An irrational fear of dental care is quite common, not only among children but also among adults. Recent studies show that approximately 10-20% of adults experience high levels of dental anxiety before visiting the dentist. Among children, this fear is even more prevalent, affecting up to 30% kids.
These figures not only reflect the number of patients who experience psychological difficulties when receiving dental care, but also indicate how many people may be neglecting their dental care due to their strong fears. Leaving their mental health issues untreated will lead to both psychological deterioration and serious dental problems. Conversely, successful treatment of dental anxiety restores mental health and helps prevent multiple issues associated with dental and gum disease. In this article, we will examine strategies therapists can use to provide psychological support to patients and treat dental anxiety.
Types of Dental Anxiety
Dental anxiety covers a wide range of conditions, from mild nervousness before a dental appointment to persistent avoidance of any dental procedure. In its most severe forms, it can develop into dentophobia, an extreme fear of dental treatment, even in the face of pain.
Let’s compare the symptoms of mild and severe dental anxiety and dentophobia. These symptoms indicate disease progression and underscore the importance of professional help in the early stages of this mental disorder.
● Mild dental anxiety: discomfort during certain dental procedures, avoidance of check-ups, elevated heart rate during dental visits, restlessness.
● Severe dental anxiety: avoidance of dental care, physical reactions during dental visits such as sweating, trembling, nausea, increased salivation, and panic attacks.
● Dentophobia: complete avoidance of dental care, panic attacks, high palpitations, dizziness, nausea, nightmares.
With high dental anxiety, dental visits are still possible, albeit difficult. Dentophobia leads to complete avoidance of dental care, resulting in problems not only in the oral cavity but also in the digestive system as dental conditions worsen.
Dental Anxiety Escalation
Dental anxiety is often caused by negative experiences during dental visits in childhood. The feeling of loss of control and inability to resist pain becomes deeply imprinted in the child’s associative memory. Later, even the smell of medication or the sight of dental instruments can trigger nervousness.
The result of such negative childhood experiences can be mild anxiety, which manifests itself in postponing dental visits. Still, such avoidance of professional dental care can only worsen the situation. Teeth cannot heal themselves from cavities, as tooth enamel is incapable of regeneration. As time passes, the situation will require more invasive procedures, further increasing the patient’s anxiety. This is the vicious cycle that can occur when a person lacks support from family or therapists in overcoming their fears.
Dental Anxiety Avoidance Patterns
Acute forms of dental anxiety are relatively easy to recognize, as the patient exhibits both mental and physical symptoms. This may include trembling, panic, and hysteria. However, to provide timely assistance, it is important to recognize even the most subtle manifestations of this disorder. For example, if a patient is extremely uncooperative with the dentist, the cause may not be their personality but fear. Or, if the patient has scheduled an appointment but keeps rescheduling it under the guise of urgent matters, this may indicate a subconscious avoidance of contact.
Distraction and preoccupation with other things are also common avoidance patterns. For example, a patient may choose to undergo dental procedures while listening to music on headphones or watching a video through special glasses. Many clinics offer these anxiety-relieving options, similar to a numbing injection. However, this approach is only half-hearted. On the one hand, it allows the dentist to do their job. But on the other hand, it doesn’t relieve the patient’s deeply rooted fears, which can worsen over time. So, for the therapist, it’s important to identify techniques that impact the patient on a deeper level and can heal their problems.
Clinically Proven Treatments for Dental Anxiety
Therapists use psychological, behavioral, and pharmacological interventions to help patients with dental anxiety. We will cover the most popular techniques and approaches, such as CBT, exposure therapy, somatic experiencing (SE) therapy, and the “tell-show-do” technique.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) targets negative, irrational thinking about dental care, aiming to replace it with a rational assessment. During therapy sessions, the patient learns to identify “automatic negative thoughts” and override them with positive attitudes toward dental procedures.
The advantage of this method is that it has been shown to be effective even in cases of high anxiety. Unlike distraction techniques, which only temporarily alleviate anxiety, CBT shows long-term reductions in avoidance behavior. In addition to cognitive restructuring, this method involves imparting anxiety management keys to the patient. For example, these may include deep-breathing techniques, guided imagery, and more.
Exposure Therapy
This method also belongs to the arsenal of behavioral therapy aimed at replacing the conditioned fear response. Its essence is systematic desensitization, or gradual exposure to increasingly frightening stimuli. An important component of this method is relaxation, which helps relieve tension when encountering an anxiety trigger. The patient gradually opens up to frightening dental triggers, such as a drill, nerve block needles, the dental chair, etc.
Like other methods, this one requires collaboration with dental clinics. Visits to them and increasingly deeper immersion can be part of a therapeutic anxiety-reduction plan. Therefore, cooperation with practices such as VIP Dental Care can create a supportive dental environment necessary for gradual patient exposure to dental stimuli.
Somatic Experiencing (SE) Therapy
Dental anxiety is not caused by the pain itself during dental procedures, but by the anticipation of that pain. This can appear due to negative memories associated with a traumatic experience at the dentist’s office. Therefore, therapists need to encourage patients to abandon their thoughts in favor of real physical sensations.
Essentially, they need to bring the patient back to the present moment and ground them. To do this, they offer the patient various tactile or visual techniques. For example, the patient can focus on the tactile sensations of spinning stress balls or examine the details of the dental office. The goal is to stop listening to their thoughts and succumbing to habitual fear.
Somatic Experiencing (SE) therapy can heal deep-rooted anxiety by applying the Balanced Awakening technique. The patient gradually experiences fearful sensations and has the opportunity to regain a sense of control over the situation. This means alternating feelings of tension and safety, allowing the patient to gain confidence in their control. During this therapy, the patient learns to manage the nervous system arousal. As a result, anxiety symptoms such as increased heart rate, sweating, or tight muscles disappear, and the nervous system becomes more resilient.
“Tell-Show-Do”
This behavioral technique is based on the belief that the patient’s irrational attitude towards dental care stems from a fear of the unknown. Therefore, the task of the therapist and the dentist, working together, is to reduce the unpredictability of the situation.
Traditional dental treatment involves the dentist performing the necessary actions without informing the patient. This speeds up dental procedures but exacerbates the fears of anxious individuals. Therefore, the “tell-show-do” method requires the dentist to explain what needs to be done, then demonstrate it on a model, and only then perform the actions on the patient.
The Bottom Line
Taking care of teeth and gums requires a partnership between the dentist and the patient. However, in cases of dental anxiety, the very thought of dental procedures precludes cooperation. The anxious person’s primary strategy becomes avoidance of contact with the dentist. This solves neither the patient’s psychological nor dental problems, as the dental condition worsens and anxiety becomes even more deeply ingrained.
To override this negative perception of dental care, professional help from a therapist is necessary. Using interventions such as CBT, somatic experiencing (SE) therapy, exposure therapy, and “tell-show-do” techniques, a therapist can help patients recognize and overcome their irrational fears.
