Dental procedures can be intimidating. Dental anxiety is defined as anxiety due to any form of dental care. As a result, dental anxiety often causes delays in seeking dental treatments

Key takeaways:
Dental anxiety or dentophobia is fear of any form of dental care.
This anxiety comes from four sources: general anxiety, distrust of dentists, anxiety about dental stimulation, and anxiety about the consequences.
Sedation, muscle relaxation, biofeedback, and acupuncture can help manage the condition effectively.
What causes dental anxiety?

Dental anxiety, also known as dentophobia, is anxiety, stress, or avoidance behavior towards any form of dental care. Fear and anxiety about visiting the dentist can cause delays in treating dental disorders or diseases.

Procedures and tools used in dental care, such as dental drills and syringes, usually cause dental anxiety. Painful procedures, the discomfort of long-duration mouth openings, and expensive dental treatments can trigger feelings of fear and discomfort in individuals. Sometimes initial interactions with dentists can elicit phobias, anxiety, and fear in patients.

Several factors, such as traumatic experiences (especially in childhood), lack of understanding, perception of body image, neuroticism, and frightening portrayal of dentists by the media, can trigger dental anxiety in individuals. Dental anxiety can be categorized into four types based on the source — general anxiety, distrust of dentists, anxiety about dental stimulation, and anxiety about the consequences of dental treatment. Individuals with dentophobia are more likely to have genetic and hereditary factors than individuals without phobia.

Symptoms of dental anxiety

People with dental anxiety experience similar symptoms as people experiencing anxiety or fear. Common symptoms include:

  • tachycardia (increased heart rate)
  • palpitations
  • excessive sweating
  • low blood pressure
  • withdrawal from treatment or crying
  • fainting

Patients with dental anxiety may also experience symptoms of post-traumatic stress disorder. This condition can occur when there is prolonged contact with the gear set. Furthermore, dental anxiety can co-occur with other mental illnesses, such as depression and bipolar disorder. This condition can cause orthodontic complications that threaten when the patient does not get the appropriate dental treatment due to excessive fear.

Deteriorating oral health and the presence of dental disorders may occur in patients with dental anxiety. It happens because patients are more likely to avoid dental treatment. Poor oral conditions can lead to pain or even life-threatening complications. Poor oral health habits such as infrequent brushing and flossing, unhealthy eating habits, and smoking also occur more frequently in individuals with dental anxiety.

Is there a treatment for dental anxiety?

Dental anxiety can be treated pharmacologically or with psychotherapy — or a combination — depending on the severity and characteristics of dental anxiety. Pharmacological intervention using sedatives and general anesthesia can help control anxiety in patients. This intervention is most effective when the patient does not respond well to psychotherapeutic interventions.

Conscious sedation means using drugs that depress the central nervous system. This approach helps to calm the patient to allow dental treatment to be performed. Conscious sedation can be administered orally, intravenously (IV), intramuscularly, or inhaled. Benzodiazepine drugs such as diazepam, triazolam, and midazolam are usually used to provide a mild anesthetic effect so that patients are more relaxed and cooperative in dental treatment. These drugs produce anticonvulsant, sedative-hypnotic, and relaxant effects on skeletal muscle.

Psychotherapy management aims to provide behavior modification in dental anxiety patients. Various relaxation techniques, such as functional relaxation, autogenic relaxation, and progressive muscle relaxation, are suggested to reduce anxiety in patients. This relaxation procedure is performed before the patient sits on the dental chair. For instance, Jacobsen’s progressive muscle relaxation can be done by stretching the muscles for less than 10 seconds, followed by relaxation for 20 seconds. These muscle relaxation techniques of the hands, arms, legs, chest, abdomen, head, face, and shoulders should be performed for approximately 15 minutes.

In addition to relaxation, distraction can also be applied to dental anxiety conditions. Distraction diverts the patient’s attention from various orthodontic procedures considered unpleasant. Visual and audio interventions such as listening to music, watching movies, and playing games can be effective between orthodontic procedures.

Biofeedback can also be used to reduce muscle tension and excessive anxiety. This technique measures physiological responses and provides feedback to regulate the physiological response of patients with dental anxiety. Electroencephalographic (EEG) biofeedback monitors brain wave activity, and electromyographic biofeedback can also be beneficial by reducing muscle tension. This procedure is effective in lessening patient anxiety before orthodontic procedures.

Lastly, alternative and complementary medicine, i.e., traditional/folk medicine, can also help in managing dental anxiety. For example, acupuncture can be effective in treating dental anxiety. Auricular acupuncture technique shows promising results in reducing chronic anxiety and pain in teeth. A randomized controlled trial indicated that auricular acupuncture is as effective as intranasal midazolam in treating dental anxiety. Psychological and pharmacological interventions should be carried out and monitored by a professional dentist. A patient should expect to overcome dental anxiety with exposure to orthodontic procedures accompanied by relaxation.

Anxiety due to any type of dental care is termed dental anxiety. Persons with dental anxiety tend to experience symptoms such as increased heart rate, excessive sweating, and discomfort during treatments. Several treatment options, including sedation, relaxation techniques, biofeedback, or acupuncture, are available. Talk to your dentist about dental anxiety to design an effective dental care plan.

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