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Articles
Dentist Fear
A "phobia" is medically defined as "an unreasonable sort of fear that can cause avoidance and panic. Phobias are a relatively common type of anxiety disorder." A more user friendly definition is "a persistent, irrational fear of a specific object, activity, or situation that leads to a compelling desire to avoid it." Dentist Phobia would be a persistent irrational fear of your dentist. An immediate anxiety response, often in the form of a panic attack, happens when there is exposure to a dentist. It's important for you and your dentist to understand the distinction between dental anxiety, dental fear, and dentist phobia.
- DENTAL ANXIETY -- Basically, it's a fear of the unknown. Anxiety is extremely common, and most people experience some degree of dental anxiety when they don't understand what's about to be done, why they need it done, or they are about to have a procedure done that they have never done before.
- DENTAL FEAR -- Is a reaction to a known danger and often involves a fight-or-flight response when confronted with the frightening stimulus. It's a fear of a procedure they have had before.
- DENTIST PHOBIA -- Is fundamentally the same as fear, just much stronger, except the fight-or-flight response can occur by just thinking about or being reminded of the fearful situation and they avoid dental care at all costs.
Dentist phobia may develop as a result of one or more of the following:
- Stimulus Generalization, the tendency for the conditioned stimulus to evoke similar responses, or previous traumatic experiences in a non-dental context. For example, a bad experience in a hospital leads to a fear of antiseptic smells.
- Hearing about others' traumatic experiences or negative views of dentistry (vicarious learning). A child picking up on his/her parents fear.
- The negative portrayal of dentistry in media.
- Feeling they have no control, are helplessness, and/or vulnerable. Most often happens when a current or past dentist has been cold and controlling.
- Learned experiences, bad or horrific dental experiences that include not only painful dental visits, but also emotional issues such as being humiliated by a dentist.
- When there is a history of abuse dental fear is common. Abuse includes being bullied, emotional abuse and sexual abused, especially in childhood.
- Insensitive and degrading remarks by a dentist or hygienist and the intense feelings of humiliation they provoke.
Treatments for dentist phobia often include a combination of behavioral, medications, and self-help or support groups. Behavioral strategies used by dentists include positive reinforcement, the use of non-threatening language, and verbal explanations of procedures in easy-to-understand language, followed by a demonstration, then the actual procedure. Other behavior treatments include relaxation techniques, cognitive restructuring, and systematic desensitization. Some dentists may change the physical environment of their office by getting rid of smells, having the staff wear non-clinical clothing, or playing music in the background.
Medications can be used to manage and treat dentist phobia, they range from mild sedation to general anesthesia, and are often used by dentists in conjunction with behavioral techniques. One common anxiety-reducing medication used in dentistry is nitrous oxide (also known as "laughing gas"). Dentists may also prescribe an oral sedative, such as temazepam, alprazolam, diazepam, or triazolam. While these sedatives may help people feel calmer and sometimes drowsy during dental treatment, patients are still conscious and able to communicate with the dental staff. Doctors can also use IV sedation is often referred to as "conscious sedation" as opposed to general anesthesia. In IV sedation, patients breathe on their own while their breathing and heart rate are monitored and are still responsive to a dentist's prompts. In GA, patients are more deeply sedated and unable to breathe on their own and are not responsive to verbal or physical prompts.
Self-help and support groups are often used to help with dentist phobia. Online communities have been a great tool in helping people to confront their fear and successfully receive dental care.
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