Dental Anxiety: Characteristics and Treatment - Step To Health

Dental Anxiety: Characteristics and Treatment

Suffering from dental anxiety poses a risk to people's oral health. We'll tell you more about this disorder and ways to deal with it.
Dental Anxiety: Characteristics and Treatment

Last update: 22 November, 2021

Many people are nervous and feel afraid when they go to the dentist. And, in some cases, this dental anxiety can mean they don’t visit the dentist, thus putting their oral health at risk.

Anxiety is an emotional state that helps us to defend ourselves in threatening situations. However, sometimes, this response becomes exaggerated or deficient, resulting in a psychological disorder, as is the case with dental anxiety.

It’s true that a dental clinic has instruments, sounds, and smells that can cause discomfort. But the longer treatment or cleaning is postponed, the greater the risk of developing serious oral problems that will require more complicated treatments.

If you’re someone who cancels their dental appointments for any excuse, read on.

What is dental anxiety?

Dental anxiety is an emotional state that brings with it some unpleasant sensations, and can even produce psychophysiological changes in a person who is thinking about dental treatment. The fear of dental procedures creates a defensive response with physical and mental manifestations.

The anticipation of the feared dental treatment is capable of producing genuine fear and anguish in the person. Just thinking about the possibility of going to the dentist creates a sense of danger or threat that can trigger a multisystemic defensive response.

This situation of exaggerated fear when thinking about receiving dental care becomes an impediment for the patient to go to the dentist. Treatments are postponed, appointments are canceled, pain is endured excessively and oral health is detrimentally affected. This problem is very common and affects both children and adults.

Causes of dental anxiety

Several reasons can lead a person to suffer dental anxiety. Here are some situations that can cause this disorder:

  • Personality traits.
  • Traumatic past dental experiences, especially during childhood.
  • Influence of family members or peers who suffer from dental anxiety: People close to you who make negative comments about dental care can transmit and awaken fears in the patient.
  • Fear of blood, injury, pain, or needles: Some people are afraid of needles, the sight of blood, or believe that anesthesia won’t have any effect on them.
  • Fear of anesthesia: Some patients worry about what it will feel like to be anesthetized or will be afraid of dizziness or nausea.
  • Lack of personal space: Many patients are uncomfortable with how close the dentist is to you when carrying out treatment.
  • Lack of control: Not being able to observe or control what’s happening in their mouth is what causes dental anxiety for many.

Tooth extractions, root canals, tooth straightening, and tooth grinding involve anesthesia, the use of a turbine, tweezers, or files. This makes them the most anxiety-provoking treatments. The choking sensation generated by taking impressions or the forceful movements exerted by the dentist during root scaling can also trigger fear.

Dental anxiety is very common.
Some procedures require more time and greater use of instruments, so they’re often associated with dental anxiety.

Symptoms of dental anxiety

Dental anxiety is a multidimensional phenomenon, as cognitive, physiological and motor components interact in the defensive response. The combination of these aspects causes the patient to experience different types of uncomfortable sensations.

At a cognitive level, there’s an unpleasant sensation that interferes with concentration and prevents the patient from remembering certain events. In addition, there’s attentional hypervigilance that causes the person to be in a constant state of alertness. It’s very common for a person not to be able to sleep the nights before a dental appointment.

The physiological aspects are those that activate the autonomic nervous system. This may cause the patient to have palpitations, sweating, dizziness, or shortness of breath.

The motor component refers to the maladaptive behavior carried out by the person. These can range from avoidance of the dental act to actually leaving the dentist while waiting for their appointment.

A serious problem

Dental anxiety is a serious problem that causes the person to avoid dental visits. Any excuse is a good one for not visiting the dentist and canceling appointments over and over again is common.

This has negative consequences on oral health. It’s very common for patients with this problem to have cavities, gingivitis, or periodontal disease and not to seek any solution.

Complications, such as pain or infections, usually force the person, eventually, to visit the dentist and face up to their problem. When going to the dentist’s clinic, people often express their discomfort of being put in that situation. They’re uncooperative, find it hard to keep still, and, in some cases, may even run away from the office or get angry with the dentist.

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Types of dental anxiety

The manifestations of dental anxiety are varied and different in each patient. However, depending on the intensity of the symptoms, we can differentiate the following three types:

  • Adaptive: This is the mildest form. The patient is able to remain calm despite their anxiety. There are often difficulties at the beginning of the treatment, but the fear can be overcome.
  • Medium: In these cases, the symptomatology is more noticeable, as the patient’s psychophysical deterioration is evident. The person shows a distrustful attitude and there is psychomotor agitation that requires the dentist to adapt the type of consultation in order to carry out the necessary procedures.
  • Disabling or blocking: This is the most severe type of dental anxiety. The fear is so intense that it causes symptoms that make it impossible to perform the examination, diagnosis, or dental treatment and the dentist will need to suspend the treatment.

How to treat dental anxiety

Continuing to put off dental care isn’t a solution to the problem of dental anxiety. Being able to face the situation and look for ways and alternatives to access the necessary therapies is essential in order to have good oral health.

Here are some tips that can help you overcome the fear of the dentist and receive the dental care you need.

1. Say what you feel

To overcome all the fears and questions that arise regarding dental treatment it’s essential to be able to share what you feel and think. Good communication with the dentist is essential in order to create a bond of trust that help the whole process.

By talking to the dentist, you can unburden yourself regarding bad experiences from the past and the worries and fears that dental care causes you. Knowing the patient’s needs and questions, the dentist will be able to treat them better, clear up any of their concerns and adapt the process accordingly.

It’s important to inform your dentist about your dental anxiety from the moment you book the appointment. In this way, the receptionist can begin to help the person by scheduling longer appointments and looking for the first available appointment so that there are no long waits that could increase the anxiety.

When you can’t speak because your mouth is open, it’s a good idea to agree on a signal with the dentist to indicate that you need a break. Raising your hand, for example. This provides peace of mind, because the patient knows that they can still communicate with the dentist and has some control over the procedure.

It’s essential to let the dentist know if you feel pain despite having received anesthesia, because it can be easily solved by adding a little more. Enduring the pain will only increase the fear and negative image of the dental practice.

2. Distract yourself

Finding ways to distract your mind and keep your thoughts from focusing solely on dental care is a great way to cope. Occupying your hands by squeezing an anti-stress ball or playing with a small object like a fidget spinner, for example, is a good way to amuse yourself while the dentist does their work.

Putting on headphones and listening to your favorite music, an audiobook or podcast also helps take your mind off what the dentist is doing. It’s also a good way to tune out the noise of the drill.

Some practices play background music to help patients relax. Other clinics even have movie screens or virtual reality glasses to help patients cope better during the appointment.

Songs are an excellent alternative to calm children down during the appointment. Preliminary games in the waiting room are another resource that helps children to reduce their dental anxiety.

3. Use relaxation techniques

Practicing a mental relaxation technique predisposes you to feel calmer and more cooperative when facing dental treatment. Visualizing yourself in a happy place or focusing on your breathing can help you calm down.

Relaxation even begins in the waiting room. Deep breathing exercises, inhaling and exhaling slowly for a few seconds, are recommended.

Becoming aware of every part of the body and trying to relax every muscle in your body one by one is a very calming exercise. You can start with your head, concentrate on relaxing the forehead, cheeks, neck, and so on, until you reach the toes.

A woman meditating.
Deep breathing is a technique that can be applied in the waiting room to promote relaxation before the consultation.

4. Ask the dentist for a detailed explanation of the treatment

If the dentist explains step by step what’s going to be done in the mouth, it prevents surprises or scares. Knowing what to expect makes it easier to relax during the treatment.

In some cases, especially for children, the dentist may show the instruments to be used and demonstrate the procedure. Knowing what’s being done inside their mouth gives the patient a sense of control and well-being.

5. Minimize triggers

This is a measure taken by the dentist when treating the patient, in order to reduce the patient’s exposure to situations that trigger dental anxiety. Covering the instruments or placing them in an area of the clinic where the patient can’t see them can prevent the fear that needles or tweezers generate.

Spraying the waiting room with pleasant fragrances may prevent patients from smelling the smell of the dentist. This blocks the olfactory stimulus that many patients associate with dental care and which creates anxiety.

Providing efficient anesthesia that reduces the chances of the patient sensing any discomfort is also pertinent in these cases. The use of special techniques and ancillary methods, such as topical creams before the injection, provide comfort in these situations.

6. Use of medication

The practitioner may find it appropriate to use medication to help the patient relax when other maneuvers have not been successful. Oral or inhalation conscious sedation may be helpful for some people.

Medication can induce a state of drowsiness, mild amnesia and the tranquillity the patient needs to let the practitioner work in their mouth. Depending on the severity and needs of the case, one of several available pharmacological options will be chosen.

In the most severe dental anxieties, deep sedation or even general anesthesia can be used. However, this alternative is usually left as one of the last options.

7. Make a psychological consultation

Sometimes, the dentist isn’t able to help the patient overcome their dental anxiety problem on their own. In these cases, it would be necessary to refer the patient to a psychologist who can offer the person other tools to overcome their problem.

The importance of asking for help

Sometimes the feeling of fear of the dentist can be naturalized and you may not be aware of the real problem that this fear causes, as well as its origin. Being able to accept that you suffer from dental anxiety is fundamental in order to deal with a disorder that has very negative consequences on oral health.

Going to the dentist with confidence and asking about the fears that dental treatments create in you is the first step to begin to overcome this condition. The dentist has the necessary resources to help you overcome your fears and gradually access dental treatments with more peace of mind.

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