Dental anxiety is not well-defined but can be taken to mean fear of all aspects of dentistry, from routine scaling to injections and dental surgery.
How will you know that you have dental anxiety?
Mild dental anxiety can manifest as sweaty palms, racing pulse, a dry mouth, or a churning stomach when in the dental setting.
You may also have difficulty sleeping the night before the dental appointment.
Some patients may also faint when under extreme stress and the strain of “trying to keep it in” during dental treatment.
Severe dental anxiety (dental phobia) is linked with intense feelings of anxiety which are too overwhelming to cope with . Dental phobia affects about 10% of the population and may result in complete avoidance of dental care.
Dental phobics may see their physician instead of a dentist, in the hope of managing acute dental pain with painkillers and antibiotics.
You may delay seeking dental treatment except when in severe or chronic pain. You may only seek treatment when persuaded by a friend or relative.
You may miss dental appointments or have not attended a dentist in years.
How can Dental Anxiety affect you?
Dental anxiety can produce unpleasant physical symptoms as a result of the stress (fight-or-flight) response. This can trigger a medical event (heart attack, stroke, epileptic fit or asthma attack) if you have a medical condition (high blood pressure, epilepsy or asthma) that is worsened by stress.
The anticipation building up to the dental appointment can be extremely potent, especially if you are left waiting for your appointment to begin.
In the dental chair, you may feel completely helpless or vulnerable.
The sights, sounds and smells of the dental environment may trigger unpleasant memories of previous dental experiences. Some patients may gag during the dental examination or during treatment and you may feel extremely embarrassed.
Dental anxiety may affect how you think about dentistry. You may tend to catastrophize (imagining the worst possible outcome of a procedure will happen). You may also believe that the dental team perceives you as being silly, stupid or weak as a result of your anxiety. You may worry about being stigmatised and this embarrassment can be a powerful motivator for avoiding dentistry.
Outside of the dental practice, dental anxiety affects many other aspects of life.
Some patients may avoid smiling because they are self-conscious or embarrassed about their smile.
You may avoid hard foods (if there is a painful tooth to chew on or if you have a reduced ability to chew as a result of missing teeth) and cold foods (because of sensitivity).
You may become hyper-aware of your oral hygiene routine and change toothbrushes regularly, use mouthwash or develop a very elaborate routine in an effort to avoid dentistry.
Self-medicating acute dental pain in order to avoid a dental procedure is common.
You may experience mood changes (becoming more irritable) when you have a dental appointment coming up.
Untreated dental disease that causes severe pain may cause you to miss work or personal commitments.
Why does Dental Anxiety develop?
Dental anxiety is usually triggered by past negative dental experiences (usually in childhood).
Occasionally, incidents portrayed by family, friends or the media can trigger dental anxiety in a person with no previous history of traumatic dental experience. This is known as vicarious learning.
Other possible triggers include a near-drowning experience or a history of sexual abuse.
Who is affected by Dental Anxiety?
Studies have shown that 10-20% of the population suffer from severe dental anxiety.
Women are more than twice as likely to be more affected by dental anxiety compared to men.
How can Dental Anxiety be managed?
With time, psychological techniques and sedation, most of our anxious patients can successfully manage to receive dentistry in a positive way.
We use neck pillows, dark glasses, noise-cancelling headphones, blankets and aromatherapy to dampen negative physical stimuli.
Painless and effective local anaesthesia is the foundation for successful pain control.
We have found that open and upfront discussion about the procedure(s) that are being planned, as well as potential risks and complications can help patients feel better-informed and prepared.
Sedation Dentistry
For very anxious patients or patients who require procedures that are more extensive or have a long duration (for example, wisdom tooth surgery or root canal treatment), we can arrange for sedation.
We offer 4 different methods of sedation:
- Nitrous Oxide sedation is very safe and can be used even in children. It produces no hangover and most patients can return to their normal activities immediately.
- Oral anxiolytics using sedative tablets (such as lorazepam). These may also be prescribed for patients who have insomnia the night before their dental appointment.
- Intravenous sedation performed by a qualified specialist anaesthesiologist who will induce sedation, monitor and maintain your sedated state and wake you up when the procedure is completed.
IV sedation causes short term memory loss, so patients will not remember anything about the procedure.
A chaperone is required after IV sedation as the drug effects last for about 12 hours. - General Anaesthesia in an operating theatre for patients who require extensive surgical procedures and for very anxious young children.
FAQ
How do I get over my dental phobia?
If you have dental anxiety that is severe enough to be classified as a phobia, it is very difficult to overcome this without professional help.
Working with a psychotherapist together with the help of your dentist to identify the underlying triggers is the best way to manage dental phobia.
Some patients may be able to overcome their phobia enough to receive routine dental treatment, while others may require medication to allow them to cope with their anxiety surrounding dentistry. Dental phobia may coexist with other anxiety or mood disorders that require professional management.
Dentally-anxious or phobic patients often require longer treatment sessions for treatment to be completed. Complex dentistry may require sedatives be used in conjunction to allow high quality dentistry to be performed even in very anxious patients.
How common is dental phobia?
Dental phobia affects about 10% of the population. Dental anxiety affects about 20% of the population. Women tend to report more dental anxiety than men.
Why am I so afraid of the dentist?
There are many reasons that may trigger the development of dental fear.
Dental anxiety is usually triggered by past negative dental experiences (usually in childhood).
Occasionally, incidents portrayed by family, friends or the media can trigger dental anxiety in a person with no previous history of traumatic dental experience. This is known as vicarious learning.
Other possible triggers include a near-drowning experience or a history of sexual abuse.
Can the dentist give you something for anxiety?
Sedatives are useful for helping you manage anxiety while having dental treatment.
We offer 4 different methods of sedation:
- Nitrous Oxide (laughing gas) sedation is very safe and can be used even in children. It produces no hangover and most patients can return to their normal activities immediately.
- Oral anxiolytics using sedative tablets (such as lorazepam). These may also be prescribed for patients who have insomnia the night before their dental appointment.
- Intravenous sedation performed by a qualified specialist anaesthesiologist who will induce sedation, monitor and maintain your sedated state and wake you up when the procedure is completed.
IV sedation causes short term memory loss, so patients will not remember anything about the procedure.
A chaperone is required after IV sedation as the drug effects last for about 12 hours. - General Anaesthesia in an operating theatre for patients who require extensive surgical procedures and for very anxious young children.
Is dental anesthesia painful?
Local anaesthesia in the mouth can be almost painless.
Before the anaesthetic is injected, numbing cream is applied on to the target areas to numb the surface of the mucosa. This numbing cream must be left on dry mucosa for 5 minutes to take effect. This almost completely eliminates the sensation of the needle prick.
However the numbing cream only affects the surface layer of the mucosa up to 1-2mm deep, so a slow and steady injection technique is crucial. Injecting slowly gives the tissues time to stretch as the anaesthetic liquid is introduced and also gives time for the acidic anaesthetic solution to neutralize before it can start working.
Generally, injections in the outer part of the upper back teeth (facing the cheek) are the most comfortable.
Can bad teeth cause anxiety?
If you are having pain from badly decayed teeth which are dark, discoloured and chipped, then your overall sense of well-being can be affected.
This may affect your confidence if you are embarrassed to smile for fear of showing your teeth. If you are worried that the infected teeth may be causing bad breath (halitosis), you may be embarrassed that your bad breath may be perceived by the person you are talking to. You may avoid smiling especially when having photos taken because you are self-conscious about your teeth.
You may think your teeth are hopeless and that the dentist may not be able to help you with your teeth at all. Perhaps you have considered having all your teeth removed and replaced with dentures.
Bad teeth can affect your life psychologically, socially and professionally. The entire modern practice of dentistry is designed to improve your smile so that you can get on with living your best life and reach your full potential.
