Dental Phobia

How common is the fear of dental treatment?

Surveys conducted in many countries show that about one adult in three is very afraid of the routine procedures accompanying dental care. Thirty six per cent in a survey in Holland said that they 'dread' visits to the dentist1. In North-West England 34 per cent were found to be 'extremely anxious' to the point that they would experience physical symptoms. In South-East England 31 per cent would prefer to be in a state of oblivion or semi-oblivion during dental treatment.

Do dental phobics have other psychological problems?

A survey in the USA examined adults with dental fear so severe that it prevented them accepting treatment. Only 29 per cent had some other psychiatric problem, such as depression. People with less intense dental fear probably have fewer psychological difficulties.

What are dentally anxious people afraid of?

Most frequently, dentally anxious people think during treatment that they are about to be hurt or that they have no control over events. However, other worries are common - about choking, losing control and making a fool of oneself, or feeling faint. Often, however, patients who are afraid of experiencing pain cannot remember having been badly hurt during dental treatment.

What are the effects of dental fear?

People who are very afraid of routine dental treatment have poorer dental health than those who are less nervous. This may be because they visit dentists infrequently. Those who are intensely afraid of dentistry believe that their fear impairs their day-to-day life especially their social relationships, possibly because of their impaired dental health.

What help is there for dental phobics?

For those who are too afraid to visit dentists, clinical psychologists and behaviour therapists can use behaviour therapy, often supplemented by training in relaxation, to help sufferers become accustomed gradually to the sights, sounds and other experiences of routine dental treatment. This is best followed by dental treatment from a collaborating dentist who can adopt a similar approach to treatment.

For those who can visit a dental clinic, inhalation or intravenous sedation can enable dental treatment to be conducted. The former, using nitrous oxide, allows patients to experience most of the treatment but in a relaxing way. Intravenous sedation also allows the patient to be aware of treatment but the patient is not able to remember the treatment clearly afterwards. However, unless such methods are coupled with some psychological therapy as described earlier, they do not readily help patients to overcome their fear so that they can do without sedation.

For those patients who do not need sedation, the following are helpful: advising the patient about pain control and how to stop treatment with a signal9, hypnosis and relaxation exercises explained by the dentist.

How can patients receive this help?

Patients can be referred to clinical psychologists by their doctors. There are clinical psychology departments in the Health Service throughout the UK. Dentists offering sedation can be found locally through Family Health Services Authorities, Health Boards and the Community Dental Service. Dentists can also refer patients to a dental hospital sedation clinic.