Treating the Apprehensive Dental Patient

Course #56052 - $36 -


Many people have varying degrees of apprehension related to various aspects of dental treatment. Even patients who obtain regular dental care can have trepidation about dental procedures, especially those that are surgical in nature, those for which anesthetic injections are required, and restorative dentistry in which use of a high-speed hand-piece is required. Most people are able to obtain and complete proposed dental procedures despite their fears. However, some patients have levels of apprehension about dental treatment that make it difficult for them to schedule dental appointments and complete treatment that has been planned, and this course will focus on this group of patients. Highlights will include an exploration of the terminology used to describe the varying levels of dental apprehension and behavioral and/or pharmacological techniques that can be used to assist patients to complete dental treatment. Treatment modifications to decrease patients' fear about procedures, the most common dental situations which patients find stressful, the origins of many dental-based fears, and the adverse effects of stress on the dental staff will also be discussed.

Education Category: Psychiatric / Mental Health
Release Date: 06/01/2023
Expiration Date: 05/31/2026

Table of Contents


This course is designed for all dental professions with patients who are apprehensive regarding dental treatments.

Accreditations & Approvals

NetCE Nationally Approved PACE Program Provider for FAGD/MAGD credit. Approval does not imply acceptance by any regulatory authority or AGD endorsement. 10/1/2021 to 9/30/2027 Provider ID #217994. NetCE is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at NetCE is approved as a provider of continuing education by the Florida Board of Dentistry, Provider #50-2405. NetCE is a Registered Provider with the Dental Board of California. Provider Number RP3841. Completion of this course does not constitute authorization for the attendee to perform any services that he or she is not legally authorized to perform based on his or her license or permit type. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this activity for 4 continuing education credits. AGD Subject Code 153. This course meets the Dental Board of California's requirements for 4 unit(s) of continuing education. Dental Board of California course #04-3841-24395. NetCE is authorized by IACET to offer 0.4 CEU(s) for this program.

Course Objective

The purpose of this course is to provide insight about dental-based apprehension from the viewpoint of the patient and to suggest methods to increase patients' ability to obtain dental care.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Differentiate between the terms used to describe levels of dental apprehension.
  2. Discuss available tools to screen for dental fear and anxiety.
  3. Describe common theories about the origin of dental apprehension.
  4. List the most common situations or instruments that stimulate a stress response among dental patients.
  5. Identify common verbal and nonverbal signs that indicate a patient is apprehensive about ongoing dental treatment.
  6. Evaluate common behavior modification techniques used to treat apprehensive dental patients.
  7. List common pharmacologic agents for the treatment of apprehensive dental patients.
  8. Analyze the role of dental treatment modifications to assist in meeting the dental needs of apprehensive patients.
  9. Discuss how dental staff is affected by providing dental treatment for apprehensive patients.


Mark J. Szarejko, DDS, FAGD, received his dental degree from the State University of New York at Buffalo in 1985. He received fellowship from the Academy of General Dentistry in 1994.

Faculty Disclosure

Contributing faculty, Mark J. Szarejko, DDS, FAGD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.