Dental Phobias

The British Dental Health Foundation reports that one in every seven adults suffers from extreme dental anxiety and that statistically, women are more likely to suffer from extreme dental anxiety than men. Visiting the Dentist is ranked number one (22%) for making people nervous, and nearly 10 times as many people are more nervous of visiting their dentist than their doctor.

Although most people can live with experiencing some feelings of anxiety about visiting the dentist, for those who have a dental phobia, the thought of attending a dental appointment is terrifying, and can result in acute anxiety or panic attacks.

Karen Coates, a dental adviser at the British Dental Health Foundation, says the organisation’s dental helpline receives many calls about fear and phobia, and that, “Some people have such bad dental phobia that they haven’t seen a dentist for years. It’s common for us to hear from someone in their twenties or thirties or even older who hasn’t been to the dentist since childhood.”

Dental phobias can stem from bad childhood experiences, associated the smells and sounds of the dental surgery. However dental surgeries are not what they used to be, and there is an increasing awareness of dental phobias and much more support and help available to assist in coping with a dental phobia.

Advances in technology have also helped to improve the dental experience. Treatment can now be completely painless. For example a computerised injection system that delivers the anaesthetic very slowly so it is painless called a dental ward can help people with a needle phobia. Many dental surgeries now also offer various form of sedation to very nervous dental patients.

Types of Sedation

Sedation can relieve anxiety and help the patient to relax. There are three main types of sedation used in dentistry.

Oral sedation

Your dentist may prescribe you a medicine, such as diazepam, to help reduce your anxiety. You take this as a tablet, usually about an hour or two before your appointment. Alternatively, you may take it the night before your appointment. You must take these medicines exactly as directed by your dentist.

Inhalation sedation

Also known as ‘gas and air’, this is a mixture of the gas nitrous oxide and oxygen. You breathe it in through a mask placed over your nose that has a tube attached to a machine. You will be able to understand what your dentist is saying throughout the treatment, but the sedation should reduce your anxiety.

When your treatment is finished, the sedation will wear off after a few deep breaths and the gases will leave your body after a few minutes. However, you’re likely to need to stay in the clinic for up to 30 minutes for the effects of the sedation to wear off fully. Your dentist may ask you to bring a friend or family member to accompany you home.

Intravenous sedation

If you have intravenous sedation, a medicine will be injected through a fine plastic tube (cannula) into a vein, usually on the back of the hand. The medicine will make you feel relaxed, but you will still be able to understand and talk to your dentist although you may not remember anything afterwards.

General Anaesthetic

Occasionally, people who have severe dental phobia may need a general anaesthetic, which means the patient is asleep during the dental treatment. In this case, the patient would need to go into hospital for the treatment.

All types of sedation will temporarily affect co-ordination and reasoning skills, so patients must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards.

Finally, some dental surgeries will also offer Psychological techniques such as the following:

Distraction techniques

Distracting attention away from dental treatment can help the patient to relax. For example, it may help to listen to music, watch a video, concentrate on relaxing the body or think about something the patient can look forward to.

Hypnotherapy

Hypnosis can bring about relaxation and help change the way the patient feels about situations and ideas. The patient will stay awake and in total control. However there is little scientific evidence to show that it can reduce anxiety.

Cognitive behavioural therapy (CBT)

CBT is a type of talking therapy that helps address negative thoughts and behaviours. A behavioural therapist may be able to teach ways of reducing anxiety about going to the dentist.

If you do suffer from a dental phobia which is preventing you attending the dentist or from having dental treatment you desperately need, it is very important that you seek help to overcome your phobia in order for you to resume your dental treatment.