Dec 5, 2024
Taylor Gowans
Sephora Djomo Ngwamou
Manisha Sharvananthan
(Taionescu)
Introduction
Dental anxiety is an extremely common and challenging barrier when seeking dental care (Cohen & Newton 385). Several factors, such as racism and geographical differences, are critical in shaping the prevalence and severity of dental anxiety. Effective coping strategies, while available, may not be equally accessible to all individuals, further exacerbating the oral health disparity. The following article will discuss the association of dental anxiety with racism, geography and procedure types, as well as a further discussion on various coping strategies and their accessibility.
How Racism Impacts Dental Anxiety in Racialized Communities
Racism within dentistry in the United States can contribute to dental anxiety and poorer oral health outcomes in racialized communities (e.g., Black, American Indian, Alaska Native and Latinx populations) within the United States. The higher levels of dental fear and anxiety observed in these racialized communities contribute to delays in seeking treatments for their oral problems. Experiences with racism are associated with lower trust in healthcare providers who are not from the same cultural background (Bianchi et al. 140). Considering that most dentists in the United States are of Caucasian descent, and it is difficult for persons of colour to find a provider with a similar background, it may deter some people from receiving treatment (Bianchi et al. 140). In the United States, Black women experience high levels of dental anxiety, which leads to worse oral health out of avoidance (Heaton et al. 896). The Black Women's Health Study on dental anxiety in Black women observed that the prevalence of dental anxiety was 17.8%, which is higher than those who are White from the United States (Heaton et al. 896). These social factors reveal that dentists should aim to tailor patient treatment for dental anxiety to the patient's needs and consider their cultural background contexts (Beaton et al. 295).
Geographical differences, Treatment Norms, Age and their relevance to dental anxiety
Dental anxiety manifests differently depending on the person (Beaton et al. 295). There are discrepancies in the level/magnitude of anxiety experienced based on geography and the types of dental procedures that are routinely performed. Dental anxiety is related to various factors, which include but are not limited to past experiences, stories from peers/media, environmental factors as well as genetic/inherited traits (Beaton et al. 295). Most of the anxiety surrounding dentistry in the United States is due to painful procedures, needles, treatment costs and having an insensitive dentist (Heaton et al. 896). Most of this reasoning typically holds true across the world. However, the magnitude or severity of the anxiety can differ between countries (Cunoti et al. 1121; Naidu & Lalwah).
There has been evidence that the magnitude of dental anxiety can vary based on geography (Cunoti et al. 1121). A previous study measured the levels of dental anxiety in patients from Germany compared to Albania (Cunoti et al. 1121). The results demonstrated that patients from Germany experienced far more dental anxiety than their Albanian counterparts (Cunoti et al. 1121). This discrepancy was because the Albanian participants did not seek as much dental care as those from Germany (Cunoti et al., 1121). When comparing these results to a study on the magnitude of dental anxiety in Trinidad and Tobago, a similar pattern was shown, although the cause was different (Cunoti et al.1121; Naidu & Lalwah). Overall, it was found that these participants experienced high levels of dental anxiety on average, with a scale ranging from low to moderate to high (Naidu & Lalwah). The reasoning here, however, was due to the high frequency of extraction procedures in this population, which appeared to be the strongest contributor to anxiety due to the level of pain it causes (Naidu & Lalwah).
Coping strategies
Although dental anxiety can be overwhelming for the patient, some strategies can be used to lower anxiety within prevalent populations. Educating uninformed populations on the importance of dental health and how it improves their quality of life may encourage them to seek dental care (Bianchi et al. 140). Increasing the person of colour representation within the workforce in dentistry may encourage more people to visit the dentist in underserved populations. Overall, diversifying oral health care would improve culturally sensitive care in persons of colour, leading to better health outcomes (Bianchi et al. 140). Regularly visiting the dentist can decrease dental anxiety because the dentist can diagnose and prevent future oral health complications (Jiang). Dentists using anesthesia can also alleviate the fear of pain from procedures (Jiang). Dental anxiety can also be reduced by encouraging patients to bring distractions to dental visits, such as headphones for music or stress balls. Meditation or breathing exercises can help with anxiety reduction as well (Jiang).
Accessibility of Coping Strategies
While there is a variety of proven coping strategies for dental anxiety, there can be a lack of accessibility for these services and strategies that differ around the world. For instance, one of the major suggestions for dental anxiety reduction is dentists' use of nitrous oxide and other anesthesias, even if it may not be the norm for that particular treatment (Jiang). In developing countries, access to anesthetics and pain management medications is extremely low and poorly executed (Maulina 1). This is primarily due to the lack of education on oral and maxillofacial pain in not only those who are experiencing it but also the doctors themselves (Maulina 1). An increase in education and the creation of an oral pain treatment plan could dramatically increase the use of pain management medications and, thus, could have an impact on reducing dental anxiety, specifically anxiety that stems from the fear of pain in patients who live in developing countries (Maulina, 1). However, many strategies are easily accessible and can help reduce dental distress, such as meditation, listening to music during treatments, and discussing the procedure beforehand (Jiang). Increasing the accessibility of some common strategies by incorporating easier accessible strategies can significantly reduce dental anxiety (Jiang).
Conclusion
In conclusion, dental anxiety is influenced by various compounded factors, including racism, geographical differences, and types of dental procedures. The systemic barriers of racism can exacerbate dental anxiety within marginalized populations, leading to a decreased trust in oral healthcare providers and perpetuating poor health outcomes. Geographical differences highlight differences in treatment and accessibility, which can significantly impact the prevalence and severity of dental anxiety across the world. Several coping strategies can be implemented to alleviate dental anxiety for individuals, including education and the use of anesthesia. The accessibility of these strategies may vary; thus, alternative relaxation strategies like meditation can play a significant role, especially in regions with fewer resources. Addressing dental anxiety requires the consideration of the existing systemic barriers to reduce the disparities and make effective coping strategies more readily available. Ultimately, this would promote equitable access to trusting dental care for all individuals, regardless of their background, improving oral health outcomes worldwide.
References
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