Dental Fear, Phobia & Anxiety

Reasons People Have Dental Phobia
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A few weeks ago, a teenage boy came into the dental school because one of his teeth was hurting.  I saw him in our pediatric dental clinic and we determined that two of his teeth couldn’t be saved and had to be pulled.

He seemed fine with everything.  I took him over to the oral surgery department to do the extractions and he started breathing heavily and acting very anxious.  I spent a few minutes talking with him about his dental anxiety.  When I tried to give him the anesthetic injection, he covered his mouth and shouted, “I decline treatment.  I have that right!”

Dental Fear and Anxiety - Dentist PhobiaI talked with him for a while and tried again.  I found one of our more compassionate oral surgeons and asked her if she wouldn’t mind helping.  The young man wouldn’t even let her give him the injection.

We scheduled him to get the teeth out under intravenous sedation.  He ended up not needing it because his mother had said that if she didn’t have to pay the $200 for sedation, he could buy something with the money that she would have saved.

Before we gave him the injection at the follow-up appointment, he tried to cover his mouth, but his mom was there with us and helped us hold his hands.  What I found shocking was that after the injection, he said he had barely felt the injection and now he has overcome his fear.

Unfortunately, not all dental fears are that easy to overcome.  Some people literally spend their whole lives being terrified of dental care.

If you want to learn more about dental fears and how to conquer them, I recommend the Dental Fears page over at Dental Fear Central.

Below you’ll find 15 common reasons why people are scared of the dentist.

15 Reasons Why People Are Scared of the Dentist

1 – The Drill. Even if you’re not getting your teeth worked on, chances are that you’ll hear the high-pitched whirring of the dental drill.  I’ve had patients who hate the sound of the drill so much that they wince whenever I turn it on, even if I haven’t touched their teeth yet!

2 – A Bad Dental Experience as a Child. A scary experience as a child at the dentist is all it takes for some people to avoid the dentist as an adult.  I would say that a majority of people who have a fear of the dentist had a bad experience at the dentist when they were young.

3 – Getting Your Teeth Scraped During a Cleaning. If I had to pick one reason to dislike the dentist (or dental hygienist), this would be it.  I used to hate it when they would scrape my teeth with the metal instruments.  It would send shocks through my body and give me goosebumps.

4 – The Anesthetic Injection. There are actually a few fears associated with getting injected.  I’ve divided them into five categories – feel free to add your own in the comments section if I didn’t cover your specific fear of the needle:

  1. Fear of the pain from the injection.  It’s usually just a little pinch, but some people (like the teenage boy in the introduction) have a fear of getting an injection.
  2. Fear of being injured by the needle.  Many people have a fear that the dentist will slip when giving them an injection and injure their mouth or face.
  3. Fear of getting diseases from the dental office such as AIDs or a cold.  How is your dentist doing when it comes to proper infection control?
  4. Fear of being numb.  Some people hate the feeling (or lack of feeling!) of losing sensation to a part of their lips and gums.  Sometimes when we give injections on the roof of the mouth, it can make it feel like it’s harder to breathe, causing a fear of suffocation in some patients.
  5. Fear of the side effects of the anesthesia.  Some people have allergies to the anesthetic or the preservatives used in the anesthetic.  Sometimes your heart races when you get a dental anesthetic injection – read this article to find out why dental anesthetic makes your heart beat faster.

5 – Getting Teeth Extracted. I’ve taken a lot of teeth out during dental school.  Some people think it’s cool, some people view it as a necessary evil, and others are extremely scared of getting a tooth pulled.  Something about having a body part removed that they’ve always had leaves some people feeling unsettled!

6 – Embarrassment. Many people are scared of the dentist because they are embarrassed of their teeth.  They have a fear of getting laughed at by the dental staff due to the poor condition of their teeth.  Trust me, we’ve seen worse!

7 – Demonstrating their Fear. Many people are scared that they will cry in front of the dentist due to their fear and end up making a fool of themselves.  This keeps them from seeking needed dental care.

8 – Having a Panic Attack. Similar to #7, many people are afraid that they will panic while at the dentist and have a panic attack.

9 – Your Dentist is a Jerk! Let’s face it, there are dentists out there who hate what they do − perhaps they got into the profession for the wrong reasons.  Hopefully these types of dentists are extremely rare.  In any case, if you hate having something done to you, and the person who does it hates doing it, it is a recipe for disaster!

10 – Not Having Any Control. Many people are afraid of the dentist because it puts them at the mercy of another individual.  They don’t have any control over the procedure while it’s happening.  One innovation to combat this lack of control is known as the dental button, which allows patients to stop the dental drill if they feel uncomfortable.

11 – Gagging or Choking. Many patients avoid the dentist because they have a fear of gagging or choking.  Dentists use many tiny instruments that can fall down the patient’s throat if the dentist does not take the proper precautions.  Stories like this one make the news and instill this dental fear in many people.  Many patients also gag when they get dental impressions taken.

12 – Allergies. Dentists use a variety of materials.  Some patients fear that they may be allergic to something in the dental office and don’t want to face the consequences of an allergic reaction.

13 – Sounds of the Dental Office. Aside from the drill, there are various sounds that can work up fear in certain patients.  If the person in the next room over is having a procedure done that you hate, chances are it will invoke a certain amount of fear into you.

14 – Smells of the dental office. The dental office has an interesting smell that is made up of a variety of things.  Read my article about the dental office smell to find out more about what exactly causes this interesting odor.  An interesting study found that those people with dental fear hate the smell of clove oil (a common dental material) while those who don’t have a fear of the dentist find the smell of clove oil to be “pleasant.”  Here’s what the study found:

In both groups, menthol was rated as pleasant and methyl methacrylate as very unpleasant, whereas eugenol was judged pleasant by non-fearful subjects but unpleasant by fearful subjects. Concerning autonomic analysis, only eugenol induced significantly different patterns of ANS responses between the two groups, with stronger variations for dentally fearful subjects, mainly observed through the electrodermal channel. These results suggest that eugenol can be responsible for different emotional states, depending on the unpleasantness of the subjects’ dental experience. This seems to confirm the role of odors as elicitors of emotional memories and to support the possible influence of eugenol odor on the avoidance behavior of some subjects toward dental care.

15 – Previous Sexual Abuse. There are many aspects associated with dental care that can bring back vivid memories of abuse.  These include being placed in a horizontal position, having someone in power that touches you and causes you to feel pain.  To learn more about this sensitive subject, I recommend reading this interview with Dr. Carmen Santos, an expert in childhood sexual abuse and its relation to dentistry.

Conclusion

There are many reasons that people may be afraid of the dentist.  Chance are that I missed more than a couple reasons.  If you have a fear of the dentist, please let everyone know what causes your fear in the comments section below.  If you have any tips for those with dental fear, go ahead and leave those in the comments section as well.

Thanks for reading!

Dental Fear You Are Not Alone
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Does the sound of a dental drill make you scared?  Is it hard to get up the courage to go and have dental work completed by your dentist?

Dental Phobia, Dental Fear, and the Dental DrillIf so, you’re not alone!  There are many other people who aren’t big fans of the dentist.  In fact, the Journal of the American Dental Association has estimated that 30 to 40 million people have dental fear.

How Common Is Dental Fear or Dental Phobia?

Many telephone surveys (like this one) have been conducted asking people about their degree of dental fear.  After looking at several of these, I would say that the overall breakdown of dental fear is the following:

About 20% of people have dental fear.

About 20% of people have a slight amount of dental fear.

About 60% of people don’t have any dental fear.

Who Has Dental Phobia or Dental Fear?

A dental unit that specializes in dental fear treatment was used to study 160 adult dental patients.  As I read over the study, I noticed some interesting facts that they found while studying people with dental fear.  They found that:

  • In 85% of the adults, dental fear had started in childhood and was the result of a traumatic dental experience.
  • A majority of those with dental fear were women (From what I’ve observed so far in my dental career, it seems that the gender of those with dental fear are about 1/3  male and 2/3 female)
  • Although there were more women that had a fear of the dentist, it was the men with dental fear that had worse teeth.
  • The average time that a patient with dental fear had avoided seeing the dentist was 16 years!
  • The most feared events were drilling, getting an anesthetic injection, and getting a tooth extracted.
  • The attributes they looked for in a dentist: Someone who is understanding and tries to avoid inflicting pain.
  • The attributes that they disliked in dentists: Being critical, remote, distant, and having a heavy hand.

Is Dental Fear and Anxiety Decreasing?

In a 2003 review of the studies on dental fear, it was found that studies done over the past 50 years “provide no clear evidence of dental fear either increasing or decreasing. Although several pairwise comparisons between study groups across locations suggest a decrease in dental fear over time, results of comparisons made within the same location are mixed and do not provide enough information to draw definitive conclusions regarding changes in dental fear over time.”

One positive point that the study found was that  “while dental fear is not dropping dramatically, it also is not rising as dramatically as is general anxiety in the United States. The fact that dental anxiety is not rising when dentists are treating patients who are increasingly anxious in general is—at least in part—a tribute to advances made in dental technology and patient management skills. In comparison with the rising tide of general anxiety in the United States, this relative reduction in dental anxiety is encouraging. The efforts of the last three decades appear to have had an impact on the problem of dental fear in our society.”

Basically, it would seem that dentists seem to be more aware of dental fear and are handling it better, thus holding the prevalence of dental anxiety down, while general anxiety seems to be increasing.

Conclusion – How to Decrease Your Dental Fear

The Internet does have a few sites that are dedicated to helping with dental fear.  One of the largest and best is called Dental Fear Central.  They have a forum there where you can get help from dentists and people who have successfully worked through their fear of the dentist.

Are you afraid of the dentist?  What have you found helpful in dealing with your fear?  I’d love to hear about any tips or hints you have for reducing dental fear in the comments section below.  Also, if you have any suggestions for what dentists can do to reduce your dental fear, I’d love to hear about them so I can better serve my patients who have dental anxiety.

Thanks for reading!

Why Don't You Go to the Dentist?
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Recently, a woman with many cavities came to the dental school.  Her two upper front teeth were so decayed that we almost couldn’t put crowns on them.  In fact, if she had waited any longer, we would have just extracted the teeth.  When I asked her why she hadn’t come to the dentist until now, she said that she thought it would cost too much money.

Dental OfficeThe treatment plan that she chose involved multiple crowns, bridge work, and many fillings.  In total, her bill was nearly $5,000.  Her insurance will be paying about 80% of that and she’ll only end up paying about $1,000.  Furthermore, the dental school offers a payment plan that will help ease the financial burden of her portion.  She told me that if she had known her insurance would cover so much, she never would have waited so long to come to the dentist.

The cost of dental care is only one reason people don’t see their dentist as often as they should.  If it’s been more than six months since you last visited your dentist, ask yourself one simple question: Why don’t you go to the dentist?

In a recent survey that was published in the Journal of Dental Hygiene (Volume 84, Number 3, Summer 2010 , pp. 137-144), respondents were asked why they didn’t go to the dentist.  The survey offered some reasons explaining why people might not go to the dentist and each respondent indicated whether they agreed or disagreed with each statement.

Why People Avoid the Dentist

I thought the survey uncovered the most popular reasons people have for not visiting their dentist.  Here are the six most popular reasons:

1 – It costs too much – 50% agreed

2 – I cannot miss work – 34% agreed

3 – I cannot find a dentist – 30% agreed

4 – I am afraid – 27% agreed

5 – It is too far to travel – 20% agreed

6 – I do not want to go to the dentist -18% agreed

The anecdote at the beginning of this article centered around the financial concerns that prevent people from receiving dental care.  Another common reason is fear.   There are many people who are simply scared to go to the dentist.  Some are afraid that it will be painful or uncomfortable, while others are afraid the dentist will have bad news for them regarding the condition of their teeth.  This category would also probably include the people who aren’t really afraid of the dentist, they are just afraid of what the dentist will think of their teeth. Many people that come to my dental school are embarrassed to show us their teeth because they aren’t in perfect condition.

Why Don’t You Go to the Dentist?

So, what about you?  If you haven’t been visiting the dentist regularly, what’s your reason?  I’m curious to learn what other reasons people have for avoiding the dentist…please let us all know in the comments below!

Dental Fear - Calm Your Dental Anxiety
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Many of the patients we see at the dental school have developed cavities and needed extensive dental work for just one reason: They were too scared to come to the dentist before now.

Dental Fear Central LogoSomething changed within them that made them finally say, “Enough is enough.  I need to get my teeth fixed.”  Sometimes it’s severe pain, and other times it’s a badly decayed, discolored front tooth that needs some dental care and compassion.  Whatever the reason, it’s a shame that it took them so long to get in to see a dentist.  There is a lot of help online.

How Dental Fear Central Can Help You Overcome Your Fear of the Dentist

Dental Fear - You Are Not AloneFirst of all, it reinforces the fact that you’re not alone in your fear of the dentist.  There are many others out there who also get anxious when they go to the dentist.  The forums are great!  They allow you to share your own personal story.  I just read the story of a young woman who went to get her wisdom teeth out.  After a few moments in the room, she got up and left.  She eventually went back and had her wisdom teeth successfully taken out.  She described the whole process.  You can read her story here.

Another way the site helps is by detailing 19 common dental fears and how to cope with them.

Dental Fear Central has an article for those who were sexually abused and have dental fear.  There is also an article for abuse survivors, that is written by a survivor of abuse.  In it, the abuse survivor shares tips on how to cope with certain fears that are instilled in those who were abused.  For example, it can be difficult for an abuse survivor to be lying down in a dental chair with an unfamiliar person poking around in their mouth.

Finally, there is a section of the site dedicated to walking you through the steps you need to take to get you into a dental chair.  It helps you discover your fears, cope with them, and eventually make that appointment with the dentist.  You can find this section, the help section by clicking this link.

Conclusion

I want to disclose that I am not affiliated in any way with Dental Fear Central.  I value this website and believe that it can help people make it to the dentist and avoid losing their teeth.  Because of that, I wanted to share it with you, in hope that if you are anxious about your dental visit, you can get the help you need.

Do you have any questions or comments on dental anxiety?  If so, please leave them below in the comments section.  Thanks for reading!