8 ways to ease dental anxiety

Dentists are commonly portrayed in the media as scary, sadistic and dental offices as a place to be feared. Considering that, it is no surprise that around 1 in 3 people have dental anxiety, and an estimated 12% of the population suffer from extreme dental fear.

This- combined with the severe lack of dental insurance coverage in America- contributes to the fact that dental care is often the lowest priority of medical care for many, and often just flat out avoided. 

Recent statistics show that 1 in 4 adults have untreated tooth decay. Even more disturbing is that almost HALF of adults over 30 have signs of gum disease, and for about 1 in 10 that gum disease is severe.

With oral health being so vital, why are we all so afraid of the dentist?

Little Shop of Horrors = dental nightmares!

The research on this does agree on one thing… it’s complicated. Although negative portrayals in the media (Little Shop of Horrors i’m talking to you!) and more anxious personality types contribute to how common this fear is, a few facts do stand out. 

About half of those interviewed reported that their dental fear began in childhood. Their fear stems from a directly traumatic event, or just from the association of pain and/or shame surrounding their dental health.

So how do we manage our dental fears?

This will require a two-pronged approach. You will need to do some preparation to work through and make plans for your anxieties leading up to your appointment. You will also need to utilize some tools and techniques while at your dental office to help stay calmer.

Before your appointment:

Explore what the root of your anxiety is.

For those who’s anxiety is centered around a certain event, this will be obvious. But for others it may take some work to reflect back on times they remember being in pain, being shamed, or frightened, and then hone in on what was happening in that moment, and how it made us feel. 

Explore if it is really the event itself that was traumatic, or if it caused you to be triggered by another unrelated trauma, past abuse or assault.

We can’t change what happened in the past, but we can adapt our surroundings to minimize the triggers of those big or little traumas. 

For example, if you had a particularly painful procedure, you can make a plan with your dentist for more effective pain relief before and after the procedure. Or maybe a certain sound or smell reminds you of a particular negative event; You can bring headphones to listen to music to drown out the noises, or bring something to smell that will help overpower the trigger smell.

Most any trauma is rooted in feeling a lack of control or being powerless over our own bodies or minds. Find ways to help you feel in control, or actively a part of your dental care.

Reflect on the benefits of maintaining your oral health, and the consequences of avoiding it.

The World Health Organization makes this statement regarding the importance of oral health & hygiene:

Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.

World Health Organization (WHO; 2012)

Research shows that increased oral health is associated with a higher quality of life; Physically by decreasing your risk of disease, oral cancers, and chronic pain, and emotionally with increased self confidence and reduced stress levels.

Ignoring our oral health on the other hand costs us not only our quality of life, but also our money and time that could be spent on things we enjoy.

Work WITH your dentist to reduce your dental fears.

Speak with your dentist about your fears and make a care plan.

You are not the first patient with a dental phobia that your dentist has cared for. Chances are they want to hear your fears and concerns, and will have some ideas of their own to make you feel more at ease. 

Be specific with your history. Let them know the environmental factors that may be triggering. Explain to them how you may react when you are feeling anxious or scared. 

You can even work out a hand or verbal signal with your dentist ahead of time if you need them to pause during a procedure.

Work on addressing your dental trauma.

If your dental phobia is getting in the way of your dental care, it will be helpful to seek professional help in working through the related trauma. 

Trauma literally reprograms our brain, causing emotional and physical reactions outside of our control. Like you would only have a trained dental professional care for your teeth, you will have the most success working through trauma with a trained mental health provider.

In the chair:

Refresh the care plan with your dental team.

The day of your appointment you will want to make sure each person caring for you is on the same page. This will include not only your dentist, but the hygienist and dental assistant as well. 

Refresh with them the relevant parts of the history leading to your anxieties, and go through the tools you and your dentist discussed using. Encourage them to check in with you throughout the procedure.

Practice deep breathing.

Diaphragmatic breathing is one of the easiest tools that has been proven to reduce stress, lower your heart rate, and reduce cortisol levels. Watch the video linked in this article to learn how to ensure you are breathing with your diaphragm and not your chest.

It will be beneficial to practice this daily to strengthen your diaphragm, reduce your overall stress levels, and help this tool come more naturally and effectively when your stress levels are heightened.

Use relaxation techniques.

There are many types of relaxation techniques to choose from. Progressive muscle relaxation, guided imagery or visualization, and self hypnosis are among the most popular.

All of these have been proven to reduce stress in dental patients. However some might be more effective than others for you, so you will want to utilize the ones you are most familiar with and respond to the best. This will require you practicing some of these ahead of time to find what is the best fit for you.

Utilize distractions.

Distraction is not only helpful to reduce triggers such as smells or sounds, but also by engaging the Gate Theory of Pain and therefore diluting the pain or stress responses.  

Here are some practical ways that you can use distractions while in the dental chair:

  • Bring headphones and listen to music, podcast or audiobook.
  • Utilize aromatherapy by smelling a bottle of essential oils or having another pleasant smell placed nearby your head.
  • If the office has TVs in the rooms, ask for it to be turned on during your visit.
  • Engage in conversation with your care team.

Your dental anxiety will likely not disappear after the first visit when utilizing these 8 techniques. However, we are glad you are taking on this journey to steadily improve your oral health and mental well being. Taking time to work through trauma and reduce your stress levels is work that never is fruitless. 

Let us know if any of these tools worked for you!

Citations:

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Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2019.

 Eke P, Thornton-Evans G, Wei L, Borgnakke W, Dye B, Genco R. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009-2014. JADA. 2018;149(7):576-586.

Locker D, Liddell A, Dempster L, et al. Age of onset of dental anxiety. J Dent Res. 1999;78:790–796.

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Kaur, Puneet et al. “Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents.” Journal of clinical and diagnostic research : JCDR vol. 11,4 (2017): ZC05-ZC08. doi:10.7860/JCDR/2017/23362.9515

Bowman U, Carlsson V, Westin M, Hakeberg M. Psychological treatment of dental anxiety among adults: a systematic review. Wide. Eur J Oral Sci. 2013;121(3 Pt 2):225–234. 

Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016;8:35-50. Published 2016 Mar 10. doi:10.2147/CCIDE.S63626

Hopper, Susan I.1,2; Murray, Sherrie L.1,2; Ferrara, Lucille R.1,2; Singleton, Joanne K.1,2 Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review, JBI Database of Systematic Reviews and Implementation Reports: September 2019 – Volume 17 – Issue 9 – p 1855-1876

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