Dental fear

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The fear of dentists is one of the phobias. Many people feel queasy at the thought of a visit to the dentist. In the case of dental phobia, however, the fear takes on pathological proportions that prevent any treatment. Accordingly, the condition of the affected person's teeth is often poor. Fear of the dentist is usually triggered by a very unpleasant experience. Read here what you can do about fear of the dentist.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F40

Dental fear: description

There is hardly anyone who likes to go to the dentist. A certain fear of the drill, the pain and being at the mercy of the treatment chair is quite natural. In some people, however, the fear is so pronounced that they avoid a visit to the dentist altogether. You make appointments, but cancel them again and at some point don't even call the dentist. A dental phobia - also called oral phobia or dental phobia - has developed from a (normal) fear of dental treatment.

Dental fear: symptoms

The fear of the dentist leads to a vicious circle: If you postpone dental appointments, you risk that a small problem (like the onset of tooth decay) will grow into a big one (like destroyed teeth). This then requires a correspondingly more complex and thus more stressful treatment - which the dentist phobics really fears. Many of those affected would rather accept severe damage to their teeth and gums than face their fear.

In addition to the pain that emanates from the broken teeth, there are usually feelings of shame due to the unsightly dentition and the mostly foul-smelling breath. Those affected withdraw from social life. Some also develop depression and other mental illnesses.

Dental anxiety: causes and risk factors

Fear of the dentist is usually triggered by a negative experience during a visit to the dentist. The pain suffered, fears (such as not getting enough air) and / or feelings of helplessness and being at the mercy of the dentist's chair can make a deep impression on the person concerned. The next time you visit the dentist - or even just think about it - these negative sensations are called up again. Like when you went to the dentist at the time, you experience palpitations, sweats and shortness of breath, for example. Psychologists refer to this process as conditioning.

Also horror stories from other people about painful experiences at the dentist stir up the queasy feeling. So even someone who has never experienced pain at the dentist can become a fearful patient. Whether a dentist treatment or just tooth cleaning - both can panic in the same way.

Experience has shown that the panic of those affected increases the longer it has been since the last visit to the dentist.

Dental fear: examinations and diagnosis

To diagnose dental phobia, the therapist uses clinical questionnaires as a guide, which cover the most important aspects of the symptoms. The doctor can ask the following questions to diagnose dental fear:

• Does the thought of going to the dentist make you fearful?
• Does this fear prevent you from seeing a dentist?
• What physical signs do you feel when you have to go to the dentist (e.g. palpitations, sweating, dry mouth)?
• Do you feel that your fear is excessive?

Dental fear: therapy

If you are afraid of the dentist, speak openly about the problem to him. In this way, he can react accordingly and specifically address your fears.

If the consultation with the dentist is already overwhelming for you, talk to your family doctor. He can recommend suitable contact points where you can get advice on your dental phobia. Almost all state dental associations also have lists of relevant experts and practitioners specially trained in this field.

Contact one of these specialists to discuss how to proceed. Together you can develop a plan that will enable you to get your fears under control and to have your teeth treated largely without fear - for example by means of hypnosis or psychotherapy.

There are now also dental practices that specialize in working with anxious patients. The care of the dentist then goes beyond the normal treatment. Discussions in advance of the treatment and special support during the treatment counteract the patient's fear of dentistry.

Help with mild dental fear

Less pronounced fears can be alleviated by relaxing music during the treatment - or by a particularly strong local anesthetic or a humorous distraction by the dentist. In many cases, an empathetic and explanatory conversation has an anxiety-relieving effect.

But in the case of a real anxiety disorder, that is not enough. Then you should consult a doctor or therapist who deals specifically with such pathological anxiety states.

Sometimes acupuncture helps relieve fear of the dentist and treatment. To do this, acupucture needles are placed on the outer ear 30 minutes before the procedure, which, according to a study, can significantly help reduce anxiety.

Dental fear - treatment under general anesthesia

Some practices offer therapy under general anesthesia in collaboration with anesthetists. It is especially indicated when the dental problems are acute. If, for example, a purulent root inflammation threatens to spread to the jaw, action must be taken quickly.

In such cases, general anesthesia enables dental treatment, but the patient's dental phobia remains. In addition, there are general risks associated with general anesthesia, which are often not in proportion to the procedure required. General anesthesia is therefore only an emergency solution. After that, it is important to get the dentist phobia under control mentally.

Dental fear - drugs as anxiety relievers

Anxiety-relieving medication (in the form of tablets, injections) can temporarily lower the level of anxiety. Like general anesthesia, they are suitable for urgent acute treatment, but they do not solve the problem permanently.

A "fear-away injection" may only be administered by a doctor. After treatment, the patient must be supervised by a doctor for some time until the anti-anxiety drug wears off. Because some agents can impede breathing, they require particularly close monitoring of respiratory function.

Dental fear - psychotherapy

To get a dental phobia under control, cognitive behavioral therapy has proven to be particularly effective.

At the beginning there is an informative conversation with the therapist about the fear and its reasons. The fearful patient is then exposed to the respective fear trigger (confrontation training), for example the sound of a drill. At first, the feeling of fear increases. With repeated confrontation, however, it gradually degrades. In this way the patient learns to reassess the fearful situation.

In addition, he is taught certain distraction strategies, for example imagining something beautiful, as well as relaxation techniques such as autogenic training or special breathing exercises.

Dental fear - hypnosis

Hypnosis is also suitable for treating dental phobia. A dentist trained in hypnosis techniques puts the patient in a trance state. This only works if the patient is ready to fully engage in hypnosis. In a trance state, he should concentrate on pleasant images in his mind. In the meantime, the dentist carries out the treatment.

Children have a lot of imagination and a very good imagination. That is why special forms of hypnosis are also suitable for children.

However, hypnosis is not successful in every patient. In addition, it may or may not sometimes be done, for example in patients with a mental illness or who have a lack of concentration or imagination.

It is also not suitable for every dental procedure because some treatment steps require the cooperation of the patient.

The German Society for Dental Hypnosis e.V. (DGZH) offers a list of dental practices that perform dental hypnosis.

Dental fear: course and prognosis

About 70 percent of people with fear of dentists learn to control their fear of the dentist with the help of psychotherapeutic methods. You will then have it so well under control that normal treatment is possible again.

In severe cases, anxiety-relieving medication or - as the last option - general anesthesia can enable necessary dental treatment despite dental phobia. A suitable strategy can be found for everyone with dental fear - including you!

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