Dentist anxiety: how to deal with it explained!

Dentist anxiety is the fear of dentists and dental offices. People also refer to this as dental anxiety or dental fear, and in severe cases when it is an extremely unexplainable irrational fear and feeling of anxiety it is called dental phobia. Other terms used for this condition are odontophobia, dentophobia, or dentist phobia. Dentist anxiety is a topic that has been around for some decades. In recent years many studies have been done in regard to the etiology of dental anxiety, its signs and symptoms, and how to get over it.

Let’s have a deep look at all these aspects together.

What are the signs and symptoms of dentist anxiety or dentist phobia?

Dental anxiety can demonstrate a wide variety of signs and symptoms in two main categories: Physical signs and psychological signs.

Physical signs:

  • Sweating
  • Fast or racing heartbeat or heart palpitation
  • Low blood pressure and the possibility of syncope and fainting
  • High blood pressure and flushed face
  • Paleness
  • Dry mouth
  • Muscle tension
  • Hardships in breathing
  • Nervous stomach
  • Physically feeling ill
  • Dizziness
  • Shaking

Psychological signs:

Psychological signs consist of both cognitive and behavioral signs including:

  • Visible panic or distress
  • Withdrawal mechanisms (humor or aggression to avoid the situation)
  • Postponing the dental appointment or delaying the onset of the visit
  • Difficulty sleeping the nights before the appointment
  • Crying
  • Avoiding the dentist
  • Nervousness that grows worse as time goes by
  • Pessimism and assuming the worst-case scenario
  • Constant worry
  • Racing thoughts

The possible reasons for dental anxiety

Reasons for dentist anxiety can originate from either external or internal triggers. This means the fear and anxiety can be due to external factors such as environmental triggers and what happens in a dental office that affects the patients. Internal triggers come from within such as medical and mental health issues that lead to extreme fear.

It could be a traumatic experience

Dental anxiety can be due to bad dental experiences. An invasive dental treatment that led to pain and complication creates a bad memory for the patient and makes them afraid to undergo another dental procedure. Bad experiences especially in childhood cause more fear and anxiety.

Another reason can be the cold and unfriendly behavior of the dentist. When a poor patient-dentist interaction is formed, the patient can not know much about the procedure and is not able to communicate well to express their concern and this leads to fear and anxiety.

Other than unpleasant experiences at a dental office, previous trauma related to other doctors and medical environments can also cause distress towards treatments. In simple words, people and especially children fear anyone who wears a white coat.

An unpleasant memory of abuse also causes anxiety and fear when it comes to dental settings.

Being afraid of the dentist could be vicarious learning through others and the media

Not always a direct traumatic event is a reason behind dentist anxiety, something learning of others’ misfortunate experiences can create a negative image in the individual’s mind and cause a dental phobia. This can be through witnessing other people’s complications or pain, hearing their stories, or just reading. Childhood phobias are more likely to be formed due to witnessing a traumatic experience of a family member. This can exacerbate the fear of pain in people without prior direct experience. They build up a painful image in their heads and get frustrated when visiting a dentist.

Another factor that contributes to dental fear is the media. Stories that are shared on mass media and internet platforms affect people. A viral story of dental treatments gone wrong frightens many people and makes them ask themselves what if this happens to me too?

It could be fear of dental equipment

Needles, drills, and other dental equipment scare many people. Harsh and scary noises caused by different dental tools induce anxiety and distress. People do not have a clear understanding of what these devices do when they are put into their mouths and this adds up to their fear.

It could be fear of blood

Many people fear bleeding and seeing blood come out of their bodies. When it comes to bleeding during a dental procedure they see blood there is no exception for them, even if it’s a few drops.

It could be fear of choking

Some people have this fear that when they have their mouths numbed by the medications, they might choke on their blood or saliva.

It could be a lack of personal space

Many people might feel intimidated when a person gets too close to them. They feel their privacy is invaded and as a result, they show fearful responses.

It could be personality traits

Two major traits that play a crucial role in dentophobia are neuroticism and extraversion. But what do they mean and how do they relate to dental anxiety?

Neuroticism is a personality trait that heightened feelings of anxiety, self-consciousness, anger, irritability, and depression. People with this trait disposition have difficulty interpreting ordinary situations and usually see them as threatening and dangerous.

They don’t respond well to distressing situations and become overwhelmingly frustrated. This trait is associated with physical problems and complications that exacerbate when under stressful circumstances, as well as episodes of anxiety and depression. For these people attending a dental clinic may seem like a big challenge and intimidating.

Another personality trait that can be a cause of dental anxiety is extraversion. According to studies, introverted people tend to suffer more from dental fear and anxiety compared to extroverted people.

Your heritage could be the reason 

A study published by Ray et al. showed there’s a genetic component responsible for dental fear and anxiety, thus dentist anxiety can be inherited from parents. This gene affects girls more than boys.

It could be mental illness

Dentophobia can be seen in association with some mental illnesses. The most common ones are:

  • Depression
  • Generalized anxiety disorder
  • Bipolar disorder
  • Feeling of loss of control. When the patient feels like they can not control the situation especially when invasive treatment is done, they panic.
  • PTSD aka post-traumatic stress disorder
  • Trust issue

How to deal with dentist anxiety?

Dentist anxiety is a disorder that requires management and treatment. Two main components that contribute to managing anxiety are the patient and the dentist. Let’s see how to deal with dentist anxiety.

How can your dentist help you to get over your anxiety?

Your dentist can be a big help to relieve your stress, as they encounter many patients that suffer from the same condition as you. An expert dentist knows how to handle the situation and help you overcome your fear.

Conversation and cooperation

Talk to your dentist. Let them know you are afraid of this situation. Knowing this helps them to understand what to expect and act accordingly. A patient with severe anxiety might be difficult to deal with and this will affect the treatment.

When you speak up about your fear at a dentist’s office, the dentist can ease your stress by explaining the whole process step by step. By understanding the procedure patients trust the dentist more and are less afraid.

You can also agree on a signal with your dentist to stop the procedure when you feel uncomfortable.

Discussing your concern also enables the staff at the dental clinic to be aware of your condition. The staff will cooperate to ease your tension.

Another effective practice is playing relaxing music in the office. This reduces anxiety levels.

Analgesia, sedation, and mediaction

Nitrous oxide or laughing gas is a method some dentist use to help patients relax during dental treatment. The patient is awake during the procedure but is relaxed and stress-free. Some patients might not remember all the details after the effects are worn off.

Dentists can prescribe medications to relieve anxiety to help patients remain relaxed during the process. This is usually a single-dose tablet given to the patient to take before the appointment with a short action duration. It is recommended for the patient to have company, as the impacts of these medications might take some time to fully vanish.

Conscious sedation is a very helpful technique for people with severe anxiety. In this technique a sedative agent to relieve anxiety and an anesthetic agent to prevent pain are given to the patient, whether orally or through an IV implement. The patient is aware during the procedure and responds to being called but doesn’t feel pain or discomfort. The dentist and the patient discuss this technique in case of any underlying medical condition.

General anesthesia

In case of extreme anxiety at the dentist, general anesthesia is applied, either by the dentist who has been trained or an anesthetist. In this case, the dental practices are done in a hospital. However, this is not safe to perform general anesthesia every time the individual visits the dental office and they should seek serious and effective treatment to overcome this unexplained fear. It is best to use general anesthesia for dental procedures that are challenging and complicated and require more time than usual work.

What can you do to manage this fear of dentists?

A person with dental anxiety should look for ways to manage the situation. There are a variety of useful options to benefit from.

Psychological coping mechanisms and techniques

Discussing your condition with a psychologist or a psychiatrist helps you learn coping mechanisms and face your fears in a confident way. These techniques are:

  • Deep breathing exercises: One of the most well-known practices against stress and anxiety, taking deep breaths helps alleviate tension by taking more oxygen to the body and regulating the altered breathing pattern caused by anxiety.
  • Guided imagery: This is a nice method to release stress. The person will picture positive and pleasant visions. By illustrating nice images in the mind the person becomes calm and less anxious.
  • Graduated exposure or systematic desensitization: This is a psychiatric therapy that gradually exposes the anxious patient to a situation that is afraid of. By slowly facing the situation, the patient becomes less frightened and learns that the condition is not as scary and stressful as they gave it credit for. By experiencing the situation step-by-step, the patient finds the opportunity to discover all of its hidden aspects that they were not able to see due to intense fear. This exposure-based treatment makes the situation less intimidating.
  • Meditation and muscle relaxation: Meditation helps individuals concentrate on different parts of their body and have control over them. Muscles become tense as a result of stress which leads to more discomfort and anxiety. A useful way for muscle relaxation is to meditate and focus on them.
  • Mindfulness: This is a new and specialized way of meditation. Mindfulness means paying attention to your surroundings, your current situation, your thoughts, your sensations, and your position at the moment without judging or analyzing them. Mindfulness is all about being aware of what’s around you and accepting it without judging or overreacting.
  • Distraction: By not paying attention to the inconvenient situation and distracting themselves, the patients can be at ease and avoid a negative experience. Listening to music or touching a comforting device can be good options for distraction. You can always take an object with you that gives you comfort and helps you remain calm.
  • Hypnotherapy: Also known as hypnosis is an induced relaxed state or dream done by a trained and expert person. This helps the patient cope with the fear of pain, anxiety, and stress.
  • Other relaxation techniques: such as drinking tea or doing yoga before the appointment can be useful in managing stress. Discuss this with your dentist to see if it might interfere with your treatment.

Take a friend with you!

A family member or friend who is close to you can accompany you to the dentist’s office. The presence of a loved one, can make the atmosphere less intimidating and more reassuring. If possible, holding their hands or hearing their voice can be a great relief.

Let your dentist know!

Speaking up about your dental anxiety, especially before the appointment helps the dentist and the staff to cooperate better and help you if needed. The dentist can explain the whole process in detail, so you will know what is about to happen and be less nervous about it. Don’t hesitate to ask all your questions and express your concern.

How extreme anxiety at the dentist affects your oral health?

Undoubtedly, dental visits are crucial to maintaining a good dental care routine and good oral health subsequently. Dental anxiety leads to avoiding dental treatments. This causes dental health deterioration and problems. As a result, the person is embarrassed to visit the dentist, and even if they do they will need more aggressive and intense treatments due to their teeth condition. This adds up to their fear and anxiety and therefore a vicious cycle is created. Avoidance of dental care due to anxiety can result in dental health complications such as tooth decay, cavities, tooth loss, periodontal disease, and gum disease.

Many oral health issues such as mouth cancer are detected through regular check-ups. Preventive care is another essential outcome of dentistry, which will be lost due to not showing up for dental appointments.

Irrational fear of dentists and dental work affects not only dental health but also overall health. Poor oral health can result in many health complications such as cardiovascular diseases, respiratory disorders, diabetes, general bloodstream infection, and even brain abscess. In simple words, fear of a dentist can affect your quality of life.

Reference:

Beaton L, Freeman R, Humphris G. Why are people afraid of the dentist? Observations and explanations. Med Princ Pract. 2014;23(4):295-301. doi: 10.1159/000357223. Epub 2013 Dec 20. PMID: 24356305; PMCID: PMC5586885.

Widiger TA, Oltmanns JR. Neuroticism is a fundamental domain of personality with enormous public health implications. World Psychiatry. 2017 Jun;16(2):144-145. doi: 10.1002/wps.20411. PMID: 28498583; PMCID: PMC5428182.

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