The Relevance of Hypnosis and Behavioural Techniques in Dentistry

Dental fear is an universal phenomenon justifying the increasing relevance of psychology and the behavioral sciences to dental training and clinical practice. It has a wide-ranging and dynamic impact in patients’ lives and shows some links with other anxiety disorders, as described in psychiatry, such as post-traumatic stress disorder (PTSD) and phobia. Pharmacological sedation has been introduced and used more and more over the past two decades, in order to relieve dental anxiety and phobia and let the patient face oral surgery safely. However, its use is only a step in a much more complex approach, the aim of which is helping the patient to overcome their anxiety and get rid of it. The appropriate approach includes several steps: (1) assessing dental anxiety; (2) proper communication and ensuring patients are thoroughly informed; (3) iatrosedation to make patients comfortable and earn their trust; (4) a properly performed local anaesthesia, able to ensure a full analgesia; and (5) hypnosis and/or a wise use of drugs to ensure full anxiety control as needed. Iatrosedation combines the principles of verbal and non-verbal communication and the emphatic approach pertaining to neurolinguistic programming. Given its effectiveness in relieving dental anxiety, it should be regarded as the essential strategy of communication with the patient. Hypnosis is a powerful tool in dentistry. A relevant advantage, unique to hypnosis, is its twofold role: (1) achieving an effective and even deep sedation and amnesia while maintaining the patient’s collaboration; and (2) treating dental anxiety and phobia, helping the patient to overcome it, as well as other associated anxiety disorders (e.g., claustrophobia).As far as eye movement desensitizaion and reprocessing (EMDR) is concerned, there is still a shortage of information on EMDR in dentistry, but it might be potentially useful when dental phobia is related to previous bad experiences involving PTSD components. The superiority of hypnosis and other behavioural techniques in comparison with pharmacological sedation lies in their ability to help patients rid themselves of their dental anxiety. While pharmacological sedation only affords a temporary respite and helps the patient to cope with a single procedure, hypnosis and iatrosedation can effectively allow for both an excellent sedation in a physiological way and the treatment of patient’s anxiety, helping them to get rid of their fear and other anxiety components.