Tooth anxiety, also known as dental anxiety or dental phobia, is a condition in which a person experiences excessive fear or anxiety related to visiting the dentist or receiving dental care. It is estimated that between 9% to 20% of the population suffers from some level of dental anxiety. For some, it can be a mild uneasiness, while for others it can be so severe that they avoid dental care altogether. Understanding the causes, symptoms, and treatments for tooth anxiety is important for those who struggle with this condition.
What causes tooth anxiety?
There are a few potential causes of tooth anxiety:
- Previous bad dental experiences – Negative experiences in the past, such as having extensive dental work done or experiencing pain during treatment, can lead to developing anxiety about future dental visits.
- Fear of pain – The anticipation of pain during dental procedures is a major cause of anxiety for many people. Even routine procedures like getting a filling can trigger fears.
- Feeling out of control – Anxiety may stem from feeling like you are not in control or from vulnerability from having someone work inside your mouth.
- Fear of needles or drills – Dental phobia is closely linked to needle phobia. The sounds and sensations of the dentist using sharp instruments invokes anxiety for some.
- Embarrassassment – Some people feel awkward about the appearance of their teeth or breath and feel uneasy about having someone examine inside their mouth.
- Traumatic conditioning – Negative experiences as a child, such as seeing frightening media about dentistry or having poor dentist interactions, can lead to a learned fear response.
- Personality traits – Traits like feeling out of control or predisposed sensitivity make some people more prone to dental phobia.
- Genetics – Research suggests some genetic factors make certain individuals more susceptible to anxiety disorders like dental phobia.
Often dental anxiety stems from a combination of factors such as an innate predisposition coupled with negative experiences that reinforce the fear response. The most common direct causes are fear of pain and lack of control.
What are the symptoms of dental anxiety?
There are both emotional and physical symptoms associated with dental anxiety, which can range from mild to severe. Common signs and symptoms include:
- Avoiding making dental appointments
- Canceling or not showing up to necessary dental appointments
- Feeling extreme uneasiness about upcoming dental visits
- Insomnia or loss of sleep before a dental appointment
- Crying or feeling tearful about going to the dentist
- Panic attacks or feeling like you cannot breathe
- Uncontrollable shaking or sweaty palms
- Racing heartbeat
- Feelings of dread a few days or weeks before a dental appointment
- Nausea, diarrhea, vomiting due to anxiety
- Difficulty eating due to oral anxiety
Those with a full phobia may go years without seeing a dentist or have such severe symptoms that they cannot bring themselves to enter a dentist’s office. Even sitting in the waiting room for some dental phobic individuals induces panic. More mild dental anxiety is characterized primarily by extreme uneasiness and tension about dental visits.
When does tooth anxiety become a phobia?
Mild or moderate dental fear becomes a true phobia when it leads to significant life impairment and distress, such as:
- Avoiding the dentist for several years despite having dental problems
- Inability to go through with necessary treatments
- Panic attacks when needing to see a dentist
- Feeling ill for hours or days when dental care is sought
- Extreme measures taken to avoid dental care, like crossing borders
- Willingness to endure pain and dental problems rather than seeking treatment
- Significantly increased anxiety for weeks leading up to a dental appointment
- Interference with work productivity or daily life activities
The distinguishing factor between manageable anxiety and a phobia is the degree to which fears inhibit functioning and necessary dental care. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), specific phobia such as dental phobia involves “marked fear or anxiety about a specific object or situation”.
What are the complications of leaving dental anxiety untreated?
While occasional dental anxiety is common, leaving a true dental phobia untreated can lead to complications such as:
- Tooth decay and cavities
- Gum disease
- Tooth loss
- Infection or abscesses
- Need for root canals or tooth extractions
- Lowered self-esteem and confidence
- Nutritional deficiencies from inadequate chewing and eating
- Painful teeth and mouth
- Headaches or jaw soreness
- Higher medical costs for complex dental work needed
Dental anxiety often worsens over time without treatment. Fears can become ingrained and more difficult to overcome. Early intervention provides the best chance for overcoming dental phobia before severe dental disease or complications develop.
What treatments are available for dental anxiety?
There are effective therapeutic techniques dentists use to help patients with anxiety. Common options include:
- Relaxation techniques – Deep breathing exercises, mindfulness, massage, or listening to music can relieve anxiety.
- Sedation dentistry – Taking an oral sedative like Valium before a dental appointment can induce relaxation.
- Nitrous oxide – Laughing gas provides sedation, relaxation, and pain relief.
- IV sedation – Intravenous medications like midazolam produce a deeper sedation state.
- General anesthesia – Being fully unconscious under general anesthesia eliminates all sensations.
- Anti-anxiety medication – A prescription anti-anxiety drug can be taken the night before and morning of an appointment.
- Cognitive behavioral therapy (CBT) – CBT helps reframe negative thought patterns.
- Systematic desensitization – This exposes the patient to dental stimuli slowly over time to reduce fears.
- Distraction techniques – Listening to music via headphones, watching videos, or using virtual reality glasses can divert attention.
The dentist will determine the most suitable options depending on the severity of anxiety and the planned dental procedures. Combining relaxation and anti-anxiety techniques before and during a visit is often the most effective approach.
Are there any self-help tips to overcome dental anxiety?
There are some self-help techniques individuals can try at home to help manage dental anxiety, such as:
- Practicing relaxation techniques daily like deep breathing, meditation, or progressive muscle relaxation
- Doing cardio exercise which naturally reduces anxiety
- Listening to calming music or white noise before a dental visit
- Watching funny videos to put yourself in a positive mood beforehand
- Trying guided imagery visualization of being relaxed at the dentist
- Reading inspirational quotes and positive affirmations
- Voicing your fears and anxieties to dentist beforehand so they can accommodate
- Bringing a small object like a smooth stone to hold during the appointment
- Starting a fear hierarchy to gradually expose yourself to dental stimuli
- Recalling previous successful dental experiences
- Staying well-rested before an appointment
While self-help strategies alone may not overcome a clinical phobia, they can be a beneficial part of managing dental anxiety in conjunction with professional treatment.
What role does finding the right dentist play?
One of the most critical factors in easing dental anxiety is finding an understanding dentist you trust. Ideal traits to look for include:
- Specializes in treating anxious patients
- Offers sedation dentistry options
- Allows you time to discuss fears without judgement
- Is patient, caring, and empathetic in manner
- Allows you to listen to music during your appointment
- Offers a hand signal to raise your hand if you need a break
- Stops immediately if you say you need them to stop at any time
- Answers questions thoroughly and avoids lecturing
- Doesn’t pressure you into procedures and explains all options
- Provides a relaxing office environment
With an understanding dentist using proven techniques for anxiety reduction, many people find their dental fears become manageable over time.
Can dental anxiety be cured completely?
While dental anxiety usually cannot be cured permanently, the majority of individuals with dental phobia can achieve a state where they are comfortable receiving dental care with the right techniques. While an underlying predisposition may still exist, the most severe manifestations of anxiety often go away following therapy. Maintenance may be needed over time, but long-term management is very feasible in most cases with today’s anxiety treatments.
What helps ease anxiety right before a dental appointment?
Some immediate things that can help reduce anxiety right before a dental visit include:
- Listening to calming music in headphones
- Imagery visualization and deep breathing
- Reading a favorite book or inspirational quotes
- Talking to a close friend on the phone
- Aromatherapy with a calming essential oil
- Focused muscle relaxation and stretching
- Eating a light healthy snack
- Massaging pressure points linked to anxiety relief
- Sipping herbal tea to relax
- VOIP calling a therapist for a quick pep talk
Having coping tools prepared that work for you is important for acutely alleviating anxiety before a dental appointment.
Conclusion
Dental anxiety and phobia are common conditions that affect many people. While the causes are multifaceted, some of the main triggers include fear of pain, lack of control, and previous bad experiences. Symptoms range from mild unease to full-blown panic attacks. Leaving dental phobia untreated can lead to more complex dental issues and health complications over time. Fortunately, today there are many effective therapeutic techniques available to help patients overcome their fears, such as sedation dentistry, cognitive behavioral therapy, systematic desensitization, and finding an empathetic dentist you trust. Combining professional treatment with self-help strategies provides the best chance for managing dental anxiety long-term.