Fear of the Dentist Phobia

A fear of the dentist or at least some level of apprehension is fairly normal. It’s normal to be wary when you head to the dentist and to perhaps feel some fear of possible procedures. But where this becomes crippling and actually prevents you from going to the doctor it becomes a problem and is no longer just an amusing character trait. Here we will look at full blown fear of the dentist, its implications and how it can be treated.

Prevalence

A fear of the dentist is one of the most common fears/phobias that there is and in fact it is suspected that 75% of US adults have at some point experienced a degree of dental phobia. It is variously known as ‘dental fear’, ‘dental phobia’, ‘odontophobia’, ‘dentophobia’, ‘dentist phobia’, ‘dental anxiety’ and other similar terms. In some cases people are described as having dental phobia wrongly, and in fact they feel that rather their fear is just a measured response to previous traumas much like a post-traumatic syndrome. Interestingly more women report a full blown dental phobia than males.

Associated Problems

While some cases of dental phobia are manageable, other result in the undesirable outcome that the individual avoids at all costs any kind of dental treatment. This then results in their of course developing various problems with their teeth which go unnoticed and invariably worsen. This then also leads to a ‘cycle of avoidance’ wherein by avoiding the dentist they inadvertently ‘reinforce’ their fears and thus the phobia becomes worse. At the same time, because they have avoided the dentist for such a long time, any trips they eventually do make will of course be more likely to be painful and involve serious procedures – again reinforcing their fear further.

Anything that causes you to consistently avoid the doctor is always going to be a negative influence and will have various repercussions. This is due simply to the importance of dental treatment, and the potential problems that can come from not seeing a dentist. Of course abscesses and tooth decay are serious and can worsen if left untreated, as are problems like overcrowding but at the same time there are various other problems that can occur as a result of not seeing a dentist and you can find you experience a build up of bacteria that causes your immune system to be weaker and that can make you more susceptible to problems like cancer as a result. Furthermore, this can cause halitosis (bad breath) and can cause your teeth to stain and look worse which can have implications on your relationships and your career.

Causes

There are various causes of dental phobia and obviously in many cases it is simply a result of bad experiences. Usually this will mean that they have gone through a traumatic and painful dental experience with complications – having painful wisdom teeth removed for instance or getting an infection. However this on its own is not enough to completely explain dental phobia as it does not shed light on why some individuals develop the phobias while others don’t who have been through the same or similar experiences.

If you have a very cold or callous dentist, or one who comes across this way then this can be a cause of dental phobia too and some studies have shown this to be a highly causative factor.

Interestingly though it does not have to be a direct experience that causes the dental phobia and in some cases it is possible to develop the phobia without actually having a bad experience yourself. For instance it is possible to learn a fear of the dentist vicariously – by witnessing a friend of family member going through a very traumatic experience. The media too can cause these kinds of fears if dentistry is portrayed in a scary or negative light.

Other people might find that their dental fear is actually a fear of other stimuli that have been ‘generalized’. For instance if you have had a very bad experience when seeing a doctor then you might find that some of the paraphernalia is the same and that the clinical setting is enough to trigger your fears. You might otherwise be afraid of individual aspects of the dentist – such as the scalpel or the chair. A surprising number of patients are actually afraid of the chair, but in this case the fear is actually of being helpless and unable to escape and thereby avoid negative consequences. In this case the phobia is of helplessness but is generalized to the situation of being at the dentist.

Theories of Phobias

When the phobia is of something like medical gloves, then it is unlikely that the individual had a bad experience, so it’s hard to understand where it might have come from. Freud’s psychoanalytical theory describes such phobias as being an expression of a different repressed issue. So if you maybe had a bad experience that you don’t want to face or admit to, you become afraid of a different item that is taken to represent that experience in some way. This theory is not universally accepted by psychologists, but it is one of the few theories that provides a satisfactory explanation of these kinds of phobias.

Treatment

If you suffer from dental phobia then it is important to make sure that you overcome it so that you can receive normal dental treatment and maintain good oral health. There are a couple of ways that it is possible achieve this and different treatments that will help different people:

Medication: For some individuals an immediate treatment might be to use medications such as anti-anxiety medication in order to induce a more relaxed state and calm the ‘fight or flight’ response. These medications may cause drowsiness and can have some side effects and they won’t provide a long term solution so they should not necessarily be considered the best course of action.

Relaxation Techniques: A similar effect can be achieved by using relaxation techniques to calm your heart rate and clear your mind. These include meditation and focusing on your breathing. Cognitive behavioral therapy can teach you some of these stress management techniques.

Re-Association: Behavioral psychology is a school of psychology that looks at how we can come to associate two things – such as a stimulus and a result and how this can then cause us to have actual physical reactions. Here you have become classically conditioned to associate the dentist’s with pain and complication, so the strategy is to create a new association and get you to connect going to the dentist with more positive experiences. This might be achieved through praise or through other pleasant experiences – for children it is customary to give lollypops or stickers for instance. Gradually the individual is exposed more and more to the aspects of the dentist that cause the fearful reaction until they are able to go to the dentist with a drastically reduced sense of dread.

Cognitive Restructuring: This is a relatively new technique that involves changing the negative thoughts that lead to the fear of the dentist. When someone with a phobia goes to the dentist they will likely think things like ‘it’s going to hurt’ or ‘what if I bleed?’, whereas cognitive restructuring would aim to replace those thoughts with more positive ones such as ‘this will help to keep my teeth healthy’ or ‘they’re professionals’.

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