It is completely normal to find some dental procedures somewhat frightening or nerve-wracking. For some people, however, the thought of going to the dentist for even a simple procedure can trigger panic, anxiety, and dread. Dental anxiety and dental phobia may include fear of specific dental procedures, fear of certain dental instruments, fear of the general dental setting, or fear of the actual dentist. Dental phobia can cause people to forego dental visits, which can lead to complicated dental problems that may necessitate an emergency dental visit; this can cause the phobia to worsen, of course, and the cycle of dental phobia carries on. It is estimated that one out of every six adults experience dental phobia.
Dental phobia can elicit emotional, physiological, cognitive, and behavioral responses, just as any phobia might. Emotional responses include feelings of apprehension and panic and may be accompanied with cognitive responses, where the patient thinks they are in significant danger. Physiological responses might include breathlessness, sweating, an increased heart rate, and nausea, and behavioral responses include vigilance and irritability.
It can be very challenging for people to determine the factors that contribute to phobia. Research indicates that dental phobia is caused and exacerbated by a complex combination of factors, though the specific factors aren’t easily defined. Dental phobia may also be related to underlying generalized anxiety and fear. If a person has a traumatic first experience with the dentist, cognitive conditioning may lead them to develop a fear of future dental visits and procedures. Some people may also pick up dental phobia through stories told by friends or family who have had negative experiences, and some may see fear reactions in their parents or other elders and absorb this fear as their own.
There are multiple surveys and scales that can be used to diagnose dental anxiety and phobia in children and adults. Treatment and management varies from person to person. Short-term treatment for dental phobia may include hypnosis or anesthesia, while longer-term treatment may focus on cognitive behavioral therapy and other types of therapies. Usually, both short-term and long-term treatments may be necessary. For children with dental fear or anxiety, especially, distraction techniques and modeling may be effective at dispelling fear, which is why pediatric dentists are trained in these techniques.
A calming environment may help calm dental phobia; you may notice soft music playing in the waiting room at your dentist’s office, along with dim lights and a homey atmosphere. For patients with severe phobia, hypnosis or mindfulness meditation techniques may help the patient to at least feel comfortable enough to enter the dentist’s office, and a calming waiting room can ease the transition. Once the patient has entered the office, depending on the severity of the phobia, the dentist may use conscious sedation or general anesthesia so that the patient is unaware of the dental procedure. Dentists may also prescribe medication to be taken before the dental treatment, usually using a benzodiazepine to calm the patient a few hours in advance. These medications are addictive, however, and should only be prescribed in small amounts and when other techniques have failed.