Dental phobia or a fear of visiting the dentist is seen in a significant number of children and adults and is universally recognised as a rather common phenomenon.
Why does it happen?
Reasons for such fears may be due to:
- Previous traumatic experiences at the dental clinic
- Fear of pain and/or the injection
- Fear of the sound of the drill/the instruments used
- Embarrassment about the mouth and teeth, looking at it as an invasion of personal space
How does this affect you?
Dental anxiety may result in:
- Sleeplessness, the night before an appointment
- becoming restless and fidgety
- feeling uneasy with the placement of dental instruments in the mouth
- have difficulty breathing or a perception of breathing difficulties during the dental exam or procedure
So, what?
Alas, people with such fears put off dental visits indefinitely, going only when forced to due to severe pain. Many times, they prefer symptomatic treatment only, which may serve to give only temporary relief.
Sadly, many a time, it becomes too late to do anything simple to alleviate the problem.
All this may lead to an increased need for more invasive treatment options, increased expenses, and longer treatment times.
What about children?
It is important that such fears are not passed on to children from adults. Surveys have clearly shown that children whose parents are afraid of the dentist are more likely to be scared of dental visits than children whose parents have no such fears or have not instilled them in their children. Therefore, it is imperative to find dentists who are empathetic, friendly and communicative. Dentists, who handle children well, are usually good listeners and are able to allow the child/parent to voice their concerns, if any, and address them accordingly.
How can you help your child?
Dental visits should begin at a young age, preferably age 1, so that children develop a rapport with the dentist and eventually get comfortable with regular cleanings and other simple dental procedures. Parents can help by conditioning the child at home on simple things to expect at the dental clinic, inclusive of helping them with brushing teeth and showing them how to open and close the mouth. Parents must be very clear NOT to project their own fears onto children, which could be highly detrimental to creating a good experience at the dentist’s clinic.
What if you are or your child is already fearful of dental visits?
Start with acknowledging the issue and figuring out why one is fearful. Self-assessment tools such as Dental Fear Survey (DFS) and Dental Anxiety Scale (DAS) can be used to understand the extent of anxiety. Having an open chat with your dentist and voicing your concerns helps.
How can dentists address these fears?
At The Capstone Clinic, we follow the principle of ‘pre-treatment conditioning’, where we set aside time for the patient/parent to come in and discuss his/her dental issues so that we can, together, come up with appropriate treatment decisions. At this appointment, the patient has the opportunity to raise concerns and queries and have these addressed. This also gives us the chance, as dentists, to understand individual treatment needs and allows for better rapport once treatment begins.
Overview of some techniques used to help anxious and/or fearful patients are as follows:
- Tell-show-do: Involves an explanation of what is about to happen and also a mock demonstration of the procedure and instruments used.
- Allowing signalling: Establishing a signal during treatment to give the patient a sense of control of the situation. This can be as simple as raising a hand to indicate discomfort or ask for a break.
- Using distraction: Playing calming music, allowing the patient to use their headphones to listen to music or audio books of their choice, watching television, or playing games on their mobile – all these allow patients to focus their attention mentally on something other than the dental procedure at hand.
- Procedure modifications: Seating in the dental chair can be modified by different angulations of the chair if the patient does not feel comfortable lying down flat. Autistic patients benefit from dentists standing near them rather than sitting, to dispel the discomfort of close physical presence.
- Pharmacotherapy: Prescribing of mild sedative agents on the night before and in the morning of the dental procedure can promote relaxation. Having dental appointments earlier in the day can also help to soothe frayed nerves and the patient can go through the rest of the day in a comfortable manner.
Apart from the above, pharmacological strategies such as the use of ‘Conscious Sedation’ in conjunction with the anaesthetist are also widely used in the truly fearful patient.