Understand the emotional patient and why dental visits can be hard

Learning time: ~ 45 minutes

Welcome to Module 1 of the Fundamentals of Human-First Dentistry: Caring for patients experiencing hard emotions. In the first part of the course, psychologist Denisa Moravcik Debrecka will walk you through the hard and heavy emotions many patients face during dental appointments, explore the underlying causes and how you can easily spot these emotions in patient behaviour.

What you'll learn in Module 1:

• The underlying emotions behind patient distress.
• How patients typically react when experiencing negative emotions at the dentist.
• Five signs your patient is in emotional distress.
• The latest research on the complex reasons behind dental anxiety and fear.
• How anxious, ashamed, or panicked patients react in your experience

Key takeaways

1. Fear and shame are the most common emotional struggles
   These are the two heavy-hitting emotions the psychologist Denisa Moravcik Debrecka frequently sees in patients who struggle with dental appointments.
2. Fear is not just about pain
   While fear of pain is common, many patients also struggle with the idea of pain, of not knowing what to expect or whether they will be able to handle it. Anxiety can also stem from other sources, such as worries about the cost of the dental procedure, ongoing mental health struggles or a lack of trust in medical professionals.

3. Loss of control can feel overwhelming
   During a dental procedure, the patient must trust the dentist to not only manage their pain, but also to make the correct diagnosis and decisions about their care. For some patients, this relinquishing of control is stressful, uncomfortable and can make them act out.

“When we don't trust someone, we do not want to lose control around them.”— Denisa Moravcik Debrecka

4. Fear and shame go hand in hand… like fire and gasoline
   Many patients view their fear or anxiety as something shameful. They may judge themselves for feeling this way and worry their dentist will judge them too. This makes them less likely to speak up, ask questions, or express discomfort, further amplifying the sense of powerlessness.
5. Many patients feel shame about the state of their oral health
   This shame is worsened if they have previously been lectured about their oral care in a way that made them feel judged. But it can also stem from internalised societal beliefs that associate poor oral health with irresponsibility or low social status.

How patients will likely react while experiencing negative emotions at the dentist.

Fight:

The patient becomes aggressive or arrogant toward the dental professional. They might snap or argue as they try to “fight” to feel safe.

“The patient's face flushed red as they pointed a shaky finger at the assistant, their voice rising, "You're hurting me!"

Flight:

The patient might be very fidgety and restless, or they might cancel their appointment before they even arrive. Their instinct is to avoid the situation entirely.

With wide, panicked eyes, the patient bolted from the waiting room the moment they heard the drill start.

Freeze:

The patient will often become quiet, not ask any questions, and hunch in on themselves. 

Hunched low in the chair, the patient stared blankly at the ceiling, their hands white-knuckled around the tissue.