Dental Anxiety

What Is Dental Anxiety?

Dental anxiety is the term used to describe anxiety, fear or stress associated with a dental setting. Being nervous or even scared to visit the dentist can result in delaying or avoiding dental treatment. It can be associated with certain triggers such as needles, drills or the dental setting in general.

Is Dental Anxiety Normal?

Dental anxiety is very common (some studies suggest up to 24% of the world’s population deal with dental anxiety) and there are ways of managing it. When dental anxiety is severe and results in irrational fear and complete avoidance of going to the dentist, it can be classified as a dental phobia. A dental phobia is less common and sometimes this could require your dentist to work with your doctor and other health professionals in order to manage it.

If you are unsure whether or not you suffer from dental anxiety, here are some common signs and symptoms to look out for:

• Sweating
• Racing heartbeat
• Low blood pressure which can result in possible fainting spells
• Visible distress or panic
• Withdrawal – using humour or aggression to mask your anxiety

Research carried out in 2019 by the DeCare Health Promotion Manager looked at people’s lived experiences and personal expert witness accounts across the life course in relation to oral health. A key finding was that most participants spoke about pain and anxiety experiences in relation to the dentist. All of the participants had attended a dentist and most related this anxiety and fear to a past experience of their mothers.

Some recalled this experience with social supports such as  ‘’The scent and smell “ ,  “If I was in pain you got to go” ,  “ I would leave it on the long finger for years’’.

There was also a theme of negative experiences reported by participants ‘’It had bad experiences for me. Not nice.’’ Others reported ‘fear’, ‘’yes I fear the dentist. Even though I know they are gentle, experience from years ago stays with me; the smell, the chair’’. Another said ‘’dental one word (that) terrified’, others also spoke of fear ‘’It’s an ordeal’’. ‘’A big ordeal for me!  It affects all hospital things with me having anything to do with medical things’’.

There was also a positive preventive approach found in these results. ‘’But you get over these things prevention is key’’ and ‘’there is a big difference now going to a dentist’’. ‘’Going 35/40 years ago there was a fear, in modern days it has improved enormously’’. Another participant said ‘’dentists are caring and if they don’t need to pull a tooth they will not, the care is excellent’’.

How Can Dental Anxiety and/or Phobia Affect Your Oral Health?

If you are deciding to avoid the dentist due to your anxiety, it can result in the worsening of your dental disease, which in turn can cause a greater need for emergency care or more complex treatment. Regular visits to your dentist (twice a year) for check-ups can prevent the worsening of your Oral Health which will stop the need for invasive treatments that can heighten your anxiety.

Most dental disease is lifestyle-related and preventable. By avoiding going to the dentist, not only are you more likely to need more complex treatments when you do finally attend, but you are also missing out on learning how to better care for your oral health.

The lifestyle factors that lead to dental disease are very similar to those that lead to diabetes, obesity, heart disease, stroke and some cancers, so taking care of your oral and general health is very important.

Causes of Dental Anxiety Can Include:

• A traumatic dental experience
• Previous trauma to the head and neck
• Other traumatic experiences (ie: abuse)
• Generalised anxiety, depression or post-traumatic stress disorder
• The view that the mouth is a personal area and accessing the mouth is an invasion of personal space
• Fear of loss of control
• Trust issues

Can Anyone Suffer From Dental Anxiety?

As we stated previously, Dental Anxiety is very common. It can occur at any age. Children who have had bad dental experiences in most cases can overcome their fear if the situation is managed well and they are well cared for and supported during further dental visits.

Adults who are anxious about dental care tend to remain anxious throughout life.

Many anxious dental patients can find a dentist who is sympathetic to their situation, so they are able to cope with going to the dentist.

Ways To Manage Dental Anxiety/Phobia:

• Deep breathing
• Meditation
• Distraction (such as listening to music or the use of screens)
• Guided imagery
• Progressive muscle relaxation
• Hypnosis

In severe cases, you may require management with relative analgesia (happy gas), anxiety relieving medication, conscious sedation (twilight sedation) or general anaesthesia.

Other Mental Health Issues Related to Dental Anxiety/Phobia

Dental Anxiety/Phobia can occur in tandem with other mental health issues. Some of the most common combinations include:

• Panic and Agoraphobia – you are scared of what ‘MAY’ happen if you panic while at the dentist. You also may not feel comfortable leaving your ‘safe space’ to even attend the dentist.
• Depression – Lack of motivation is common with depression. It often leads to a lack of self-care (which includes oral care). Adding in the feelings of guilt and shame will cause you to avoid visiting the dentist. The fear of getting ‘lectured’ by your dentist or needing a lot of treatment can be very overwhelming for some people.
• Emetophobia – If you have a fear of throwing up, dental treatment can be very daunting. Thoughts that you may ‘gag’ or choke on something can heighten your anxiety.

Oral health has strong links to quality of life. For example a painful, unsightly mouth or ill-fitting denture can exacerbate social withdrawal, isolation, and low self-esteem as well as cause problems with both speaking and eating. Fear and anxiety must be addressed early in the life course and building healthy habits such as regular dental attendance and having a benefit such as dental insurance can help with the financial burden.

Fear and anxiety is a common feeling but its management is improving greatly with major advances in psychological medicine and pain management therapies. The mouth is the gateway to our bodies and is linked to overall quality of life, affecting eating, speaking, self-esteem and appearance.

It is important to remember that you can overcome dental anxiety/phobia or at least take some steps to begin to overcome it. It may seem incredibly hard at the moment but remember if others can overcome it, you can too.