By Jennifer O’Mann
Healthcare as a whole – including dental healthcare – is a source of discrimination for members of the LGBTQ+ community, a fact which can worsen the anxiety that many can feel when visiting the dentist. As stated in a study by W Jacobson, around 8% of LGBTQ+ people have experienced discrimination in their dental center. Some problems that stopped them from receiving the care they needed included financial worries, a lack of health professionals with training in the specific needs of the community, and a lack of dental professionals with knowledge of HIV/AIDS and STIs. Transgender people are at a particular threat because they have fewer visits to the dentist and report greater discrimination. It is easy to see how all these aspects can contribute to higher levels of anxiety than those encountered by non-LGBTQ+ people when visiting the dentist.
Dental Fear Amongst Transgender People
A study by M Heima and colleagues, published in the journal Special Care in Dentistry, has shown that transgender people often have a fear (and past experiences) of discrimination or maltreatment that increases their level of dental anxiety. The study reports that 19% of people who identify as transgender, for instance, have experienced refusal of healthcare, 28% have experienced harassment, and 50% have felt that their providers lacked knowledge about caring for transgender individuals. As found in a study by O Hagqvist, patients who have experienced psychological trauma or poor treatment have a higher level of dental anxiety. Dental fear is also linked to mental conditions such as depression and PTSD, which are often reported in people who are transgender. In Heima’s study, it was found that 85.5% of participants in the study reported at least one instance of maltreatment, and 14.2% said they were ‘very’ or ‘extremely’ fearful of experiencing maltreatment in a dental clinic.
Reducing Stress In The Dentist’s Office
Dentists who are aware of possible fear and anxiety in their LGBTQ+ patients should present various relaxing options like sedation dentistry, which involves the use of specific medications to induce calm and reduce anxiety. Different options should be included – such as oral conscious sedation (taking a calming pill prior to the dental visit), nitrous oxide sedation (also known as laughing gas), and IV sedatives (often used alongside maxillofacial surgical procedures, including wisdom tooth removal). If anxiety is truly to be addressed, then patients should feel free to choose the type of sedation they are most comfortable with.
Reducing Dental Anxiety In The LGBTQ+ Community
Health professionals must be educated in the specific needs, problems, and concerns of LGBTQ+ patients. Education and training should be consistent, and professionals should know the pertinent questions to ask. They should also be aware of specific health issues that LGBTQ+ patients face, which in turn can affect their oral health. These issues include (but are not limited to) a higher risk for cancers, substance abuse, obesity, and cardiovascular disease. All staff—including dental assistants, receptionists and hygienists—should be mindful of the needs of their patients. Documentation should be non-discriminatory as well, including more options than two checkboxes (male or female), for instance. Staff should use neutral language and respect their patients’ right to privacy.
Alternative Approaches For Dental Anxiety
Adults who have severe dental anxiety experience major health consequences, including poor oral health, followed by a sense of shame and withdrawal from social interaction. It is, therefore, vital to approach dental anxiety in the community from a multifaceted perspective, considering alternative treatments such as acupuncture. Researchers from the University of York found that acupuncture could help quell dental anxiety while also boosting the effectiveness of standard care for issues such as depression and chronic pain.
Members of the LGBTQ+ are at a higher risk of dental anxiety for a variety of reasons. These include fear of discrimination and past experiences of maltreatment from medical health professionals. Continuous education and training are vital for dental professionals so that they are aware of specific issues they should discuss with these patients. Dental offices should also make an effort to create a non-discriminatory atmosphere and to offer patients various approaches to quell their anxiety, including sedation and holistic approaches to stress reduction.
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