Dental Anxiety: Drilling Down on the Fear of Visiting Your Dentist

If the sound of a not-so-distant drill while you wait in your dentist’s office makes your heart race, stomach flutter, and sweat break out on your brow, fear not, you are not alone!

In fact, a 2017 article in the Journal of Dental Hygiene showed that one study found that fear of the dentist (24.3 percent) was right up there with fear of snakes (34.8 percent). And more than half the population have some degree of dental anxiety.

“According to researchers, anywhere between 50 and 80 percent of adults in the United States have some degree of dental anxiety, ranging from mild to severe. More than 20 percent of dentally anxious patients do not see a dentist regularly, and anywhere from 9 to 15 percent of anxious patients avoid care altogether,” wrote the article authors.

Fortunately, for most patients, a trip to the dentist may not be a joyous occasion, but it is a completely manageable and necessary experience akin to a trip to the DMV or completing your tax return.

“For others, just the thought of going to the dentist causes severe anxiety, leading them to delay or avoid dental treatment. Unfortunately, this behavior can spiral into a vicious cycle of dental pain, health problems, worse anxiety, and more complex and costly dental procedures,” writes Tien Jiang, DMD, Med, in the Harvard Health blog.

Dental Anxiety is a Common Issue that Affects All Ages

Dental anxiety is a common issue that affects patients of all ages.

When dental anxiety is very severe it can be called a dental phobia or odontophobia.

“It’s very common for people to fear going to the dentist. When dental fear is severe and leads people to delay or cancel a treatment, these individuals may meet the criteria for dental phobia,” says Jiang.

A 2016 study published in Clinical, Cosmetic and Investigational Dentistry journal says that “fear and anxiety toward the dentist and dental treatment are both significant characteristics that contribute to avoidance of dental care” and defines dental anxiety vs. dental phobia as:

• Anxiety associated with the thought of visiting the dentist for preventive care and over dental procedures is referred to as dental anxiety. Anxiety is an emotional state that precedes the actual encounter with the threatening stimuli, which sometimes is not even identifiable. It is normally experienced in day-to-day life, such as during exams, while making crucial decisions, in the workplace, and in several other circumstances.
  
  
• Fear is a reaction to a known or perceived threat or danger. It leads to a fight-or-flight situation. Dental fear is a reaction to threatening stimuli in dental situations. Phobia is persistent, unrealistic, and intense fear of a specific stimulus, leading to complete avoidance of the perceived danger.

This dental anxiety can become a vicious circle for patients as it can lead to worst dental experiences.

“Both dental anxiety and fear evoke physical, cognitive, emotional, and behavioral responses in an individual. This is a frequently encountered problem in dental offices. Anxiety is often closely linked to painful stimulus and increased pain perception, and thus these patients experience more pain that lasts longer; moreover, they also exaggerate their memory of pain,” says the Clinical, Cosmetic and Investigational Dentistry article.

The Causes of Dental Anxiety

There is no single cause of dental anxiety but the condition can be brought on by a combination of factors.

While having a “bad experience” at the dentist as a young patient is high on the list of causes of dental anxiety, it is far from being the only factor.

Dental anxiety can be triggered by any of the following:

• Anxiety associated with other conditions such as agoraphobia (fear of being in situations where you feel you cannot escape), claustrophobia (fear of closed spaces), or obsessive-compulsive disorder where there is an obsession around cleanliness.
• Fear of loss of control.
• Fear of needles and/or drills
• Fear of pain
• Generalized anxiety, depression, or post-traumatic stress disorder (PTSD).
• Other traumatic experiences, including abuse.
• Previous trauma to the head and neck.
• Traumatic dental experience or other healthcare experience.
• Trust issues or distrust of dental personnel
• View that the mouth is a personal area and accessing the mouth is an invasion of personal space.

Signs that You Might Suffer from Dental Anxiety

Dental anxiety may manifest differently in different patients but many of the signs are classic hallmarks of the “fear or flight” feeling that is innate to humans.

Some signs that you might suffer from dental anxiety include:

• Desire to flee or leave the dental office before the treatment begins.
• Dizziness or feeling lightheaded.
• Frequently needing to urinate.
• Gripping dental chairs or other things tightly.
• Hands shaking.
• Low blood pressure and possible fainting (syncope).
• Nausea, upset stomach, or the feeling that you might vomit.
• Racing heartbeat (tachycardia) or palpitations.
• Sweating including sweaty palms, forehead, upper lip.
• Visible distress, crying or signs of panic.
• Withdrawal, or using humor or aggression to mask anxiety.

Meditation to Laughing Gas: Methods to Lessen Dental Anxiety

Some dentists offer their patients the option of using nitrous oxide to help them relax and fight dental anxiety.

Often called laughing gas or happy gas, nitrous oxide is provided by a mask fitted to the face and can relax a patient in a few minutes. Once the gas is stopped being administered, it wears off quickly.

Patients under nitrous oxide will still be awake and able to communicate with the dentist but many do not remember everything that occurs during the visit.

Other methods that are used in certain situations include oral anxiolytic tables such as temazepam, IV sedation by a dentist with advanced training in sedation, or general anesthesia carried out in a hospital setting by an anesthetist.

The first and foremost method to lessen your dental anxiety is to have a frank discussion with your dental provider prior to treatment about your fears and to have them thoroughly explain to you what will occur during your visit and treatment.

Other tips to lessen dental anxiety include:

• Acupuncture
• Agreeing with your dentist on a signal to stop during treatment for a break (such as raising your left pointer finger or hand).
• Asking to be given topical numbing medication.
• Deep breathing.
• Distraction (such as listening to music, watching television, or the use of other devices).
• Guided imagery.
• Hypnosis.
• Meditation.
• Positive reinforcement.
• Progressive muscle relaxation.
• Requiring the dentist to ask permission before moving on to next steps during treatment.
• Using a weighted blanket (bring your own).

At Northwest Oral Surgery, our surgeons are highly trained and skilled at administering and customizing each type of anesthesia plan to fit every patient's needs.  We strive to provide the highest standard of care and safety for our anxious patients, contact us today for a consultation.