Dental fear – no reason to worry!

Do you belong to the group of patients who dislike to go to the dentist? Are you even afraid of it? Perhaps because you made bad experience and your fear was ignored? And the treatment was painful and you left the dentist with the decision never to come back again? Although you know that a treatment of your teeth is absolutely necessary and the quality of your life strongly suffers under the conditions of your teeth, you avoid the visit to the dentist because of fear. Then you seem to belong to the group of dental phobic patients and need an extra sensitive therapy.

Numbers & Facts

„Dental fear – a natural appearance that concerns a lot of people.“

Most patients realize a treatment at the dentist as an unpleasant and threatening situation.

• 60-80% of the population mention a feeling of fear before the treatment
• up to 20% are even rated as extremely afraid
• 5% avoid the dentist at all

These people suffer after ICD 10, 40.2 from dental phobia.

Causes

Anxiety of a treatment at the dentists is mostly generated because of the following reasons:

• traumatic experiences during a treatment. (vgl. Lindsay und Jackson, 1993)
• uncertainty if the treatment will be painful. Most patients expect any form of pain during a treatment. This leads to a form of expectancy fear. (vgl. Wardle, 1982)
• anecdotes in the social environment can led to dental anxiety
• Some more facts are involved in the development of a dental phobia:
  • imminent loss of self-control and therewith the feeling to be committed.
  • unknown and unexpected operations during the treatment.
  • the individual and biological disposition of the concerned person to deal with anxiety.
• Skills and knowledge of the dentist and all the assistants.

States of anxiety

One has to distinguish between two different states of anxiety for dental phobic patients:

Dental fear (2/3 of the population is affected) These patients suffer from more or less but not abnormal strong feelings of anxiety. Dental phobia (5-205 of the population is affected)

Dental phobia is a special phobia and belongs to a group of simple phobias (Jöhren, 1999). Besides the great extend of their fear dental phobic patients distinguish themselves from dental anxiety patients through the fact that they completely avoid the visit to the dentist.

*All information is based on research of the German Association for Dental, Oral and Orthodontic Health (DGZMK), as well as all other stated sources.

To find out if you are a dental fear patient or a dental phobia patient fill out the HAF in our questionnaire:

Phobia test

Observations

The specialisation of Dr. Unterhuber on the treatment of dental fear and dental phobia patients brought the following findings:

1. Most of the time negative experiences in the past excite a dental phobia.
2. In many cases dental phobic patient are not treated gently by their dentists or are evenhumiliated. Often the disease is not recognized and symptoms of anxiety are played down. This decreases the trust of dental anxiety patients to dentists and enforces a feeling of fear.

   When regarding our experiences, a problem called malocclusion cannot be a reason for dental anxiety, as these variances are evident in almost every natural denture and dappear with our fearless patients as well as with our fear patients.

3. general anaesthesia: for patients with distinctive dental phobia a treatment in general anaesthesia is reasonable, because these patients can make use of the advantage not to notice anything of the treatment. In general, a treatment in general anaesthesia led to the result that patients lost their dental phobia. Today, general anaesthesia has just the same risk as an injection at the dentists.

   In Germany it is possible to have a general anaesthesia as an outpatient, which is for. example not the case in the United Kingdom.

4. alternative methods: like hypnosis frequently fail because of missing cooperation of dental phobia patients due to their anxiety.
5. analgesia and sedation: are not suitable for protracted and demanding dental treatments. The swallowing reflexes are reduced and increase the risk of swallowing items.