Anxiety Through the Roof

• Recognize different parts of the brain responsible for behavior

• Identify different medications and their effects to enhance, complement, or interfere with anxiety.

• Apply strategies to enhance treatment and comfort of the patient and self

Types of Anxiety• Generalized Anxiety Disorder (GAD) - 6.8 million

• Panic Disorder - 6 million

• Social Anxiety Disorder (SAD) -15 million

• Specific Phobias - 19 million

• average onset is age 7

• Obsessive-compulsive disorder (OCD) - 2.2. million

• Post-traumatic Stress Disorder (PTSD) - 7.7 millionAnxiety and Depression Association of America

Anxiety Pathway

Thalamus Amygdala Hypothalamus Brain Stem

CortexSNS (Sympathetic Nervous System)

Med Summary• Benzo/PAM good for situational experiences,

doesn’t aid in learning or rewiring

• IrINE/RAM promote ability for neural flexibility and helping to change underlying anxiety

• Betty Blocker LOL - don’t facilitate or impair the rewiring process but prevent one from experiencing the physical symptoms of anxiety

What do Patients Value• Treated as a person and not as a patient!

• Listen to their concerns

• Made them aware of existing preventive options

• Explain how to maintain a healthy mouth

• Support and reassure them during visits

• Stay away from the blame game

• Show them your credentials

Clues that a Shadow lurks!• 1. If other people often give us feedback inconsistent

with how we see ourselves, a shadow is present.

• 2. When we feel stuck or blocked with a real loss as to what to do next, a shadow is holding us back.

• 3. As strengths become counterproductive, some hidden dynamics need to surface.

• 4. When we are not open to new information, new learning, or other people’s views, a shadow is limiting us.

More Shadows• 5. If we react to circumstances with emotional

responses disproportionate to the situations, we are right over the target of a shadow belief.

• 6. When we find ourselves forcefully reacting to the limitations of others in a critical, judgment way, we are often projecting our shadow onto others.

• 7. If we often experience pain, trauma, or discomfort in our body, a shadow may be attempting to rise to the surface to seek reconciliation.

MIND HELP OR HINDER

FREQUENCY

Dental Anxiety Pathways• Pavlovian cognitive conditioning - most common, where past

painful dental experiences may negatively impact future dental experiences

• Informative pathway - indirect pathway to phobia as told by others

• Vicarious conditioning - indirect pathway to phobia by observing response of others

• Verbal transmission - hearing or reading about threatening information creating fear

• Parental pathway - fearful display by parent becomes a pathway of acquiring it by the child

Cycle of Dental Fear

Coping• Healthy

• Exercise, talking to a friend, breathing, SMILING, stratagies,

• Unhealthy

• AVOID, withdrawal, procrastinate, drink

• Recognize

• Have to understand what we do, and then realize that unhealthy ways are only amplifying my anxiety.

Communication Flags!

• Face your patient - make eye contact

• Listen to not reply but understand

• Ask open questions with (what) and (how)

• Get them to say their anxiety issues

• Solutions

• 1. Vargas C. Third National Health and Nutrition Examination Survey (unpublished estimates). U.S. Centers for Disease Control and (14)

• 2.Dispenza, Dr. Joe. (2012). Breaking the Habit of Being Yourself: How to Lose Your Mind and Create a New One. Carlsbad, CA. Hay House, Inc.

• 3. Emoto, Masaru. (2001) The Hidden Messages in Water. Hillsboro, OR. Beyond Words Publishing, Inc. • 4. Pittman PhD, Catherine M. & Karle MLIS, Elizabeth M. (2015). Rewire Your Anxious Brain: How to use the neuroscience of

fear to end anxiety, panic & worry. Oakland, CA. New Harbinger Publications, Inc. • 5. Schrieber-Pan PhD, Heidi. (2019). Taming the Anxious Mind. Guide Book to Relieve Stress and Anxiety. Towson, MD.

Chesapeake Publication. • 6. Brewer, MD,PhD, J. (2021)Unwinding Anxiety: New Science Shows How to Break they Cycles of Worry and Fear to Heal

Your Mind. Avery, NY. Penguin Random House LLC • 7. Bono PhD, Tim. (2018) When Likes Aren’t Enough. A Crash Course in the Science of Happiness. New York, NY. Grand

Central Life & Style Hachette Book Group. • 8. Burley-Allen, Madelyn. (1995) Listening, The Forgotten Skill: A self-Teaching Guide. 2nd Edition. NY. JohnWiley & Son, Inc. • 9. Accessed 2018. http://www.imagegently.org/ • 10. Mungara Jayanthi, Mangalampally Shilpapriya, Venumbaka Nilaya Reddy, Arun Elangovan,Rajendran

Sakthivel, and Poornima Vijayakumar“Efficacy of three-tone disclosing agent as an adjunct in caries risk assessment” Accessed 2018 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549987/

• 11. Sinek, Simon. (2009) Start with Why: How Great Leaders Inspire Everyone to Take Action. New York, NY. The Penguin Group.

• 12. The Arbinger Institute. (2010). Leadership and Self-Deception: Getting out of the Box. San Francisco, CA. Berrett-Koehler Publishers, Inc.

• 13. Bradberry, Travis & Greaves, Jean. (2009) Emotional Intelligence 2.0. San Diego, CA. TalentSmart • https://www.medicalnewstoday.com/articles/232248.php Serotonin • 15. Sbaraini, Alexandra, et al. 2012 “Experiences of dental care, What do patients value?” BMC Health Services Research

12:177.