Fear of the dentist – tips against dental phobia
Everyone knows the queasy feeling before visiting the dentist, because the treatments are really not pleasant. But when the fear of visiting a dentist grows to panic, doctors speak of a so-called dental phobia, or dental phobia – the pathological fear of the dentist. Dental phobia has been a psychosomatic illness recognized by the World Health Organization (WHO) since 1997, but the causes are not yet fully understood.
Fear of the dentist – Article overview:
In European industrialized countries, it is estimated that around 10% of adults suffer from dental phobia. This does not mean the queasy feeling that affects almost everyone when they look at the treatment chair or when the drill is buzzing. Those affected simply see themselves unable to go to the dentist – sometimes for thirty years. In extreme cases, those affected prefer to swallow tons of painkillers and watch their teeth rot rather than go to the dentist.
Those affected accept pain and the complete decay of their teeth – and with it a dramatic loss of quality of life. Out of shame they hardly dare to laugh or open their mouths. Nevertheless, their fear is not taken seriously. "Nobody has to be ashamed of his dentist phobia," emphasizes Dr. Michael Leu, President of the German Society for Dental Treatment Phobia. "It also affects extreme athletes, ski racers and managers."
Dental phobia – the pathological fear of visiting the dentist
Dental phobia denotes an exaggerated, pathological fear of every dental treatment. This fear almost always leads to years of avoiding dental treatment and is often so pronounced that those affected do not go to the dentist even when it is sorely needed. Those affected are not aware that severe dental problems that have remained untreated for years can even be life-threatening.
Dental phobia, as dental phobia is often called, belongs to the group of simple phobias as a specific phobia. Dentist phobia patients differ from patients with "conventional" fear of visiting the dentist in addition to an extremely high level of anxiety, especially by strictly avoiding visiting the dentist. All possible objects and situations that are associated with dental treatment can serve to trigger anxiety. The transition from normal to phobic fear can be gradual.
Causes of dental phobia
Negative childhood experiences and traumatic experiences during dental treatment are common but not the sole cause of dental phobia. The impending loss of self-control and the associated feeling of being exposed can be factors as well as the fear of unknown and unpredictable processes during dental treatment. Even stories from the social environment can lead to varying degrees of fear of the dentist.
In fact, however, there are still many causes in the dark, and recent research results also indicate the possibility of a genetic predisposition: traumatic experiences in childhood seem to lead to the constant overactivation of stress centers in the brain in people who are predisposed to this.
Tormented patients, overwhelmed doctors
Those who put all their courage together often experience a fiasco. "The days before a dentist appointment are an emotional catastrophe for phobia patients", Andrea Herold describes her experiences.
Andrea Herold felt like she was in prison for years. "The sounds and smells of a dentist’s office were hell for me," says the 48-year-old from Leipzig. "I avoided everything related to it and felt completely at the risk of being scared." For 23 years she had not been to the dentist, and despite good care, her teeth were in a catastrophic condition.
Many manage to suppress their panic at first. But a wrong word, a careless reaction by the dentist, and the painstakingly maintained facade collapses: the patient suffers a panic attack with a racing heart, tremors, sweating and nausea. "A simple examination of the oral cavity can exceed the limits of what is tolerable," says Herold.
Since no psychosomatic basics are taught in dental training, dentists often feel overwhelmed by the violent reactions. The situation quickly gets out of control: the patient escapes from the practice and avoids the situation for many more years. "We dentists are basically craftsmen," says Leu. "Only a few have a feel for how the patient is doing and choose their words so that the physical reactions calm down."
Tips: anesthesia, hypnosis, psychotherapy – what helps best?
So that particularly anxious patients can relax during treatment, dentists use various methods – from empathetic attention and relaxation exercises medical hypnosis and acupuncture to sedatives and anesthetics.
In the case of dental treatment phobia, behavioral therapy, which is usually also paid for by the health insurance company, can be useful. As part of this therapy, affected patients learn strategies to control fear so that treatment at the dentist is possible again (70% success). Ultimately, however, anxiety as a mental illness can only be improved or cured sustainably through psychotherapeutic therapeutic approaches.
But until patients can benefit from these diverse options, dental phobia sufferers have to overcome many obstacles. "For many, it is already a great challenge to find out about the existing options," explains Andrea Herold, who now advises those affected – including patients from Austria – and is a member of the German Society for Dental Treatment Phobia. "It takes some years for them to dare to call a phobia patient consultation office." In many conversations, she tries to gradually build trust with patients
Only when trust is built up, do the patients see themselves able to make an appointment with the dentist. At the first meeting, their sensitivity is particularly required. "The patient needs the feeling of being respected and taken seriously," emphasizes Leu, who has built up a network with dentists and anesthesiologists who specialize in dentist phobia with the German Society for Dental Treatment Phobia. In Austria you will find the following address dental specialists for fear of dentists.
Rules of conduct for doctors
The following simple rules of conduct can be used by doctors to help their patients.
Like any other doctor, the dentist should inform them of what they basically plan to do before treatment and announce again what happens next before each treatment step. In this way, a startle during treatment can be avoided, for example when the drill is switched on. Agree a "stop signal" with the patient if it becomes too painful or uncomfortable. This also helps to prevent the feeling of being helplessly exposed to the situation.
Shorten the time of suffering
The time of suffering reached a first high point in many patients in the waiting room: Here dentists could avoid an overly clinical atmosphere and offer distraction, for example through magazines, music or television. Specialized dentists offer music and films in the waiting room but also during dental treatment.
Pain reliever and sedative
Analgesics are an aid for many anxious patients. The greatest possible sensitivity is required to keep the balance between inappropriate and sensible administration. Even if some would go through the treatment without it, the desire for pain relievers should be fulfilled.
Even if it sounds exaggerated because the doctor treating you shows compassion, he can relieve the patient’s fears. By regularly asking during the treatment whether it is tolerable for the patient, he shows that he takes fears seriously and thus brings some relaxation into the tense situation.
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