience or by secondhand information recognizes it as a real or imagined threat to his immediate comfort. The result of this anxiety is stress. Shannon and Isbell3 conducted a series of studies with a group of patients subjected at short notice to a dental injection procedure. One group went through the entire procedure; the other grou