title: The effects of deep diaphragmatic breathing and focused attention on dental anxiety in a private practice setting.
abstract: OBJECTIVE
  High dental anxiety is pervasive and associated with treatment avoidance and poor oral health. Ideally, anxiety reduction techniques should be easy to use, low in cost, non-pharmacological, comfortable, and effective. This study compared the effectiveness of two self-taught anxiety reduction techniques--breathing and focused attention--with a control group.
  
  
  METHODS
  Anxiety was assessed in 272 adult private dental practice patients with a modified dental anxiety scale-revised. Frequency of oral health care visits in the last 10 years to all dentists, including the current dentist, was collected. Immediately prior to the dental procedure, participants in the two experimental groups were given written instructions outlining the respective anxiety reduction technique they were to use. Efficacy of technique was assessed by subjective comparison to anxiety during previous oral health treatment. Participants also listed techniques that they believed to be effective for anxiety reduction.
  
  
  RESULTS
  Twenty-six participants (9.56%) scored high in dental anxiety. High anxiety was associated with infrequent oral health care visits. Compared to the recall of anxiety experienced during prior treatment, there were no significant differences in anxiety between breathing, focusing, and control groups. But there was a trend toward decreased anxiety overall. Controls who reported infrequent visits and use of their own anxiety reduction technique showed significantly reduced anxiety.
  
  
  CONCLUSIONS
  Dental patients employ numerous strategies for anxiety reduction. Anxiety reduction techniques not yet practiced may place unwanted expectations on patients. It is suggested that oral health care practitioners be aware of the patient's preferred technique for coping with anxiety and encourage them to use self-help techniques.
authors.affiliation: Department of Health Psychology and Behavioral Medicine, University of North Texas, Denton, Texas, USA.
authors.forename: Quinn M
authors.initials: QM
authors.lastname: Biggs
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Kelly
authors.forename: J David
authors.initials: JD
authors.lastname: Toney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention; D001945:Breathing Exercises; D016854:Dental Anxiety / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D012064:Relaxation Therapy; D012648:Self Care; D011795:Surveys and Questionnaires; D017211:Treatment Failure