A phobia refers to an anxiety disorder or a strong fear response to objects, situations, or people without there being an objective reason for it. The body and mind are alarmed and react very differently to the fear triggers, which can range from blood, heights, enclosed spaces to crowds or darkness. Fear of doctors and especially dentists has been around for many centuries. The causes are varied and so are the methods of treatment. Mostly doctors start from bad experiences in the past, which can develop into a phobia over the decades. In this article there is further information about anxiety disorder in adults.
What is dental phobia in children?
Children often possess the feeling of being at the mercy of a stranger when going to the dentist. This can be ingrained over years, especially if the initial experience was not very positive. Children often have the feeling of being at the mercy of a stranger when they go to the dentist. This can last for years, especially if the first experience is not very positive. But for healthy oral hygiene and general health, regular treatment by a specialist dentist is very important and can have a lasting positive impact on later life. Parents who notice anxious behavior or problems in their children during or before a visit to the doctor should therefore work with the doctors to find out where the anxiety is coming from and how to combat it.
Cause of phobia in children
In both adults and children, traumatic experiences are among common reasons for the development of a phobia. These can be accidents, other mental illnesses, surgeries, but also violence and abuse. These extreme cases must first be recognized, because often they are not directly related to the dentist or the surgery, but are basic fears of being exposed, pain or violence. Parents who notice a strong change in their children should therefore seek support from professionals. A major area of influence for children is the behavior of adults and their own parents. If they themselves possess a great fear of the dentist or do not come with them to the treatment room, they tend to refuse treatment. Some studies found that children can learn their parents’ fears, especially with very strong reactions such as to spiders, heights or doctors. Therefore, it is important to combat one’s own fears so that the child does not acquire the fears and copes well with the unfamiliar situation. Other reasons include very negative stories from other children who may have had bad experiences with doctors or shame about the condition of their own teeth. Often it is a combination of many causes, for example, those who have a fear of injections or nausea will not be able to deal positively with some of the dentist’s treatment procedures. Children quickly develop fears and a wariness of people and situations in which they do not feel comfortable. With doctors who do not make a positive impression at the outset, or where the child even experiences initial pain, these fears can very quickly become entrenched. Those who do not go to the dentist regularly risk neglecting their oral hygiene in general and getting damage to their teeth, which can lead to metabolic diseases, injuries in the oral cavity or tongue carcinomas. Many other diseases and problems such as headaches, backaches, or even allergies and heart problems can be attributed to poor dental hygiene and its consequences in some patients. Patients withdraw from social contacts because of the shame or pain severely limit their quality of life. Therefore, parents should consciously take action against dental phobia in childhood.
Signs and behaviors
Parents should make sure their children brush their teeth regularly every day. This way, children will have to go to the dentist much less often and fear of the dentist will not have to develop in the first place. Children usually express themselves very directly, saying what they feel and think. General signs include trembling, nausea, palpitations or shortness of breath, but the behavioral changes are very clear, especially in children.While adults can always postpone or cancel the set appointments, children are naturally not in a position to determine this themselves. So there is the refusal attitude, crying fits, screaming or retreating into their own room. But even at the dentist himself, the child may initially appear very calm, only to panic in the treatment room, not open his mouth or cry. An examination or treatment is then often no longer possible. It is only in recent years that dental phobia has become a recognized mental illness, accepted both by doctors and by the immediate environment of those affected. Therefore, forcing children to undergo treatments or visits is very counterproductive, as it can further aggravate the phobia. However, such a phobia can be treated very well nowadays.
Treatment methods and prevention for children
Taking away the fear is not an easy task when it has already developed for several years. Many doctors recommend making appointments with the dentist first in the sixth to eighth month of life and again in the 16th to 18th month, and having the six-monthly checkups from the second year of life. Ideally, parents take their children to dental checkups together, showing them that treatment does not have to be painful and that they need not be afraid of it. However, many doctors recommend remaining realistic and explaining procedures and equipment to children in detail. An overview of the early stages of children’s lives and their dental development is provided by the DZMGK, German Society for Dental, Oral and Maxillofacial Medicine. However, if dental phobia is pronounced, other treatment methods are appropriate. After a professional consultation, parents should take the child to the dentist, who will not initially treat or examine the child, but will explain the practice and plans in detail. In this way, the child gets to know the treatment room as a safe space and can gain trust in the treating dentist. In the next session, depending on the severity of the phobia, the doctor can already examine the oral cavity, but should not yet treat immediately, so that the child can slowly get used to the environment and the procedure. If there are findings, the doctor should explain to the child and parents exactly how he wants to treat and what steps are necessary to do so. Many parents are often not quite sure themselves which treatments are even relevant and which methods the doctor can even use. In this summary, the most important steps of a visit to the dentist are listed and explained, from ultrasound and X-rays to the different types of anesthesia and the procedure protocol of a general examination. Pain-free treatment is especially important for children, so dentists should use anesthetics that are tailored to the needs of children. Many do not like syringes and panic at the very sight of them. Some good alternatives include:
- Hypnosis and behavioral guidance
- Local anesthesia using surface anesthetics.
- Laser treatment
- Nitrous oxide
Laughing gas is not widely used in Germany, but is experiencing a resurgence since the successes in the U.S. and other countries, because especially children are anesthetized by this sedation without feeling pain and can still cooperate with the doctor. Hypnosis is not without controversy, but many doctors and patients swear by the method, which does not require additional substances or drugs. Trained therapists can use it to alleviate anxiety and put patients in a hypnotic state where they are calmer and feel less or no pain. However, children are much more difficult to hypnotize than adults, as they are not able to concentrate as well and usually require a fantasy journey or other stimuli to induce the trance. For more information, see the following entry. Dental phobia is not a disease that parents should deny their children or not take them seriously with it. To prevent it from becoming an anxiety disorder that lasts for years or decades, usually based in childhood, parents should respond to fears and behavioral changes early and work gently and patiently with the child on the phobia. With pressure and coercion, symptoms intensify and later health limitations can be the result. Perhaps affected parents can even seek treatment together with the children.
