The Dental Learning Network

Best Practices for Treating Anxious Dental Patients of all Ages

Chapter One - The Body's Response To Pain And Fear


Introduction
Gate Control Theory

Chapter 2: Assessment Techniques

Chapter 3: Children

Chapter 4: How Do Dentists Treat Anxious Patients?

Chapter 5: The Role of the Dental Staff

Chapter 6: Intervention Strategies

Chapter 7: Pharmacological Sedation Techniques

Chapter 8: Referral to a Mental Health Specialist

Chapter 9: Conclusion

Bibliography and Suggested Reading List

Post Examination

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Introduction

It is valuable to compare the physical response of pain in the body to the relaxation response of the body. (Kroeger 1987)


STRESSFUL RESPONSE
RELAXATION RESPONSE
The stressful situation activates two systems: The relaxation response produces the opposite effects.
System 1
hypothalamus to anterior pituitary to adrenal cortex
  • adrenal cortex produces steroids
  • inactivates lymphoid tissues
  • stimulates glucose production
  • irritates G.I. tract lining
  • stimulates kidney to produce renin
System 1
hypothalamus to anterior pituitary to adrenal cortex
  • adrenal cortex is deactivated
  • decreases steroid production (syntoxic)
System 2
hypothalamus to sympathetic division of the autonomic nervous system, sympathetic nerve endings secrete norepinephrine and epinephrine
  • adrenal medulla produces epinephrine
    • increases
      • blood pressure
      • heart rate
      • blood glucose
      • blood cholesterol
      • respiration
  • irritates G.I. tract
  • decreases salivation
  • dilates pupils
System 2
hypothalamus to sympathetic division of the autonomic nervous system
  • deactivates sympathetic system
    • decreases
      • epinephrine production
      • blood pressure
      • blood glucose
  • activates parasympathetic system
    • constricts pupils
    • increases salivation
    • decreases respiration
    • decreases heart activities


Continue on to Gate Control Theory