A Dannan. Phobic Patients in the Dental Clinic. The Internet Journal of Dental Science. 2009 Volume 8 Number 2.
Almost every dentist had once a patient in the clinic who wanted to wash his/her hands nearly every five minutes, who frequently asked for new cloths during the treatment, who did not want to touch the door handle, or who always needed a confirmation from the dentist that all instruments are sterilized.
Though rare, such cases may face the dentist any time in the clinic, and when occur, he/she must know that the patient suffers some kind of phobic disorder, or phobia.
A phobia is defined as an irrational fear that produces a conscious avoidance of the feared subject, activity, or situation. The affected person usually recognizes that the reaction is excessive. Phobic disorders can be divided into 3 types: social phobia (now called social anxiety disorder), specific phobias (e.g. animal type, natural environment type, blood injection/injury type, situational type), and agoraphobia (fear of being alone in public places).
In the dental clinic, it seems to be difficult to control the phobic patient, since every step in the room, every touch, and every person may present a potential threat for these patients.
A possible reason for such extreme anxiety in the dental clinic could be related to a traumatic experience in the past. For instance, a patient who got so many types of viral infections in the past would become a phobic patient and may always be afraid of being infected in the dental clinic (e.g. due to non-sterilized instruments). This patient is called “bacteriophobic patient”, and usually suffers an uncommon type of fear of the bacteria and microorganisms. Their fear about these bacteria could be everywhere, and in almost everything such as food, clothes, bed, water, etc.
Although it is not the responsibility of the dental-team to relieve the bacteriophobic patient from his phobia, such cases should be seriously taken into consideration, and the patient must be advised to undergo psychological therapy.
The dentist should make the bacteriophobic patient’s visit very comfortable in the clinic. He/she has to deal with the patient’s psycho-irritants seriously. Any condition which might be traumatic for the patient should be strictly considered. A bacteriophobic patient must be allowed to enter the dental treatment room only when the last spot of the dental chair is totally clean. Signs of “disinfection” in the whole clinic, with “sparkling instruments” are preferred to be noticeable.
The dentist is encouraged to react to the phobic patient before the later becomes active starting to express his/her negative feelings. Offering the patient a disinfectant from time to time, and changing the paper hand-cloths as normal procedures during therapy are also clever hints at this level. In best cases, the phobic patient would start to act normal with no extra stress.
Sometimes it might be useful for the dental team to deal with bacteriophobic patients in order to think always about keeping the most hygienic standards in the clinic!