Up to 20% of people avoid going to the dentist unless absolutely necessary. Why do people fear the dentist?
One reason is a previous bad dental experience. For others, it is a loss of control--of being in the dental chair with someone hovering over you and not being able to speak.
Still others have anxiety disorders or post-traumatic stress disorder and the fear of the dentist is a “side effect” of the primary condition.
Drugs to Help with the Fear and Pain
- Conscious sedation helps dental fear, particularly when having dental surgery, by drugs that work as both a sedative to calm the patient and an anesthetic to block pain.
- Anesthesia: For those that need more sedation, anesthesia renders the patient unconscious.
- Local and Topical Anesthetics: For less involved dental work such as dental fillings, local and topical anesthetics work well for stopping pain.
Alternative Therapies for Fear
- Visualization techniques can help with dental fear by the patient picturing calming scenes such as a beach or a forest.
- Hypnosis puts the patient in an altered consciousness state and has been shown to be effective against anxiety.
- Relaxation techniques that can be effective include progressive muscle relaxation where the patient tenses and relaxes different muscles in turn. Controlled breathing or deep breathing exercises can also help.
- Humor reduces stress and creates a welcome atmosphere
- Distraction techniques are becoming more common in dentists’ offices such as a TV screen on the ceiling above the patient’s chair so that the patient can watch television or a movie while dental work is being done. Another distraction alternative is for the patient to wear a headset that is playing music while the dental work is being performed.
Research on Coping with Dental Phobias and Fear
A study from Sweden published in the Journal Acta Odontologica Scandinavica found in addition to “distraction,” as noted above, there were the following coping strategies regarding dental treatment:
- Distancing: The patient tells himself that the pain is something else (not unpleasant)
- Prayer: The patient prays the experience will soon be over
- Self-efficacy: The patient tells himself to be “strong” during the dental treatment
- Optimism: The patient says to himself that “everything will be okay after the dental treatment is over.”
Psychologist Interview before Dental Treatment
Another recommendation for dealing with dental fear is to see a psychologist before undergoing dental treatment. For example, a university in Washington state has a psychologist on staff who interviews fearful patients before dental treatment. Dr. Heaton’s goals are to make a “personal connection” and “talk about concerns” to help ease the patient’s anxiety.
Children’s Fear and Response to Pain Affected by Parents
Children’s anxiety and response to pain regarding medical treatment has been found to be related to the interactive behaviors of the child, parents and medical staff. In particular, parents affected their child’s perception of pain through positive reinforcement and modeling of pain behaviors. Several studies have noted the impact of parental anxiety on the child’s “distress.” Nevertheless, researchers have found that it is important for the parent and child to be together during the medical procedure.
Researchers found four patterns of communication between parents and children before, during and after medical procedures:
- Normalizing:
- Invalidating:
- Supportive:
- Distancing:
Invalidation by the parent was found to be the most related to a child’s distress. Additionally, a “dismissive” parenting style correlated with less facial expression of the child’s pain ie. The child learned to not show pain in front of the parent due to the parent previously not believing the child was in pain.
Lower levels of distress in the child were shown when parents demonstrated distraction, including engaging the child in talking about something unrelated to the procedure, or humor, as a way of coping.
When the parent demonstrated criticism, empathy, reassurance, apologies or gave the control to the child, the child had increased distress levels. Theories as to why empathy and reassurance may increase a child’s distress have centered on the idea that the child does not perceive that he/she has the necessary skills to cope with the situation.
Conclusion:
Regardless of the source of the anxiety or fear regarding dental treatment, there are myriad ways of alleviating these feelings. Medications that alter consciousness and/or relieve anxiety are common. Additionally, there are various alternative techniques including forms of distraction
This is a guest post by Charles Smith. Occasional guest poster on dental healt and full time health expert. Charles currently represents Smile Stuido, a dentistry that has been involved in implant dentistry for over 15 years now and has experience in wide range of dental services from single teeth to full mouth reconstructions.
