Treatment of the geriatric dentally phobic patient.

The elderly patient, who is phobic or exceedingly anxious established behavior patterns years ago when dentistry was not as advanced as today and when dental experiences were unpleasant and uncomfortable. The elderly phobic patient may view his role as a passive participant as he was in his youth; that is, he fears that the dentist will treat him as he was treated by an unsympathetic dentist years ago. In order to create acceptable, positive experiences for the phobic or anxious patient, the first appointment should give the patient an opportunity to know the dentist and office staff. The dentist can take this opportunity to reassure the patient that pain does not have to be a part of dental treatment. It is imperative that the dentist and staff involve the patient and instill trust. One must always have the patient's perspective in mind and constantly, by word or deed, assure the patient that he will always be in control of decisions and treatment. The dentist must not view the geriatric patient as different from his other patients. He or she must be perceptive and deliberate in the initial encounter and early relationship and determine what is the best treatment for that patient. The dentist must be realistic about the goals and requirements of that patient, for whom the dentist's ultimate objective should be to achieve quality dental care, done expeditiously, without fear and pain.