Saudi dentist explores dental anxiety

An increasing number of Saudi women are showing their ability to excel professionally. Dr. Abeer Al-Namankany is among those, as a Saudi dentist who developed a new standard to measure anxiety in dental patients. Arab News reporter Mohammad Murad interviews Dr. Al-Namankany, a rare Saudi woman in the dental profession and an expert on dental anxiety.
What can you tell us about yourself and your career so far?
“I am a highly motivated individual with exemplary interdisciplinary skills. I specialized in Hypnosis, Child Psychology and Pediatric Dentistry. I am an extremely dedicated researcher with a specific interest in young patients who show signs of dental fear, anxiety, phobia and other behavioral problems.
“My qualifications and clinical experience rank as the first in the field of treating dental anxiety with drug-free psychotherapy methods. This protects the patients from the risks and side effects of general anesthesia. I have created a new measure that is recognized as the gold standard and the first cognitive measure for dental anxiety worldwide: the Abeer Children Dental Anxiety Scale (ACDAS).
“I won six international Distinguished Clinical Research Awards, and was an international speaker at many conferences and universities. I teach postgraduate students in the University College London-Eastman Dental Institute.”
What is the main concept of your research?
“I seek to validate my new ACDAS dental anxiety scale for children and adolescents in English and Arabic at three Clinical Trials-hospital, to investigate the effect of video modeling on the behavior of anxious children undergoing dental treatment.”
Do you have any solutions for children who fear dentists or dental treatment, which is a painful experience for both adults and children?
“Yes, I have. All of my my Ph.D research was based on the treatment of dental fear and phobia using drug-free psychotherapy methods in order to turn dental treatments into a positive experience.”
What makes your study unique in comparison to the available anxiety scales?
“The ACDAS performance was validated using 439 participants from clinical and non-clinical sites across London and Dubai. It is different from existing scales as it is the first dental anxiety scale for children correlating dental anxiety with cognitive status. It can recognize the stimuli for dental anxiety in a logical order and it questions the expectation of a child’s legal guardian about the behavior of the child before the treatment. Whether the child has had any previous dental treatments and the dentist’s rating for the child’s behavior at the end of the treatment are also measured.”
Would you recommend applying this scale in all Saudi Arabian health facilities?
“To date there is no study that includes dental anxiety measurement in the list of preventative strategies. Therefore, I suggest the inclusion as a prevention item from the first visit and throughout the dental treatment. Assessing patients’ thoughts could be a first step in the development of cognitive treatment strategies for dental anxiety. It is important to understand the importance of measuring children’s dental anxiety and its correlation with the cognitive status of the child. ACDAS helps to highlight the unmet needs of many children who do not go to dentists because of fear of general anesthesia. While some cases may still require this, with appropriate anxiety management there is a significant number for whom it could be avoided.”
Did any hospital ask you to apply this scale in their hospital?
“Yes, the UCL-Eastman Dental Hospital in London and many others in Sharjah and Dubai in the UAE.”
What factors contributed to the establishment of this scale?
“I conducted a systematic review to investigate the existing measures of dental anxiety in children to determine which was best suited for use in a multiple randomized controlled clinical trial. We found 14 available scales. None of these encompassed the ideal criteria of the assessment scale to be regarded as a ‘gold standard’. Hence, there was a need to develop a new scale to measure dental anxiety with consideration of the other dental anxiety contributing factors such as the behavioral, psychological, cognitive and negative thoughts characteristics. Therefore, the idea of the new scale came through.”
What feedback did you receive on your invention?
“I have received excellent feedback and many international awards and recognitions. ACDAS is the winner of the Research Award by the Royal College of Physicians and Surgeons of Glasgow in Scotland and the British Society of Pediatric Dentistry (2011), the Award of Education and Scientific Excellence in ExCel London (2010) by Prince Mohammed bin Nawaf, ambassador of Saudi Arabia in the UK and Ireland. I also won the Young Researcher’s poster Prize and UAD1,000 cash at the 3rd Sharjah Dental College at the EMA International Dental Conference (2011).”
The uniform you wear is very colorful. Does that add to the wellbeing of the patients?
“Yes. Also, the use of white coats at clinics and hospitals is not allowed in the UK for a psychological and infection control reasons.”
What got you interested in dental anxiety in the first place?
“Dental anxiety is a common experience that everyone has from time to time. Severe anxiety can have a serious impact on daily life. The lack of clinical studies in this field got me to be the first pediatric dentist specialized in this field at a PhD level. I conducted my study in Dubai. It was the first in the Middle East to indicate the prevalence of dental anxiety among children at 48 percent. This prevalence is 35 percent in Europe.”
What has been your most challenging project and why was it so tough?
“It was the chance to conduct randomized clinical trials for children, with a dental staff who used to treat patients for a regular dental treatment under general anesthesia. Working with anxious children is a challenge and the referral with a recommendation to use general anesthesia was between 88 percent and 93 percent in the department.”
What advice would you give to someone interested in a dental career?
“Dentistry is unique branch of medicine that requires both theoretical studies and good manual skills. A dentist must always be alert to the importance of treating the patient and not the disease. Using anesthesia does not cure the patient’s fear and phobia; it simply allows the dentist to perform the dental treatment with greater control.”

For nine years, I was the only child in my family. My father was a very independent, strong character and I learned a lot from him.

Having started from zero, he taught me to work hard, seek perfection and always believe that anything was possible if you set your mind to it.

My mother was very easy going and encouraging. She really believed in me and was always supportive. There was a balance at home for me with these two different characters.

Some people might think that being an only child for quite some time, I was spoiled and dependent. But that was never the case and I have an amazing relationship with my little sister Maha; she is my best friend.

My father works in pharmaceuticals and is chairman of the board of directors at Al-Dawaa Medical Services.

My mother was a schoolteacher before entering the world of business, and my sister is a chemical engineer. Though we are a very diverse family, we all have an appreciation for art which is evident in our household. My mother is an artist and art collector too.

I do not have a role model; there are many people I look up to in the business world and in my social life.

I studied software engineering and worked in that field for almost a year, but although I learnt a lot I wanted more from my career. Software engineering made me think and solve problems in a different way and it played a major role in how I operate in the field of business.

I worked at Al-Dawaa for almost two years and found that I was more attracted to business and marketing than the technical side of things. That is when I decided to take on the family business, Waleed Al-Jaafari Establishment.

I run PIECES, a retail store I founded in Alkhobar in 2012 and later opened a branch in Riyadh in 2014. Now, we are working to make it an online business too.

I noticed that there was a demand in the Kingdom for custom-made furniture, and although some stores offered the service there was little choice. So, I decided to provide high-quality furniture made in Saudi Arabia.

In 2015 I founded Teak Woodwork in Alkhobar which has extended its services to cities including Jeddah and Riyadh. My father has other branches dealing with different fields, but I opted to run the retail store and woodwork services.

I truly believe that if you set limits to your abilities you will never be able to exceed them. Once you realize that there are no limits, all doors will open for you.

Saudi dentist explores dental anxiety