Dental fears in general practice: new guidelines for assessment and treatment.

Dental fear is a world-wide problem and universal barrier to oral health care services. Fears acquired in childhood through direct experience with painful treatment or vicariously through parents, friends or siblings, may persist into adulthood. Symptomatic treatment and lack of trust and control exacerbate fears. Coexisting psychiatric conditions further complicate treatment. Treatment steps recommended in this paper include careful assessment of fears, application of dental and psychological management techniques to enhance trust, feelings of control, and the development of coping skills, and appropriate and targeted use of pharmacological agents. Prevention of fear development through the use of effective behavioural child management techniques combined with preventive dentistry should be a fundamental part of general dental practice throughout the world.