Pain catastrophizing in dental patients Implications for treatment management

Background. "Pain catastrophizing" refers to an exaggerated negative mental set brought to bear during an actual or anticipated painful experience. A patient's perception of a dental care experience as catastrophic can result not only in poor satisfaction with the therapy but also in avoidance of necessary treatments, resulting in the deterioration of oral health. Methods. The author reviewed literature regarding pain catastrophizing regarding dental treatment as well as behavioral models related to catastrophizing. Results. People who catastrophize show excessive attention to pain (rumination), exaggerate the threat value of pain (magnification) and feel unable to cope with their suffering (helplessness). During dental treatments, greater pain catastrophizing is associated with increased pain, dental anxiety and negative thoughts regarding pain and dental procedures. Conclusions. It is important that clinicians identify dental patients who catastrophize so as to plan and provide the best treatment for their needs. Practical Implications. To manage the care of patients who catastrophize, the clinician can actively probe patients' pain experience, help them reappraise threat, manipulate their attention to pain and improve dentist-patient communication.