- Dental fear is very common, affecting more than half of the population.
- Fear of seeing the dentist kicks off a vicious cycle that can eventually lead to serious oral health problems.
- Behavioural strategies can ease anxiety through distraction and physical relaxation, and increasing the patient's sense of control.
- Cognitive strategies can tackle fear by challenging and restructuring negative thought patterns.
When was the last time you saw your dentist? During the COVID-19 pandemic, many people have struggled to maintain existing routines of dental check-ups. Some people avoided leaving the house in favour of social distancing. Others didn’t see the point of visiting the dentist given the reduced number of dentistry services offered during lockdown. Finally, some patients were simply unable to arrange appointments due to decreased availability. Apparently, one desperate patient even felt forced to take matters into his own hands and remove an aching tooth with pliers at home.
While dentists fear a “tsunami of post-lockdown tooth decay,” many dental patients are likely to have experienced a feeling of relief at having an excuse to put off appointments. Let’s face it: Going to the dentist isn’t fun. Personally, I tend to dread every appointment, despite my dentist being a perfectly nice man who has never inflicted any pain on me over many years of regular treatment.
Dental Fear Is Common and Serious
It turns out that I am not alone in experiencing anxiety. Dental fear is shockingly common: It affects more than half of the British population. The level of fear experienced varies from patient to patient and sometimes develops into a debilitating phobia that leads patients to avoid seeing the dentist even when in pain. Indeed, dental phobia appears to be one of the most common types of phobias, often rooted in a deep dislike of having one's mouth examined. But some people experience more specific fears, including a fear of needles or dentist drilling.
Dental fear has serious consequences for people’s oral health and overall well-being. Scientists refer to a “vicious cycle of dental fear,” in which initial fear leads to delayed dentist visits, which result in higher numbers of dental problems, and, consequently, require symptom-driven treatment. Unpleasant experiences during treatment increase existing levels of dental fear, aggravating the problem.
How to Tackle Dental Fear
Breaking the vicious cycle of dental fear is a challenge. Luckily, research has demonstrated the effectiveness of several psychological strategies to overcome the struggle. Below, I outline some of the most promising techniques, all of which can be practiced without professional help or long-term therapy.
- Distraction. Depending on the severity of one's dental anxiety, a quick and easy fix can be simple distraction of the mind during dental procedures. By taking your mind off the dental exam or treatment, the appointment is experienced as passing more quickly — and may even be pleasant. Methods for distraction could involve playing background music, listening to an audiobook, or watching videos (e.g., on a phone or tablet). The type of distraction is only limited by your own imagination. During the low-tech times of my childhood, I remember counting the ceiling tiles in the dental office to keep my mind occupied.
- Physical relaxation. Relaxation techniques targeting the body’s physical response to stress and anxiety can be useful both before and during a dental visit. Relaxation techniques can be adapted to the personal preferences of the patient and may include meditation, mental visualisations such as imagining sandy beaches, muscle relaxation, and breathing exercises.
- Increasing control. A common source of dental anxiety is a fear of the unknown. Handing over control to a dental team covered up by face masks and surgical gowns, and equipped with ominous tools, drills, and machinery can be terrifying. Luckily, there are several strategies to regain a sense of control and feel like you’re back in the driver’s seat. Two key techniques are “stop-signaling” and “tell-show-do." Stop-signaling involves agreeing on a simple gesture (e.g. raising one’s hand) that will act as a cue for instant termination of an ongoing procedure. Having the power to put an immediate end to whatever unpleasant procedure is under way is a significant step toward increasing a patient’s control. “Tell-show-do," on the other hand, places a larger emphasis on the actions of the dentist. It involves the dentist clearly communicating all planned procedures in patient-friendly language, demonstrating what specific instruments and actions those procedures will involve and carefully following outlined plans. By providing detailed insights into every step of the procedure, a patient’s fear of the unknown can be targeted at its very root.
- Cognitive restructuring. Cognitive restructuring refers to the careful evaluation and subsequent adaptation of unhelpful thoughts and irrational thinking patterns that cause problems when visiting the dentist. Patients may ask themselves what thoughts come to mind when picturing a dental appointment. What is the source of their fear? What assumptions or beliefs fuel it? If they imagine terrible pain, a helpful strategy can be to seek further information about what their treatment might involve and whether it is likely to cause any physical discomfort. If pain is indeed a likely consequence, developing practical strategies for overcoming the pain will help to deal with the fear. Talking to the dentist about sedation options, for example, could be a simple solution.
As lockdown restrictions are lifted and the world opens up again, excuses to dodge the dentist are becoming more difficult to justify. Similarly, with lots of proven self-help options at hand, tackling dental fear is easier than ever. Why don’t you book your next checkup right now?
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