Dental Anxiety and Phobia
Dental anxiety and phobia are disorders
causing people to avoid dentists
and important dental treatments. People suffering with dental
anxiety experience increased stress and nervousness when at the
dental office and are therefore reluctant to visit the dentist.
Those suffering from dental phobia, a more serious condition
characterized by a severe, unreasonable fear, are actually
panic-stricken and would rather suffer from
tooth pain, tooth loss or unsightly
teeth, than visit the dentist.
dental anxiety or phobia have a higher risk of gum disease and
tooth loss. In addition to the monetary costs associated with
avoiding necessary dental care, emotional costs of avoiding the
dentist include feelings of self-consciousness, insecurity and
low self-esteem. More troubling still is the fact that research
shows that neglecting dental care can lead to serious health
problems, such as heart disease, stroke and diabetes.
Who Suffers from Dental Anxiety and Dental Phobia?
If you fear
the dentist, you're not alone. A survey by the American
Association of Endodontists found that 80 percent of adult
Americans fear dentists; more than half say this fear may keep
them from seeing a dentist. Approximately 5 percent to 10
percent of adult Americans are considered dental phobics —
people so terrified of dental treatment that they avoid dental
care at all costs.
Women and children report more dental fear
than men and the elderly. Understandably, people tend to be more
afraid of invasive procedures, such as
oral surgery, than they are of less
invasive treatment, such as professional cleanings
Reasons for Dental Anxiety and Dental Phobia
dental anxiety and/or dental phobia are numerous and include
factors both related and unrelated to dentistry. Among them
of helplessness and loss of control
Embarrassment or shame about the look and condition of the
teeth, as well as the fearful behavior itself
experiences. This not only includes physically painful
dental visits and treatments, but also psychologically
uncomfortable experiences, such as being humiliated by
dental professionals, family, friends or others.
abuse. Dental phobia is common among sexually abused
individuals, especially children. Physical or emotional
abuse by an authority figure also may contribute to dental
phobia, particularly when combined with bad experiences
shared with dental professionals.
dental professionals. Pain inflicted by dental professionals
who are perceived to be "cold" and "controlling" has a
negative psychological impact, according to research.
Observational or vicarious learning. If a parent or other
caregiver is terrified of dentists, children also may learn
to be scared, even in the absence of their own bad
experiences. Hearing other people's dental "horror stories,"
or being exposed to negative dental images and/or
information in the mass media also may trigger fears.
Post-traumatic stress. Research suggests that people who
have suffered terrible dental experiences demonstrate
symptoms typically reported by individuals with
post-traumatic stress disorder, which is characterized by
oppressive thoughts of the negative experience and
needles (needle phobia), injections, drills, gagging, etc.
and/or extensive treatment
Hopelessness that neglect or the condition has made it too
late to do anything
effects of medication or their ineffectiveness in providing
relief from anxiety and pain
Strategies for Addressing Dental Anxiety and Dental Phobia
several psychological and behavioral approaches for addressing
dental anxiety and/or phobia. These effective strategies include
others share your fears and are ready to help you overcome them
through self-help and peer support groups, some of which are
online. Professional psychological counseling and psychotherapy
also are available for more serious cases.
fears and educate yourself about realistic and unrealistic
expectations, possible treatment options and what they involve,
how to find the right dentist, areas of specialty, etc. Discuss
your treatment with your dentist so you will know exactly what
to expect. Ask for information you can read at home, and conduct
dental team with the technological-savvy, tools and skills to
make you feel safe and well cared for; one that possesses the
patience and expertise to reassuringly guide you through the
your fears and anxieties to your dental team. Good
dentist-patient communication is considered a crucial factor for
relieving dental anxiety and phobia. Openly expressing your
concerns will let them adapt the treatment to your needs.
dental appointment, eat high-protein foods, which produce a
calming effect; avoid foods high in caffeine and sugar, which
may increase jittery nerves.
relaxation techniques like deep breathing, progressive muscle
relaxation, guided imagery and hypnosis.
situation as much as possible. For instance, try choosing a time
for your dental appointment (perhaps a Saturday or early-morning
time) when you're less likely to feel rushed or pressured.
Discuss a signal (such as a raised hand) that lets your dental
team know you feel uncomfortable or need a break.
Take advantage of in-office distraction
amenities. Some dental offices offer television, music or
virtual reality glasses to entertain you. Pillows, blankets and
aromatherapy also help people relax. Other practices
dental spas) even offer complimentary
spa-like services, such as mini massages and hand/foot
treatments during procedures, and full spa treatments at
additional cost after dental procedures.
Pharmacological Techniques for Addressing Dental Anxiety &
psychological and behavioral approaches, most people with dental
anxiety and/or phobia also need pharmacological methods to cope
with their condition during dental appointments.
dentistry techniques, which may be mild or moderate, can
alleviate fear/anxiety, but do not entirely eliminate pain.
Therefore, these are frequently used in combination with local
anesthetics that control regional pain.
Sedation dentistry consists of the following:
sedation involves no needles. Instead, you take a pill that
helps you feel calmer and sometimes drowsy during dental
treatment. You'll remain conscious and able to communicate
with and respond to the dental staff.
sedation involves breathing in nitrous oxide ("laughing
gas") through a mask worn on the nose; it produces conscious
relaxation and dissociation.
Intravenous (IV) sedation is administered with a needle
directly into your arm or hand. IV sedation, also called
"twilight sleep," is conscious sedation. You can breathe
independently and respond to verbal instructions.
anesthesia (GA), a deep sedation, renders you completely
unconscious and free of pain (even without local
anesthesia). You may not be able to breathe independently
and unable to respond to verbal commands.
Oral sedation is frequently used for
many anxious dental patients and works extremely well. GA
and IV sedation are appropriate for people receiving long
and/or complex oral surgical procedures (such as
implant dentistry) and those with
certain physical/mental handicaps, but are recommended for
only a small percentage of highly phobic dental patients.
IV, inhalation and GA sedation are considered safe and
effective, but cost more and may increase cardiovascular and
medications should be administered and monitored by dental
professionals who are skilled to provide the safest dental
Authored By: Nayda
Reviewed By: Donald M. Jayne, DDS