Cameron Randall – Pediatric Dental Anxiety-2025 CSPD Sunday Session 2 Pediatric Dental Anxiety Speaker Cameron Randall

Video Transcription

Video Summary

Dr. Cameron Randall, a clinical health psychologist and assistant professor at the University of Washington School of Dentistry, presented an extensive lecture on dental care-related fear and anxiety (DFA). He emphasized that DFA is a prevalent and persistent issue affecting nearly half of U.S. adults, with origins typically in childhood or adolescence. The complex causes of DFA include genetic predispositions, personality traits (such as neuroticism), pain sensitivity, conditioning (one negative dental experience leading to lifelong fear), cognitive factors (misperceptions, catastrophic thinking), and social learning (parents’ fears influencing children). Adolescence is highlighted as a critical developmental period where advanced cognitive abilities and shifting social influences impact the development and management of DFA.<br /><br />Dr. Randall distinguished fear as an immediate reaction to threat during dental visits and anxiety as anticipatory worrying before appointments. He emphasized that dental fear and anxiety exist on a continuum, from minimal to debilitating phobia, with phobia affecting 3-5% of the population.<br /><br />Assessment is essential, often neglected, and should be systematic using validated tools tailored to age groups, combining verbal reports, observable behaviors, and physiological signs. He recommended various child-appropriate and adult assessment scales.<br /><br />Management involves psychoeducation, behavior guidance strategies (stimulus control, social praise, modeling, mental control, tell-show-do, distraction), relaxation techniques (e.g., bubble breathing), cognitive restructuring (especially in older children and adolescents), and systematic desensitization (exposure therapies). Pharmacologic options like sedation have a role but may not foster positive memories needed to reduce fear long-term.<br /><br />Dr. Randall encouraged individualized patient assessment, understanding the origins, triggers, presentation, severity, and impact of the DFA to tailor interventions effectively. He underlined pediatric dentists’ pivotal role in preventing and managing dental fear to ensure lifelong oral health.

Keywords

Dental fear and anxiety

DFA prevalence

Childhood origins

Genetic predispositions

Personality traits

Pain sensitivity

Conditioning

Cognitive factors

Social learning

Adolescence development

Fear vs anxiety

Assessment tools

Management strategies