Method: 246 practicing dentists (adjusted response rate = 40.1%) from a random sample of registered Australian dentists completed a mailed questionnaire.
Results: Inhalation (NO2) sedation was the most used pharmacological DA management technique, but was used at least once a month by only 14.1% of responding dentists. The most commonly used behavioural management techniques (1+ per week) were signalling (77.1%), tell-show-do (71.1%), having a relative or friend in the treatment room (67.1%), and distraction (66.5%). Hypnosis, muscle relaxation and graduated exposure were used rarely, with the main reasons being that dentists were not confidently trained in their use, they were too time-consuming, or there was no demand. A majority of dentists considered the pharmacological approaches to managing DA to be mostly or almost always effective, while most dentists considered the behavioural approaches to be only sometimes or not at all effective. Lack of training, not having the necessary equipment, no demand, and being too time-consuming were barriers to using pharmacological DA management techniques. There were few statistically significant differences in techniques used by practitioner characteristics, although younger dentists used tell-show-do more frequently than their older counterparts and female dentists and those seeing higher percentages of anxious patients were more likely to adopt the daily use of shorter appointment sessions.
Conclusion: Despite a variety of techniques available for managing the anxious dental patient, few were actually practiced by the respondents. There are many barriers preventing dentists from utilising DA management techniques more often.