Over recent decades, the everyday clinical practice of dentistry has benefited from major advances in techniques, technologies and materials, as well as in infection control procedures.
At the same time, public awareness of oral health has improved. Despite these gains, anxiety related to the dental environment and to specific dental treatments is a problem suffered by many patients worldwide, and it remains a significant challenge in providing dental care. So what is it about dentistry that make us so anxious?
Anxiety is an emotional state that helps normal individuals to defend themselves against a variety of threats. Anxiety disorders are a dysregulation of these normal defensive mechanisms, with either excessive or deficient responses.
Dental anxiety has been ranked fifth among commonly feared situations. Given its high prevalence, it is not unexpected that patients with dental anxiety avoid dental visits.
A study conducted in Holland reported that only 14% of the Dutch population experienced no apprehension or anxiety when visiting a dentist, whilst almost 40% experienced 'more than average' anxiety, and 22% were 'highly anxious'. In this study, the patients most likely to experience high levels of dental anxiety were women aged 26-35 years who were irregular attendees1
Overall, the fear of pain has been linked strongly to the development of dental anxiety and to the avoidance of dental treatment. However, dental anxiety is a multidimensional complex phenomenon, and no one single variable can exclusively account for its development. Studies show a number of factors that have consistently been linked with a greater incidence of dental anxiety. These include:
- Personality characteristics (eg: neuroticism);
- Fear of pain;
- Past traumatic dental experiences, particularly in childhood (conditioning experiences);
- Influence of dentally anxious family members or peers which elicit fear in a person (vicarious learning); and
- Blood-injury fears1.
As mentioned, a key sign of dental phobia is avoidance. People who are dental-phobic use every excuse to delay visiting the dentist—even though they know their reaction is irrational. As a result, phobia sufferers have poorer dental health, higher risk of tooth loss and gum disease and experience more pain and discomfort - thus further contributing to their cycle of dental anxiety. Only when the pain becomes too much to bear will they give in to a dentist appointment—which often requires complicated treatment, again making their fear of future dentist visits even more intense.
How to reduce your anxiety or dental phobia
Communication is the key to reducing your anxiety and becoming comfortable with getting the care you need. Before the appointment, discuss your fears with your dentist. Your dentist can help you understand the treatment steps and may be able to modify the procedure so you feel more at ease. Other steps you can take include:
- Establish a non-verbal signal to alert your dentist or hygienist that you need to pause the procedure;
- Make appointments at non-busy times when you won't feel rushed or pressured;
- Practice techniques such relaxation breathing, meditation or self-hypnosis before your appointment;
- Develop techniques using "mindful-based cognitive behavioural therapy" with a psychologist or occupational therapist;
- Bring your headphones to distract yourself with music during the procedure.
At Bite Dental, we take the time in our appointments to ensure that every patient has a comfortable experience during their treatment. We understand that the dental surgery can bring on stressful emotions. That's why we will never rush you through; we have relaxing music throughout the practice and a television on the ceiling to distract you!
We work with a great team of experts in anxiety and health behaviour—so just ask us if you would like some help developing these skills.
Remember—it's often the 'anxiety about the anxiety' that is the problem—not the actual treatment!
1 Ref: Hmud R , Walsh LJ (2009). Journal of Minimal Intervention Dentistry', Vol 2, Issue 1.