Addressing Dental Anxiety

If just hearing the word “dentist” is a trigger warning for you, then take a deep breath, and read this article! Dental anxiety is very real but there are ways for you to ease your fears and embrace your oral health in a more relaxed manner.

“Dental anxiety, or dental fear, is estimated to affect approximately 36 percent of the population, with a further 12 percent suffering from extreme dental fear,” wrote the authors of “Why are People Afraid of the Dentist?” published in Medical Principles and Practice. “This anxiety can have serious repercussions in terms of an individual's oral health, and it is considered to be a significant barrier to dental attendance resulting in poor attendance.”

Dental avoidance, due to dental anxiety or dental fear, leads to poor oral health.

“For many people, going to the dentist is an unpleasant but manageable experience. For others, just the thought of going to the dentist causes severe anxiety, leading them to delay or avoid dental treatment,” wrote Harvard Health Publishing editorial advisory board member Tien Jiang. “Unfortunately, this behavior can spiral into a vicious cycle of dental pain, health problems, worse anxiety, and more complex and costly dental procedures.”

In this article we’ll explore what dental anxiety is, how prevalent it is, its root causes, consequences, and effective ways to address it.

What is Dental Anxiety or Dental Fear?

Dental anxiety, also known as dental fear or dental phobia, is a feeling of extreme nervousness, apprehension, or fear associated with dental visits or dental procedures.

This anxiety can range from mild uneasiness to severe panic attacks, and in some cases, can be classified as a specific phobia.

“Dental anxiety is characterized by a physical and/or emotional response to a perceived threat,” says the Journal of Dental Hygiene. “This threat does not always have to be physically present, as the mere idea of an uncomfortable situation can provoke feelings of uneasiness and apprehension.”

People with dental anxiety may experience physical symptoms such as:

• Sweating.
• Racing heartbeat or palpitations.
• Low blood pressure and possible fainting.
• Visible distress, crying, or signs of panic.
• Withdrawal or using humor or aggression to mask anxiety.

It's important to note that dental anxiety is different from a general dislike of dental visits.

While many people may not enjoy going to the dentist, those with dental anxiety experience a level of fear that can significantly impact their ability to receive necessary dental care.

How Common is Dental Anxiety?

Dental anxiety is surprisingly prevalent. According to research, anywhere between 50 percent and 80 percent of adults in the United States have some degree of dental anxiety, ranging from mild to severe. More specifically:

• More than 20 percent of dentally anxious patients do not see a dentist regularly.
• Anywhere from 9 to 15 percent of anxious patients avoid care altogether.

The good news is that evidence from the Adult Dental Health Surveys shows that the prevalence of dental anxiety has decreased considerably – possibly due to improvements in pain reduction – but the incidence of extreme dental fear or dental phobia has remained constant.

Root Causes of Dental Anxiety

Dental anxiety can stem from various sources, and understanding these root causes is crucial for addressing the issue effectively.

“The research evidence suggests that the causes of dental fear, dental anxiety or dental phobia are related to exogenous factors such as direct learning from traumatic experiences, vicarious learning through significant others and the media, and endogenous factors such as inheritance and personality traits,” says the Medical Principles and Practices article.

Some common causes of dental anxiety include:

• Previous traumatic dental experiences: This is often cited as the most significant factor in developing dental anxiety, especially if the experience occurred during childhood.
• Fear of pain: Many people associate dental procedures with pain, which can lead to anxiety.
• Fear of injections or needles: The thought of receiving local anesthetic injections can be a significant source of anxiety for many patients.
• Loss of control: The feeling of helplessness while in the dental chair can contribute to anxiety.
• Embarrassment: Some people feel self-conscious about the appearance of their teeth or their oral hygiene habits.
• Generalized anxiety or depression: People with these conditions may be more prone to experiencing dental anxiety.
• Negative portrayals in media: Depictions of painful or frightening dental experiences in movies or TV shows can contribute to anxiety.
• Vicarious learning: Hearing about others' negative dental experiences can instill fear

Consequences of Dental Anxiety

Dental anxiety can have serious repercussions on an individual's oral and overall health. The most significant consequence is dental avoidance, where people delay or completely avoid dental visits due to their anxiety.

“High dental anxiety has also been shown to influence the quality of life, with low oral health-related quality of life associated with high dental anxiety,” said the Medical Principles and Practices article. “Indeed, 73 percent of participants in a study by McGrath and Bedi reported believing that their oral health affected their life quality.”

Dental avoidance can lead to:

• Poor oral health: Neglecting regular check-ups and cleanings can result in the development or progression of dental issues such as cavities, gum disease, and tooth loss.
• More complex and costly treatments: When dental problems are left untreated, they often worsen, requiring more invasive and expensive procedures in the future4.
• Negative impact on quality of life: Poor oral health can affect self-esteem, social interactions, and overall well-being.
• Increased risk of general health problems: Poor oral health has been linked to various systemic health issues, including cardiovascular disease and diabetes.
• Perpetuation of the anxiety cycle: As dental problems worsen due to avoidance, the anxiety about potential treatments may intensify, creating a vicious cycle.

Addressing Dental Anxiety: 10 Things You Can Do!

Fortunately, there are several effective strategies for managing dental anxiety. Here are some best practices:

1. Open communication with your dentist: Share your fears and concerns with your dental care provider. Many dentists are trained to work with anxious patients and can adapt their approach accordingly.
2. Relaxation techniques: Practice deep breathing exercises, meditation, or progressive muscle relaxation before and during dental visits.
3. Distraction methods: Listening to music, podcasts, or audiobooks during the appointment can help take your mind off the procedure.
4. Gradual exposure: Start with simple, non-invasive dental visits and gradually work up to more complex procedures as you become more comfortable.
5. Cognitive-behavioral therapy (CBT): This type of therapy can help you identify and change negative thought patterns associated with dental visits.
6. Sedation dentistry: For severe cases of anxiety, your dentist may recommend various forms of sedation, ranging from nitrous oxide ("laughing gas") to oral sedatives or even general anesthesia for more complex procedures.
7. Regular dental visits: Maintaining a consistent schedule of dental check-ups can help normalize the experience and prevent more serious dental issues.
8. Bring a support person: Having a trusted friend or family member accompany you to appointments can provide comfort and reassurance.
9. Choose appointment times wisely: Schedule your dental visits during less stressful times of the day or week.
10. Utilize technology: Some dental offices offer virtual reality headsets or other technological distractions to help patients relax during procedures.

“Talk with your dentist and explain exactly what makes you nervous about the visit. Your dentist will do a careful review of your medical history in order to make safe recommendations while considering your overall health,” concluded Jiang. “And lastly, visit your dentist regularly even if you are not in dental pain. This is the best way to prevent painful experiences and more complex and costly procedures.”

Addressing dental anxiety is crucial for maintaining good oral health and overall well-being. By understanding the root causes of your anxiety and working with a compassionate dental team, you can develop strategies to manage your fears and receive the dental care you need.

Remember, you're not alone in experiencing dental anxiety, and there are many resources and techniques available to help you overcome this common issue. With patience, persistence, and the right support, you can transform your dental visits from a source of fear to a positive step towards a healthier, happier you. Northwest Oral will work closely with you to ease your concerns, reduce triggers, and turn an uncomfortable situation into a more comfortable experience.