Although many people find a visit to the dentist unpleasant, this fear is so pronounced in only a few people that they do not go to the dentist.
About twenty percent of Germans are afraid of dental treatment, and about five percent avoid going to the dentist altogether. Fear of the dentist is a recognized condition known as dental phobia (synonyms: Dentalphobia, Dentophobia, Odontophobia, ICD-10: 40.2 – Specific (isolated) phobias). Patients with a phobia are clearly different from other anxiety patients in that they avoid visiting the dentist altogether.
Symptoms – Complaints
Patients with dental phobia do not go to the dentist. Often, sufferers exhibit significant carious as well as periodontal damage.
Pathogenesis (development of disease) – Etiology (causes)
The causes of dental phobia vary. Often, trauma, triggered by a previous dental treatment, is the underlying cause. Furthermore, a so-called anticipatory fear of pain exists in many affected individuals. Patients assume that pain will inevitably occur during dental treatment. The family or other social environment can also trigger fears through stories about negative experiences during a visit to the dentist, which can develop into a phobia. Another possible reason for dental anxiety is the feeling of being at the mercy and losing self-control by putting oneself in the hands of the dentist.
Consequential diseases
It is not uncommon for patients with dental phobia to suffer severe damage to the dentition from carious destruction and periodontal disease.
Diagnostics
Whether a patient suffers from a phobia is usually determined with the help of a simple questionnaire – for example, the Dental anxiety scale. The patient selects the appropriate answer from five possible answers. The evaluation on the basis of points provides information on whether and to what extent a dental treatment phobia exists.
The questionnaire contains four questions about how the patient feels in the following situations:
- You have to go to the dentist tomorrow
- You are sitting in the waiting room at the dentist
- You are sitting in the dental chair, the dentist is preparing the drill
- You are sitting in the dental chair to have your teeth cleaned
If a dental phobia is determined with the help of such a questionnaire, various options for therapy are open.
Therapy
Basically, a permanent solution can only be to treat the fear causally and thus reduce it in the long term. Psychotherapeutic procedures as well as hypnosis procedures are used for this purpose. In addition, medication can be used to alleviate anxiety and relax the patient. In particular, the fear of pain can often be eliminated with current anesthesia procedures.
In a meta-analysis of 29 studies, the authors concluded that non-drug interventions helped to combat psychological distress and anxiety during dental treatments. Music, relaxation and distraction were effective against mild to moderate dental anxiety. Medical hypnosis (synonym: hypnotherapy) proved most effective.
Often, patients with anxiety have avoided visiting the dentist for years, making dental rehabilitation an urgent need. In order not to subject patients with very pronounced dental phobia to long-lasting sessions at the dentist right at the beginning, a rehabilitation can also be performed under general anesthesia.