Dental Anxiety 101

What is Dental Anxiety?

Many  people don’t look forward to dental appointments any more than they look forward to visits to a physician. Modern dental procedures aren’t painful, but just being examined can make people feel stressed and anxious.

Dental anxiety and phobia are very common. Approximately 15% of Americans will not seek dental care due to anxiety and fear. That’s about 30 million to 40 million people. Surveys have shown that fear of pain is the main reason people avoid the dentist.

Most people can live with having some anxiety about going to the dentist. For those with dental phobia, however, the thought of a dental visit is terrifying. They may be so frightened, in fact, that they’ll do just about anything to avoid a dental appointment.

Those with dental anxiety will have a sense of uneasiness when it’s time for their appointments. They’ll have exaggerated or unfounded worries or fears. Dental phobia is a more serious condition. It’s an intense fear or dread. People with dental phobia aren’t merely anxious. They are terrified or panic stricken. The feelings can be so intense they will do almost anything to avoid dental visits.

There are different degrees of dental anxiety and phobia. A person with severe dental phobia may never see a dentist and engage in “do it yourself” dentistry. People with less anxiety may be able to force themselves to go, but they may feel anxious days before the appointment and not sleep the night before. It’s not uncommon for people to feel physically sick — or, in some cases, to actually get sick — while they’re in the waiting room. Uncontrolled crying or emotional outburst are also common.

Dental phobia and anxiety can be treated. Without treatment, dental phobia is likely to get worse over time and spread to other areas of life. Anxiety is like a savings bond, the longer you keep it the greater it matures.

The perception of pain is also altered. People who experience high degrees of agitation tend to have a lower pain threshold. This means they may feel pain at lower levels than other people. They may need additional anesthetics or other pain treatments. They may even develop stress-related problems in other parts of the body. For example, they may have headaches or muscle stiffness in the neck or back.

Causes of Dental Anxiety

 

People can develop dental anxieties and phobias for many different reasons. Interviews with people suffering with dental anxiety have many of the following in common.

Pain — In a survey of people who had not seen a dentist for 12 months, 6% reported fear of pain as the main reason. The fear of pain is most common in adults 24 years and older. This may be because their early dental experiences happened before many of the advances in dentistry which can make treatment pain free.

Feelings of helplessness and loss of control — Many people develop phobias about situations — such as flying in an airplane — in which they feel they have no control. When they’re in the dental chair, they have to stay still. The chair is tilted back, putting them in an unnatural position.  They may feel they can’t see what’s going on or predict what’s going to hurt. It’s common for people to feel helplessness and a loss of control, which may trigger anxiety.

Embarrassment — The mouth is an intimate part of the body. People may feel ashamed or embarrassed to have a stranger looking inside. This may be a particular problem if they’re self-conscious about how their teeth look. Dental treatments also require physical closeness. During a treatment, the hygienist’s or dentist’s face may be just a few inches away. This can make people anxious and uncomfortable. Many people also feel the dentist might judge them based upon the state of their teeth.

Negative past experiences — Anyone who has had pain or discomfort during previous dental procedures is likely to be more anxious about the next dental visit. This can remain true even if the painful dental experience happened decades ago.
There isn’t a clear boundary that separates “normal” anxiety from phobia. Everyone has fears and concerns and copes with them in different ways. However, the prospect of dental work does not need to fill you with terror. If it does, then you may need some help overcoming the fears.

Some of the signs of dental phobia include:

• You feel tense or have trouble sleeping the night before a dental exam.
• You get increasingly nervous while you’re in the waiting room.
• You feel like crying when you think of going to the dentist. The sight of dental instruments — or of white-coated personnel in the dentist’s office — increases your anxiety.
• The thought of a dental visit makes you feel physically ill.
• You panic or have trouble breathing when objects are placed in your mouth during a dental appointment.
• You are unable to communicate your wants, needs or feelings because you are paralyzed by fear.
• You have a severe gag reflex that is triggered with anything being put in your mouth.

If this describes you, you need to tell your dentist about your feelings, concerns and fears. He or she will help you overcome these feelings by changing the way you are treated, or possibly refer you to a mental health professional that specializes in anxiety disorder. Dental treatment is not the painful experience it once was, due to improvement in tools and techniques. Dental anxiety/phobia does not need to control your life, it can be controlled with help and support.

About the Author

Dr. Richard Varlinsky specializes in treatment of stress, depression, anxiety and has conducted numerous studies on dental anxiety including a 3rd party evaluation of the b-Calm system.  As a published author and frequent lecturer, Dr. Valinsky works to bring practical solutions to individual who suffer from stress and anxiety disorders.