Dental treatments of a dental phobic patient with anxiety hierarchy: a case report

Abstract

Dental phobia typically emerges during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life.
This report describes a case study of a 13-year-old girl who presented with dental phobia. The referral came from a private dental clinic doctor who had been unable to carry out even the simplest dental treatment on her. The patient required prevention, conservation, and root canal treatment, but had refused any treatment and would not open her mouth. In order to provide dental treatment, general anesthesia was administered to the patient due to her severe dental phobia. After dental treatment with general anesthesia, her response did not change. However, she requested treatment upon awakening. We created an anxiety hierarchy for dental treatment and provided exposure to a standard dental procedure. As a result, she was able to undergo dental treatment in the awake condition.
We learned from this case that dental treatment under general anesthesia was not enough to treat the patient with severe dental phobia and that the use of anxiety hierarchy should be considered as an option.