Fear to the dentist

Fear of the dental situation

Fear and anxiety about the dental situation can range from tolerable, not tolerable, to severe, in the latter the dental treatment is impossible without the previous referral to the corresponding professional.

Dental fear and anxiety is a common problem that many patients and dentists must face. Without adequate resources, the dentist often appeals to patience and even compassion, creating an aversion to working with such patients. In view of the high percentage of individuals who suffer from this type of fear, the aversion that is generated can have a harmful impact on professional practice.

Every person who worked in the dental profession has found patients with extreme fear of the dental situation. Some fears are mild and tolerable, while others are extreme and can create severe physical reactions. The latter is a situation with which it can be difficult to treat for any professional, especially when it interferes with the treatment and risks the patient’s health.

Such a stressful situation is not ideal to perform delicate restorative dentistry, nor is it to medicate these patients, considering the additional potential complications, especially in a person who is experiencing a reaction caused by stress, such as an increase of blood pressure and irregular breathing. Fortunately, medication is only one of the possibilities to alleviate the fear and anxiety in the dental chair. To understand some other methods, it is important first to better understand fear and its connection to the mind and body.

Every emotion that a person experiences acts as a signal, trying to tell that person something about their environment and experiences and their interpretation of them. The interpretation of events is a dominant element in how one responds or reacts to a situation, because it is the personal interpretation that gives the specific meaning to the event.

Human beings experience the world through their senses, visual, auditory, tactile, gustatory, and olfactory representation. Every second we have two million bits of information that come to us, but we can select only 126 bits of that information to process it. This means that many of the stimuli in our world are suppressed, distorted, and generalized to fit the 126 bits we can understand.

An individual who tolerates and even enjoys visits to the dentist can choose to focus on their health, feeling good with the office staff, the pleasant music, the taste of fluoride, the comfort of the dental chair, etc., focusing their emotions on the positive of the dental situation.

While someone who experiences fear may focus on feelings of loss of control, the fact of not being able to talk while someone works on their mouth, vulnerability, smells that may be unpleasant, the possibility of bleeding and pain. These are two very different experiences about a dental visit because the interpretation of the situation varies.

Fear is an emotion that is useful when a person is in danger. It assists them to choose the most appropriate and safest action. For example, if one were in a life-threatening situation, the feeling of fear would be a sign of the existence of a dangerous situation and the need to move away or deal with the situation immediately.

However, fear is also an emotion that appears when one begins to focus on a situation expecting the worst, consciously, or unconsciously. That is to say that the individual may be aware of what he is thinking is causing him to feel fearful, or the reason may be deeply unconscious and outside of his mental awareness.

If the situation to which a person fears is true or imagined, the body responds in the same way. Some physical responses to fear are tightness in the chest, fluctuations of breathing, sweating, high blood pressure, stomach pain, and nausea. It has been suggested that fear is an acronym for: false expectations that seem true. This essentially means that what a person believes in his mind (through images, sounds, sensations, etc.), his interpretation, can manifest in the life of that person as real.

The reason why a person can experience something as true even if it has not occurred is related to the interpretation itself and the unconscious. Remember that human beings process their experience through their senses and it is with these same senses that a person imagines. For example, a person who had a true negative dental experience will remember that experience with images, sounds, sensations, tastes, and smells or a certain combination of these senses. This will invoke fear.

A second individual who fears the dentist, but who has never had a negative dental experience, will imagine the visit to the dentist with his senses, in the same way as the previous example. Again, this will cause fear to present itself. Both situations will initiate physiological responses to fear, which is a very authentic experience for that individual. Because of this, it is important to consider each person’s experience, as it is true for him or her.

Along with their interpretation of a situation, their previous life experiences may also play a role in having dental fear and anxiety. Some experiences and conditions include, (but are not limited to) claustrophobia, sexual, physical or mental abuse, panic attacks, agoraphobia, medical trauma, emotional childhood wounds, and of course a dental encounter that presents itself as a stressful situation.

Tools and resources

Although the causes of dental fear vary and are sometimes complex, and require external professional help, there are measures the dentist can carry out in order to alleviate at least something if not all the fear that his patients may experience. The first and most important thing is not to prejudge a fearful patient, approaching this in a content and comprehensive way. Developing this type of relationship helps the patient feel confident in the office feeling it as a safe place.

One way of approaching the situation would be to find out by specific questions, the causes that trigger fear in the patient.

The office environment should be pleasant, comfortable, as well as the waiting room. Some suggestions and educational material about various dental procedures in simple terms, or with indications of how to improve dental health at home, or with testimonials from patients who have happily concluded their treatments can contribute to the relaxation of the patient during the wait. Also the images on a television screen showing information about the office, health education, etc. would be an interesting contribution. Music is another element that can contribute to the environment.

Provide the patient with tools to be used at home prior to consultation such as images, breathing techniques, etc. to promote relaxation. Explain clearly the procedure before and during the treatment, after explaining each step, ask the patient if they agree and verbal agreement or with some sign with the hand so they feel safe and still have control of the situation. Provide periodic estimates of treatment time so that they know what to expect and when they are close to completing the visit.

For many patients having headphones with their favorite music placed or watching television during the treatment is a great method of distraction and relaxation.

Conclusions

Fear and anxiety about the dental situation can range from tolerable, not tolerable, to severe, in the latter the dental treatment is impossible without the previous referral to the corresponding professional.

There are many options that do not require medication to control this situation

Taking into account that the percentage of patients with excessive fear of the dental situation is very high, it is the responsibility of the professional to take behavioral parameters as well as the staff that assists him to successfully face these situations.