Dental Anxiety – Causes, Diagnosis and Treatment

What is a dental phobia?

A surprisingly big number of people never anticipate appointments with their dentists. Even though many dental procedures are painless, the mere thought of being examined frightens a good many of people. The majority of people arguably live with some degree of anxiety about visiting the dentist. However, persons with dental phobia hardly fathom the fright that cloud them when they think about an appointment with a dentist. Indeed, some people with dental phobia get so scared that they are ready to do anything and everything to sidestep a dental appointment.

Phobias are immense, stroppy fears about certain activities, situations or objects. People plagued by dental phobia usually postpone normal dental care for as long as it takes. This avoidance leads them to live with periodontal illnesses, fractured and discolored teeth, and even pain. Dental phobia is also variously referred to as dental fear, dental anxiety, odontophobia and dentist phobia. Many practitioners, however, reserve the term dental phobia for people with irrationally extreme fears. Persons with post-traumatic stress disorder occasioned by prior distressing dental experiences fall in this category.

Dental fear prevalence

Dental fears and anxieties are shockingly common. It’s estimated that up to 15% of Australian citizens shun visiting the dentist due to fear. This translates to about 3.5 million Australians who possibly prefer putting up with gum infections and other dental conditions rather than see a dentist. Notably, the prevalence of dental fears varies significantly basing on the criteria applied in measuring as well as the population under study. From a global perspective, at least 4% to more than 20% of people have dentist phobia. Undeniably, most people usually use the words phobia and anxiety interchangeably even though their meanings are different. On the one hand, people with dental anxieties experience nervousness or restlessness when seeking dental care. On the other hand, dental phobia is a grave condition. Sufferers experience unexplainable dread or immense fear. Persons with dental phobia are not just nervous. They’re scared stiff.

Predictably, sufferers of dental phobia are highly susceptible to gum diseases as well as premature tooth loss. The fear of visiting a dentist has an emotional toll on sufferers as well. Persons who shun dental appointments usually have discoloured and disfigured teeth, making the sufferers self-conscious as well as insecure. Such people react by smiling less and keeping their mouths closed partially as they speak. In some cases, the sufferers are so mortified about their unsightly teeth that their work life and personal life takes a beating. In fact, it is common for people who avoid the dentist to have extremely low self-esteem. Additionally, dental phobia sufferers have poorer general well-being as well as a low life expectancy. This results from the fact that improper oral health is linked to various fatal conditions including lung infections and heart conditions.

Dental phobia or anxiety comes in varying levels. At times, a person with extreme dental phobia never sees a dentist. While others are forced by factors like pain, damaged or unsightly teeth to visit the dentist, they can be so stressed that they experience sleep problems on the eve of their appointment. Some people even feel sick, while others actually fall sick at the waiting bay. Worrisomely, dental phobia gets worse if left untreated. This is partly due to the emotional stress that accompanies dental phobia, and which makes seeing the dentist unnecessarily more comfortable. Persons with a tendency to intense tension also have a comparatively low pain threshold, which means that they tend to feel the subtler pain.

Causes of dental phobia

Dental anxieties and phobias can develop from different factors. Research results from patient interviews reveal that the following are the commonest causes of odontophobia;

1. Pain

A study carried out on persons who hadn’t visited a dentist for at least a year showed that at least 6 percent of them stated that they failed to get dental care mainly due to their fear of pain. Adults aged 24 and above who abandon oral care almost always cite pain as a key factor. It is possible that persons over the age of 24 had their early experiences with dentists prior to the present advanced ‘pain-free’ dentistry. Developments in this area have led to the introduction of technologies that help stave off this sort of pain, so modern approaches are painless. Children who associate with dental services with pain are most likely to have inherited the phobia from older people around them who regale them with stories of horror teeth extractions. The association of dentistry with pain may also stem from facts unrelated to a visit to the dentist. For example, if someone has endured an oral trauma in the past, they will find it difficult to let a professional take a look at them in the fear that the early pain is going to come back. Such fear is however psychological and is not based on any logical thought.

2. Shame

It would be fair to argue that not everyone among us has the perfect set of teeth. While there are people born with great oral structures, there are those who suffer from minor teeth defects such as chipping and misalignment. Such people may feel ashamed of presenting themselves to the dentist because they fear that the experts are going to be judgemental. This fear is mostly manifested in women, who tend to have a problem with perceptions. To a lesser extent, men will from time to time avoid the dentist for the same exact reasons.

Even in situations where the cause of teeth defects is not self-imposed, patients tend to have a fear of being judged. They feel that the dentist will see them as ignorant when it comes to their dental health. There are others who have an experience of getting subjected to ridicule because of their teeth, and this leads to the degeneration of self-esteem. The assumption is that since they have been mocked for their dentition in the past, then the dentist will without a doubt mock them even more.

3. Vulnerability

For many of us, the mouth is a very private area of the body. When growing up, we are taught to brush our own teeth and take care of our own mouths. Nobody has ever had to do it for us. When you go to the dentist, they will pry your mouth apart in order to perform check-ups, and most people can’t help but feel vulnerable and hapless. They imagine lying down at the dentist’s, not able to control what is happening to them. This sort of vulnerability discourages many people from visiting the dentist.

4. Fear of the unknown

There are a great many people out there who have never visited a dentist in the past, never heard someone relate a negative experience and never had teeth trauma since birth. However, they are consumed by a sense of dread that refuses to go away. When told about the processes carried out by a dentist, their minds spin out of control and they think about what could possibly go wrong. They conjure up memories of losing teeth or even ending up with horrific injuries. Because they spend a lot of time reliving pain that doesn’t even exist, it becomes part of their existence, and they have a hard time looking at it any other way. They start looking for ‘facts’ that justify their notions, and when they do, their resolve to never see the inside of a dentist’s office just hardens.

5. Fear of cost

Even though some of us have never actually consulted a dentist in the past, we assume that the procedures involved are way above our pay grade. We, therefore, put off going to the dentist’s until we ‘get the money’, which predictably, never comes around. The truth, however, is that dental procedures are way cheaper than most people think.

6. Fear of injections

There is a widespread fear of injections in the Australian psyche. Most people with dental issues get to thinking that any dental procedures would involve injections. And since they harbor an existential fear of the needle, they associate dentistry with it; at times they harbor this fear even when they know pretty well that the problems they are going through my not need any injections at all. Some of us are wary of injections since birth while others pick up the phobia somewhere along the way.

7. Fear of the side effects of anesthesia

When one is undergoing a complex dental procedure, they are put under anesthesia. In an overwhelming majority of the cases, the anesthesia is 100% effective. However, most people don’t think about how smooth everything will go; they focus on what would happen if said anesthesia did not work. They also think about the possible side effects of said anesthesia, which would include (in their imagination) dizziness and general discomfort.

8. Sign of a deeper problem

Some people are not afraid of dental evaluation on its own; they are afraid of social evaluation. Others are afraid of contracting germs and do everything possible they think would keep them germ free. Depression has also been noted as a possible cause of this form of anxiety.

Diagnosis/Symptoms of dental anxiety

Nervousness

When a patient of Dental anxiety has an impending trip to the dentist, they tend to get nervous. This could start happening as early as a week before the visit and escalate as the day of appointment draws closer. It peaks around the time the patient is in the waiting room and starts dwindling at around the time they actually sit in front of the dentist. Depending on the individual, there are a variety of responses; some people may choose to stay away from social situations. Others will want to disengage themselves from friends and family. There is documentation of people developing a cold sweat as a result of an upcoming appointment with the dentist; the worst case scenario involves developing a fever.

Trouble with sleep

As indicated earlier, people with dental anxiety tend to get more nerves as a time for appointment draws closer. Some nights become all about tossing and turning, while others are a patchy-sleep affair. During these nights, they go over what is expected to be a painful experience at the dentist’s and see the event in the most gruesome of terms. As they delve deeper into this world, sleep eludes them even further. It becomes an ongoing problem that threatens their relaxation patterns and could spill into areas of life such as career, family and education.

A feeling of uneasiness during dental procedures

Once someone with dental anxiety thinks about objects being placed inside their mouth, they undergo a series of feelings of unease. The problem becomes so aggravated that they start having fear that anything placed inside their mouth is going to be some dental mirrors, probes or even lasers. Some people actually make their way to the dentist’s office even with all this fear, but when the actual dental instruments are inserted into their mouths, they start shaking, sweating and having something akin to a seizure. These are signs of the body reacting to what the mind perceives to be negative stimuli, but it is just that-a perception. A great doctor is always able to put their patient at ease, allowing the procedure to continue successfully.

Physical illness

This is caused by a confluence of emotions related to dental anxiety. Once a patient even thinks about the impending visit to the dentist’s, they program their mind to the effect that the experience is going to be awful. The relentless flow of thought leads to a state of mind that is in many ways compromised. The end result is an illness. Apart from illness, there are people who suffer from extreme emotions such as crying uncontrollably. The illness and emotions experienced can make it hard for the dentist to carry out their treatment procedures. It also makes it way difficult for the patient to get the help they require when it comes to their dental needs.

Treating dental anxiety

While dental anxiety is a real problem in Australia, it is not beyond control or mitigation. The healthcare industry in the country has for a long time fought to help patients book and show up at appointments. There are forms of treatment that have come across as highly effective over the years. However, it would be important to note that not every method works for every patient out there, so care needs to be taken so solutions are tailored to everyone’s needs. Those suffering from dental anxiety need to cooperate with the professionals and others willing to help. Below are ways in which patients can heal from this kind of disorder;

Understand the existence of the problem

While much Australian know a little about dental anxiety disorder, they do not accept the idea that they could be victims. When a patient is not aware that they have a problem, then they do not take the steps necessary to get the help they need. To know whether you are a victim or not, simply take a look at the symptoms and analyze them realistically. It is hard to come to terms with such a problem, but it is the first step toward a healthy dental life. You can confide in a good friend or family member because the people close to you are best placed to help.

Find a good dentist

Dentistry has come a long way from the days it was associated with pain. There are sets of new technologies that make dental examinations a walk in the park. That having been said, you will need to look around and find an experienced and sophisticated professional to perform your procedures. The good news is that there are tens of thousands of dentists in the country, so you are spoilt for choice. When looking for a dentist, be keen on their qualifications and certifications. Look up the reputations of various dentists online and then reach a decision on your own gut. A good idea would be to start out with a shortlist and tick off names as you go. Once you get to the one you think will get the job done without necessarily having to charge over the top for it, then you are already home. A dentist is supposed to make you feel comfortable and in your element at all times. If they don’t strike you ask the sort of person to inspire coziness, let them go.

Talk about your fears with the dentist

If you have been trying to fight off dental anxiety for a while to no avail, then maybe you will need to change tact a little. See, the dentists you meet every day have been thoroughly trained on how to handle patients. They know that you are going to be nervous and are always desperate to make sure you are at ease at all times. Find some time alone with your dentist of choice and let it all out. Being a professional, a dentist knows how to assuage your fears. A dentist is never there to judge patients for their dental limitations; real or imagined. They are there to do their job, and that is precisely what they do. If you feel vulnerable, then the doctor will work toward making sure that you are comfortable and assured. A dentist wants to help. They have been trained to do precisely that and have no motive beyond that. Patients who tend to associate dental examinations with injuries can rest easy knowing that the dentist will always take measures to make sure that the processes go smooth.

A good idea would be to ask the dentist what it is they are going to do and how long it is going to take. A blow by blow account will set your mind at ease and prepare your body for what will eventually happen. You and the dentist can also agree on a signal; e.g., if you are getting nervous and uncomfortable, you can always raise a hand or ring a bell. This way, a communication code is established and the patient does not suffer without the knowledge of the dentist carrying out diagnoses or fixing problems.

Distractions

Your perceived problems during both the examination and treatment phases are because your whole being is entirely focused on what is going to happen at the treatment table. Finding a way to keep your mind occupied elsewhere is a great idea, and there are many ways to do so. You could simply bring to the table a pair of headphones to listen to your favourite music as the dentist works. If your dentist has a TV set at the treatment room, allow them to switch it on and go with whatever is showing. For children, games, toys and audio tapes would be the best way to go.

Look at the available pain control choices

We have arrived at the conclusion that the fear of pain is one of the most prevalent problems when it comes to visiting the dentist. However, modern technologies have made it easy to deal with this sort of pain. Not all dentists will have every single anesthesia out there, but here is what you need to expect;

· Topical anaesthetic-here, a cotton swab is used to numb the area before injection of a local anesthetic

· Laser drills- are a modern option used to prime up cavities for filling. Said drills are way better than the conventional mechanical types.

· Laughing gas- Nitrous oxide has been used as a sedative in procedures since a long time ago, and they are a perfect fit for dentistry. The gas works to keep you calm and relaxed. Its effects tend to disappear as soon as the source is switched off.

· Electronic anesthesia- a numbing current is sent to the jaw by electrodes in the cheeks.

Dental anxiety keeps you away from the dentist. While most of us may not see themselves as victims, the truth is that it is a problem in Australia. It takes courage to identify yourself with this disorder, but it is the first step toward assistance. Getting rid of this problem means that you get to enjoy dental services that enhance your smile and subsequently, quality of life.