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Super User

本地资深牙医曾一豪(Dr Alan Chan) 将在新加坡书展开办讲座,教导参加者如何正确刷牙、怎么处理裂齿和缺失的牙齿、让大家保持牙龈健康!

曾一豪牙科医生(Dr Alan Chan) 毕业于英国格拉斯哥大学(University of Glasgow)。 他曾在英国的私人诊所、牙科医院和社区卫生中心服务多年。 自2007年回返新加坡,曾医生在本地私人诊所行医了三年后,便在2010创办了Tooth Matters Dental Surgery, 执业至今。

讲座详情:

讲者: 曾一豪牙医
日期: 6月9日(星期四)
时间: 下午2.30PM - 3.30PM
地点: 新加坡国家图书馆 Imagination Room(5楼)
地址:100 Victoria Street, Singapore 188064
入场免费。活动名额有限,只限70人参加
每位参加者都将获得免费的成人和儿童牙膏,各一个

Registration Link / 报名链接:https://event.singaporebookfair.sg/dentaltalk

This annual event is organised by Singapore Press Holdings’ (SPH) Media Trust’s Chinese Media Group . Please note the entire dental health talk will be held in mandarin as requested by the organizers.

We would like to thank our following sponors

  .  .  

每位参加者在讲座结束时将获得上述一套礼品
还有有奖问答环节。请过来多多支持曾牙医。

Are you terrified of the dentist? If so, you’re not unusual. The UK’s Adult Dental Health Survey (2009) found that 12% of adults had extreme dental anxiety. And over a third (36%) had moderate dental anxiety. 

If you suffer with dental phobia, you may avoid dentists altogether. Many people who join our forum haven’t seen a dentist in many decades.

Whether your fear is extreme and you suffer from actual dentophobia, or you have specific dental fears or a feeling of anxiety that makes dental visits difficult or impossible, help is at hand!

If you already have a dentist you’re happy with, you can jump straight to our tips for coping with dental treatment!


Table of Contents

  1. Understanding your fears
  2. Find a caring dentist
  3. Tips for coping with dental treatment 
  4. Additional tips for survivors of trauma
  5. How to deal with anxiety before an appointment
  6. Coping with difficulties along the way

Part 1: Understanding your fears

1. Know that a fear of the dentist is normal

Our mouth is one of the most intimate and sensitive parts of the body. A visit to the dentist can make us feel very vulnerable. It may feel as if the dentist has all the knowledge, we can’t really move or speak, and we lose control over what is happening to us.

It may feel as if, like a judge, the dentist has all the control.

And this is just for the average person.

Anxiety and avoidance are natural, rational and purposeful reactions.

The purpose of anxiety is to prevent us from doing things that may harm us (or have harmed us in the past). So right now your anxiety is doing exactly that – keeping you safe and out of harm’s way. 

Unfortunately, for the vast majority of people, it’s very hard to get by without any professional dental care – which may be why you have arrived here in the first place. 

2. What caused your fear of the dentist?

There are many things which can cause people to develop an extreme fear of the dentist, for example:

Bad experiences

Bad experiences at the dentist, especially if the dentist was acting in an uncaring and cold manner. Common examples include pain during treatment, painful injections, complications from a procedure, unnecessary treatment, and things being done to you without your consent. Or a dentist may have made a hurtful remark about your teeth or oral hygiene.

Being scared of the dentist really is no different from being scared of a shark-infested sea if you've had bad experiences with dentists in the past.

If you were standing on Bondi Beach and you see a dark shape moving around in the water, do you have a shark phobia if you never want to go into the water? No. If you’re at your local swimming pool and you see a dark shape in the water and you decide not to get in, that’s a phobia. But for somebody who has had difficult and bad experiences at the dentist, their reality has been on Bondi Beach. Wanting to stay away from that situation is entirely rational.

Now the difference, and the crucial part, is making sure that when you do go to a dentist, you see a dentist who is as safe as the swimming pool. The phobia has protected you from all dentists when actually it’s just the dentists that are not nice to you that you need to avoid. – dentist Mike Gow (in an interview with Dental Fear Central)

Embarrassment

Embarrassment is also extremely common. Especially if dental phobia has caused you to avoid dentists for a very long time, you may feel that the state of your teeth or mouth is so horrific that showing the damage to a dentist is out of the question. Or you may feel embarrassed about crying, panicking, or making a fool of yourself in front of the dentist or their assistant.

 
In this 1-minute video, dentist Mike Gow talks about an issue which often contributes to a fear of the dentist: embarrassment

Other traumatic experiences

You may have a history of sexual, physical or emotional abuse. Or perhaps you have a fear of medical settings and doctors more generally. Such fears are often triggered by bad (first or second hand) experiences with doctors or hospitals. The dental environment has many parallels with these situations and can act as a trigger for memories to flood back.

A fear of medical settings such as this hospital can spill over into the dental realm

Or else you, or someone close to you, may have had a bad reaction to a medication. And as a result, you may be worried about something bad happening to you. Sometimes, just reading about this possibility on the internet can trigger intense anxiety.

Needle phobia

Not surprisingly, past experiences of painful injections (dental or otherwise) can make people fearful of needles. Others develop a needle phobia after they were held down against their will by doctors or nurses. Some have even reported being threatened with needles by parents or caregivers. Or perhaps it’s more just the thought of needles and being pricked that terrifies you. Some people tend to faint when they see a needle.

Indirect experiences

People may pick up on parents’ fears about going to the dentist, or hear about someone else’s bad experience. Also, the negative portrayal of dentists in the media or in movies can cause dental anxiety.

Unknown reasons

While it can sometimes be helpful to know the reasons for your fear, don’t worry if you can’t pinpoint them. Perhaps you’ve always been nervous at the dentist but you don’t know why? If so, our Dental Anxiety – Unspecified page has some useful tips!

Many people find it really helpful to find out how others tackled their fear of the dentist, and what happened when they finally managed to visit a dentist: Personal Stories of Overcoming Dental Phobia

3. Make a list of what scares you about the dentist

You may have very specific dental fears such as a fear of injections, the sound of the drill, having a panic attack while in the chair and so on. Or maybe it’s not so much dental procedures that scare you, but the dentist and their behaviour.

Why not have a look at the Common Fears section to see if any of your fears are listed?

Sometimes it can be hard to figure out what exactly it is you are afraid of. If so, you may find these forms helpful:

4. Think about what might help you

This step is not essential – a dentist with a special interest in helping anxious patients will be able to guide you through this process. But you may like to have a think about your likes and dislikes in advance:

We also have lots of information on dental fears. Each fear has its own web page, and you can read up on common fears and get tips for dealing with each of them.

And the What can help section provides lots of info on new technologies, psychology-based tips, and medications.

5. You’re in control!

It can sometimes feel as if the dentist is an authority figure who wields all the power.

Nothing could be further from the truth. You’re paying for a service, and you’re employing them to be your dentist! They would be out of business if it wasn’t for their customers. As with any business, you are free to take your custom elsewhere if you’re not happy with the service you receive.

While not all dentists enjoy helping nervous patients, those who do view it as a privilege when someone who has a huge fear of dentists puts their trust in them. And many dentists feel that helping people overcome their fears makes their job worthwhile and satisfying.

So much of it is about having the right dentist, one who will stop when you tell them to stop and who you trust 100%. I was told to remember I am paying for a service and if I am not happy to say so. I should “interview” the dentists until I find someone I am comfortable with and who understood my fears. – from our message boards


Part 2: Find a caring dentist

You wouldn’t choose a plumber without looking at their reviews or asking for recommendations, so you should do the same with any dentist.

Having a dentist who is kind, caring, and gentle is absolutely central to overcoming a fear of the dentist.

Overcoming dental phobia is not about stopping to be afraid of the dentist, but about stopping to be afraid of YOUR dentist.

1. Make a list of potential candidates

  • Ask friends or family for recommendations. 
  • Read Google and Facebook reviews for dentists in your area. 
  • Do a Google search for dentists in your area, using search terms like “dentist for nervous patients” and the name of your town
  • Look at local dentists’ websites and see if any of them have a special interest in helping anxious patients, and what sort of help they offer. Read their bios.
  • Are they enthusiastic about dentistry? Do they offer what you want? You can find out how to spot a good dentist here: How to find a high-quality dentist
  • Get help with finding a phobic-friendly dentist on our forum.

2. Get in touch with dentists, and let them know how scared you are

Contact them by email or Facebook. Dentists who are interested in helping people overcome their fears may also be happy to talk on the phone, engage in an email exchange, or have a quick informal chat in the dental practice. Or they might even agree to meet you in a nearby place if you’re too scared to set foot inside a dental practice. 

You can find a Dental Fears Questionnaire which you can give to dentists here:

If you’re lost for words, use this sample email to dentists to get started.

You can attach the Dental Fears Questionnaire to your email if you like. That way, you won’t forget to say anything important when you first meet the dentist. It also comes in handy if you’re tongue-tied due to nerves.

3. Visit the practice

This is not essential if it feels too daunting. But you may want to visit the practice before scheduling an appointment. If you haven’t been in touch with them yet, you can go on the pretext of looking for some information about the practice. Or you may want to explain that you are very nervous. Ask if any of the dentists are particularly good at helping people who are afraid of the dentist.

Note how you are treated by the reception staff – are they warm, friendly and helpful? If you feel up to it, ask if you can be shown around the practice. Or if you like, ask if you can drop in sometime for a brief informal chat with the dentist of your choice. 

The environment is important – it should be clean and tidy but welcoming. Any equipment should look modern.

4. Schedule an appointment

Do you like what you’ve seen and heard so far? Then why not schedule an appointment just for a chat. Some people find it easier to do this in writing, via email. Or you can practice making the phone call when you are sure that no-one will answer the phone. Try calling late at night or on weekends. Just dialling the number can be hard, so making a few “practice” calls can help with doing it for real.

Alternatively, you can ask a friend or partner to schedule the appointment for you.

5. Top tips for the first visit

If you suffer with dental phobia or anxiety, it's best to have a chat away from
  1. Just have a chat, away from the chair.
  2. Be honest about how scared you are. Dentists are not mindreaders, and they won’t be able to help if they don’t know.
  3. If you haven’t already done so, share your fears (for example by using this formor a list you write yourself, or by telling your dentist about them).
  4. The first visit is like a job interview – you’re sussing out your potential dentist. Are you and your dentist a good fit? Do you like them?
  5. Arrange that the first examination is not in-depth, just a quick look. This helps you to get over the “my teeth are disgusting and the worst the dentist has ever seen” syndrome.

6. How did it go?

If it went well, you’ll probably know by now! If you’re unsure, ask yourself the following questions:

  • Did the dentist make me feel comfortable?
  • Did I feel genuinely cared for? 
  • Were they non-judgmental and keen to help me?
  • Did I feel respected?
  • Did it feel like an equal partnership?

If the answer to any of these is “no”, go back to your list of potential candidates. There’s no one dentist who suits everyone (even if they get rave reviews from other nervous patients). So if you don’t hit it off with the first person you meet, try again!

7. What next?

Once you have found a dentist you like, you can work out the next steps together. If you’re not in pain, you may want to start with an easier procedure such as a teeth cleaning. Depending on your needs, you can then work your way up to more complex stuff. 

On the other hand, you may have an important event such as a wedding coming up. Or perhaps you need some major work done. A sedative may allow you to get a lot of work done in one go. 

Sedation

There are three main types of sedation:

  • Oral sedation – taking an anti-anxiety sedative in a drink, or in pill form
  • Inhalation sedation – breathing in a mixture of oxygen and nitrous oxide, which gives a pleasant, relaxed feeling
  • IV sedation – a sedative medicine is given through a vein in the arm or hand. The medicine makes you feel very deeply relaxed. You won’t remember much about your treatment afterwards

If you have your heart set on sedation dentistry, make sure that the dentists on your shortlist offer it!

Sedation dentistry is designed to make you feel very relaxed

And one last tip. Perhaps the most useful question to ask when it comes to making decisions about treatment is this:

If it was your tooth (or your mouth), what would you do?


Part 3: Tips for coping with dental treatment

Here are some tried-and-tested tips from our readers and forum members. Feel free to pick and mix! And don’t be afraid to ask for any of these things – a good dentist will want to help you as much as possible.

Preparing for your visit

  • Time of day: The first appointment of the day can be a good choice if you want less time to dwell on it. If you’re not a morning person, either the slot right after the lunch break (so you don’t have a long wait) or the last appointment of the day (so you don’t feel you’re holding up the next patient) can be good choices. Also, you could also ask the dentist if they have a favourite time of day for seeing their anxious patients.
  • Bring a friend: If you like, bring a trusted friend or family member with you. No anxious-friendly dentist will object to an extra person in the room.
  • Clothes: Wear an outfit you feel confident and comfortable in.
  • Bring a comforting object, for example, a stuffed toy, stress ball or fidget widget. Or you may want to bring or wear a lucky charm.
  • Bring a blanket, or a weighted blanket, to help you feel safe and protected.
  • Aromatherapy: Put an essential oil such as lavender oil around your nose while in the waiting room.
  • Bring dark sunglasses if you hate bright lights. Although you’ll be given safety glasses, they may not be dark enough for your liking.
  • Make a playlist: If you’re planning on listening to your own music, make a playlist of songs that you feel will help.

During your visit

  • Stop signal: Rule #1: Always agree on a stop signal, such as raising your left hand. Then, test your dentist by trying it out! Having a coping signal (for example, a thumbs up) is also helpful.
  • If you don’t feel able to give a stop signal, let your dentist know beforehand. Then you can practice giving the stop signal together. Or you can work out an alternative way, such as putting your hand around your nurse’s wrist very lightly and if you need your dentist to stop, just squeeze their wrist. They can then let your dentist know to stop. Or else, you may like to try a dog clicker.
  • Counting: Start off with doing treatment in short bursts of 10 seconds at a time, until you know you’re comfortable and that there’s nothing to fear.
  • Take a break: Agree with your dentist on taking breaks during treatment. Natural pauses in the flow of procedures can be used to relax and rest a little. Or if you’re concerned about “freezing” and not being able to give a stop signal, your dentist can approach the treatment in manageable chunks of time (say, a break every 5 minutes).
  • Explanations and running commentaries: Ask your dentist to explain the procedure to you before it begins. You may also want to ask for a running commentary about what they are about to do, what sensations and sounds to expect, and how long each part of the procedure will last. Of course, not everyone wants to know exactly what is happening, so let your dentist know your preference!
  • Touch, see and hear: You may find it helpful to see what tools and materials are going to be used, what they sound like and what they feel like: Tell-Show-Do – It’s not just for children!
  • Listen to music or watch TV:  You may enjoy the radio playing in the background, your dentist offering you a choice of music, or bringing your earphones to listen to music or podcasts on your mobile phone. Some dental practices even have a TV on the ceiling. 
  • Breathing: Breathe deeply and evenly – for example, in for 5 seconds, out for 5 seconds. When breathing in, inhale slowly through your nose while pushing your belly out. Make a conscious effort to relax all the muscles in your body.
  • Imagine being in a relaxing place, for example, in a beautiful garden or on a beach.
  • Eyes closed or open: You may find dental treatment easier with your eyes closed, or you may prefer to keep your eyes open. Why not try both and see which you prefer?
  • Numbing gel: Talk to your dentist about using numbing gel on your gums if you have a fear of needles.
  • The Wand: If you are phobic of dental injections, see if there are any dentists in your area who offer The Wand or similar systems.
  • Hold the suction tube: You may find it helpful to hold the saliva ejector (a thin flexible suction tube) to hoover up any pooling saliva and give you a feeling that you’re participating in the treatment.
  • Baby steps: Unless you’re in acute pain and need urgent treatment, prove to yourself that you can handle one aspect of your fears before addressing the next. For example, just have an injection without any treatment. If possible, start with a simple procedure such as a cleaning, and work up to more complex treatments.
  • Medication: If you are interested in using sedation, choose a dentist who offers this, and ask them about it.

After your visit

  • Celebrate: Have a treat lined up as a reward – a bunch of flowers, a parcel that will be waiting, a special drink, cake for after dinner, a meal out, whatever!
Make sure you celebrate after your dental visit - overcoming dental fears is a huge thing!

Part 4: Additional tips for survivors of trauma

For victims of abuse and trauma, the dental environment can be full of triggers because of the parallels it has with particular kinds of abuse. More and more dentists are aware of these issues, but it can be difficult to figure out beforehand if a dental practice provides trauma-informed care.

You can find lots of information and resources on our website: Tips for Abuse Survivors and Their Dentists

You may also wonder how much you can disclose to your (potential) dentist. Here’s a dentist’s take on this topic: How much should I tell my new dentist?

In addition to the tips above, here are some other things you can request if you feel they would help:

  • Leave the door open if possible.
  • Have a dental nurse present at all times.
  • Ask your permission before touching you or starting a new procedure.
  • Put the dental chair in a more upright position wherever possible. You can read more about chair position on our Lack of Control page.
  • Check in frequently with you to make sure you’re OK.

You may also like to use this Your Wellbeing During Dental Appointments form, which was created by VictimFocus.


Part 5: How to deal with anxiety before an appointment

It’s ok to be scared and to worry and this is part of the journey of coping with dental anxiety. Be kind to yourself and allow yourself to worry. You may want to do things to pamper or distract yourself in the run-up to the appointment, for example:

You can combat dental anxiety before an appointment by distracting yourself, for example by going shopping.
  • go shopping
  • watch your favourite TV shows 
  • listen to music
  • do a task which doesn’t require too much concentration, such as spring cleaning or playing a monotonous game
  • have a hot bath
  • go to the gym
  • go for a long walk
  • try out a new recipe.

Part 6: Coping with difficulties along the way

You will find lots of success stories on our forum, and most people feel a huge weight lifted off their shoulders once they have found the right dentist.  

Having said that, overcoming a fear of the dentist isn’t always a straightforward process. There can be setbacks and bumps along the way. We have dedicated a web page to this difficult topic, where you can find more information: When things don’t go to plan.

Even if you feel on top of the world just after an appointment, it is not uncommon for the fear to return – especially if there is a long gap between appointments.

Here are some tips:

  • Always schedule your next appointment before you leave: That way, it’s much easier to stay in the routine of regular visits. We all know how hard it is to pick up the phone to make that call!
  • Reward yourself: Have a little (or a big!) celebration after an appointment that went well, or treat yourself to something nice.
  • Replay positive memories from your visit in your mind: Strengthening positive memories can help with overriding negative ones – it’s like exercising a muscle.
  • Write a journal: Keep a journal, either in a diary or on our forum. You can then read back over it to remind yourself of things that went well.

And most of all:

  • Feel proud of yourself – facing your greatest fear and trying to overcome dental phobia is an incredibly courageous thing to do!
Overcoming a fear of the dentist is a huge achievement, and one you should be very proud of.

Ambling along an innocent-looking road, you pass a sign for a dental surgery. Immediately, your heart starts racing, you break out in a cold sweat, and you feel shaky and nauseous. Argggh, not yet another reminder of the dreaded D-word – better cross that road and face the other way!! Is that you? You may be suffering with dental phobia.

Dental phobia refers to an extreme fear of the dentist. It is often used as an umbrella term which can involve many different fears or one specific fear.

You may spend an awful lot of time thinking about your teeth or dentists or dental situations, or else spend a lot of time trying NOT to think about teeth or dentists or dental situations. This can be pretty hard in today’s society, which is saturated with ugly reminders such as toothpaste commercials.


Table of contents


The difference between dental anxiety, fear and phobia

People often use the terms dental anxiety, fear and phobia to mean the same thing. Sometimes they use them to express a continuum of severity, ranging from mild (anxiety) to more extreme (phobia). At other times, “dental phobia” is used to describe an extreme fear that doesn’t respond to TLC and that is seemingly irrational and particularly hard to overcome.

Rather be dead than be faced with a dentist? – You might be suffering with dental phobia!

A perhaps more useful way of distinguishing between anxiety, fear and phobia is as follows:

  • Dental anxiety is a reaction to a potential, anticipated danger 1. Most people have some degree of dental anxiety, especially if they’re facing a procedure which is new to them. Often, it’s a fear of the unknown – the “uncertainty factor”.
  • Dental fear tends to be far more specific. If somebody has a fear, they can usually tell you what exactly it is they’re scared of 2. Common examples include needles, pain, gagging or being humiliated. If you have a lot of different dental fears, pinpointing them can become a little overwhelming. But you should be able to identify them with some prompting.
  • If you have a dental phobia, the terror you feel is so strong that you avoid the dentist until either the physical pain or the emotional burden of the phobia becomes overwhelming. Some people, for various reasons, may still attend a dentist. But they will endure these encounters with intense fear or anxiety.3
A dentist in teddy's clothing

When you’re in the depth of a dental phobia, this cute teddy may strike you as pretty frightening (a dentist in teddy’s clothing) – yet another reminder of your worst nightmare…

Phobias are sometimes described as irrational or greatly exaggerated fears. But once you start digging a little deeper, this usually isn’t the case with dental phobia.

How is dental phobia different from other phobias?

At the moment, dental phobia is treated as a type of Blood-Injection-Injury (BII) specific phobia4. This type of phobia also includes needles and invasive medical procedures.

The problem is that dental phobia shouldn’t be classed under BII phobia – it should really have its own category. Some dental phobics do have a very specific fear of needles and may faint when having an injection, and see this as their main problem. But this is the exception rather than the rule.

Here are some key differences which set dental phobia apart from other specific phobias:

1. The fear involves another person

With a dental phobia, the fear is often directly linked to another person (usually the dentist) and their behaviour.

2. The large variety of fears

There are pages for over 20 common dental fears on this website, and this list is by no means exhaustive! Most people with dental phobia have more than just one dental fear.

3. The fear is not necessarily exaggerated or unrealistic

You may think your fears are excessive or irrational. Then again, you may not. Dental fears are often very realistic. Many of the things people are afraid of really can happen – especially with the wrong dentist. Examples include being lectured or told off, not getting numb, wrong or unnecessary treatment, and the dentist not stopping despite you being in distress, to name but a few.

On Bondi Beach

Is dental phobia really out of proportion to the actual danger? This will depend on your point of view and your previous experiences.

Dental phobia analogy

Mike Gow, a dentist from Glasgow and founder of the International Society for Dental Anxiety Management, uses the following analogy:

If you were standing on Bondi Beach and you look out into the water, and you see a dark shape moving around in the water, do you have a shark phobia if you never want to go into the water? Is that a shark phobia? No. Because you’re on Bondi Beach and it’s a suspicious dark shape that could be a shark. If you’re at your local swimming pool and you see a dark shape in the water, and you decide not to get in, that’s a phobia. That’s excessive.

Now, somebody who has only had difficult and bad experiences at the dentist, their only reality has been on Bondi Beach. And actually, their phobic response is legitimate. If their recollection of what happened during this horrible appointment is true, then wanting to stay away from that situation for me is entirely rational, that is not a phobic response. Now the difference, and the crucial part, is making sure that when they go to a dentist, they see a dentist who is as safe as the swimming pool. So it’s the environment that becomes important rather than the phobia. The phobia has protected them from all dentists when actually it’s just the dentists that are not nice to them that they need to avoid.

Phobia vs. Trauma

Some researchers feel that dental phobia is a misnomer. The reason being that in many cases, dental phobia more closely resembles post-traumatic stress disorder (PTSD) 5:

We propose that the term “Posttraumatic Dental-care Anxiety (PTDA)” is more accurate since it specifies that the mode of acquisition is typically not innate (as with blood phobia), but rather acquired, most frequently through direct conditioning akin to PTSD.

Of course, not everyone fears the dentist because of previous bad experiences with a dentist. As we’ll see, there are many reasons why people develop dental anxiety and fear.

What causes dental phobia and anxiety?

Bad experiences with dentistry

Previous bad experiences at the dentist

Most (though by no means all) dental fears and phobias are caused by previous bad experiences with dentists or dental treatment 6 7.

In one large study, people who reported painful dental treatments and a perceived lack of control were 13.7 times more likely to report higher dental fear, and 15.9 times less willing to return to dental treatment 8.

Sometimes, people can’t recall a bad experience, for example, because they were very young when it happened. They may only learn about the event of their parents or other people who were around at the time. But the anxiety is still there, even though they have no conscious memory of the event.

Other traumatic experiences

Dental phobia is more common in people who have been sexually abused. 9

For victims of trauma, feeling vulnerable and at the mercy of an authority figure is a trigger for memories to flood black. And the dental setting is full of such triggers for memories because of the parallels it has with particular kinds of trauma and especially with power imbalance 10.

So it’s not at all surprising that sexual assault victims are more likely to have high dental anxiety. Fear related to lying flat in the dental chair and a strong gag reflex is very common among abuse survivors 11 12.

A history of being bullied and physical or emotional abuse by a person in authority can also contribute to developing dental phobia.

Finally, traumatic experiences in medical settings often spill over into the dental realm. It’s common to have a phobia of dentists if you have a phobia of medical settings more generally.

Feelings of being powerless

Prison bars

Many people with extreme dental anxiety or phobia feel powerless in the dental chair. You may have felt in the past that you had to obey the dentist, or you may have had a dentist who would not stop even though you were in distress.

Uncaring dentist

People often assume that it’s the fear of pain that keeps you from seeing a dentist. But even where pain is the person’s primary concern, it’s not necessarily the pain as such that is the problem. Otherwise, dental phobics would not avoid the dentist even when in pain from toothache. Rather, it is pain inflicted by a dentist who is perceived as cold or controlling that has a huge emotional impact. Pain caused by a dentist who is perceived as caring is far less likely to result in psychological trauma.13

Embarrassment

If you have avoided the dentist for many years, your teeth may be in bad shape. As a result, you may feel shame and intense embarrassment in social situations and try and hide your mouth. The thought of a dentist seeing your teeth may be impossible to even contemplate 14.

Humiliation

Another cause of dental phobia is insensitive, humiliating remarks by a dentist or hygienist. In fact, insensitive comments are one of the main factors which can cause or contribute to a dental phobia. Human beings are social animals, and negative social evaluation will upset most people, apart from the most thick-skinned folks. If you’re the sensitive type, being judged and shamed can be shattering.

Observational learning

Observational Learning

Learning that takes place through watching others can also cause dental anxiety15.

If a parent or other caregiver is afraid of dentists, children may pick up on this and learn to be scared as well. Hearing other people’s horror stories about visits to the psycho dentist can have the same effect. Also, the portrayal of “the dentist” in the media (films, cartoons and comedies, and of course horror movies) can fuel dental fears.

Preparedness and Genetics

By nature, people may be “prepared” to learn certain phobias, such as needle phobia. For millions of years, people who quickly learned to avoid snakes, heights, and sharp objects such as spears and needles had a good chance to survive and to transmit their genes. So it may not take an especially painful encounter with a needle to develop a phobia 16.

Other mental health issues and dental phobia

Dental phobia and anxiety can occur together with other mental health issues. Here are some of the more common combinations:

Generalised Anxiety Disorder and Health Anxiety

Generalised Anxiety

The things you worry about may include or focus on dental stuff.

Panic and Agoraphobia

You’re scared of what will happen if you panic while visiting the dentist. Also, you may not feel confident to leave your safe space to visit a dental practice.

Depression

A lack of motivation is common with depression. It often leads to a lack of self-care. That includes caring for your dental health. Add to this the feelings of guilt and shame that often go hand in hand with depression, and it’s easy to see why you may want to avoid the dentist. The fear of getting lectured or needing lots of dental treatment can be overwhelming.

Eventually, the state of your teeth may make it even harder to feel good about yourself or to socialise. Sometimes, dental phobia can cause depression or make it worse – resulting in a vicious circle.

Emetophobia

If you have a fear of throwing up, dental treatment can be daunting. You may fear that you may gag or choke on something and throw up. Or you may worry that the drugs used in dentistry or pain control may cause nausea and vomiting.

Social Anxiety

Even a mild degree of social anxiety can make you more prone to feeling easily embarrassed. You may worry about crying, shaking, or making a fool of yourself. And, of course, you may worry about what the dentist or their assistant thinks or says about your teeth or oral hygiene.

When you have another mental health issue, it can make tackling dental fears more challenging. Getting extra support from a therapist can be invaluable.

How common is dental phobia?

A fear of the dentist is very common. In the UK’s Adult Dental Health Survey (2009), 12% of adults had extreme dental anxiety, while over a third (36%) had moderate dental anxiety 17.

It’s really hard to say how many people in Western countries avoid dentists altogether due to fear. Surveys on dental phobia may not be very reliable. After all, few dental phobics will freely admit to never visiting a dentist… that’s if they hang around to complete a questionnaire which contains the d- word!

In this video, dentist Niall Neeson answers the question: “Is dental phobia still common?”:

 

Is dental phobia more common among women than men?

The 2009 Adult Dental Health Survey in the U.K. reported that women are twice as likely as men to experience extreme dental anxiety 17.

But the odds are that women are simply more willing to admit to their fears.

Here are some comments from our forum:

I’m a 37-year-old VERY heavily tattooed construction worker and I’d like to think I can handle everything, except my teeth.

I’m a grown man and a full-time firefighter. I can run into a burning building without blinking an eye but the thought of sitting in a dentist chair scares the hell out of me… even typing this puts a knot in my stomach.

Being a man can make things more complicated because you may find it harder to be open about your fears. Many men also mention their fear of a young, pretty dental nurse seeing them frightened and seeing their teeth. This can be as big a deterrent as seeing the actual dentist.

The good news is that once you do manage to seek help and open up about your fears, you may feel a huge weight lifted off your shoulders:

In the past, I did everything to please the dentist, being brave and putting up with anything… When I thought about that, I realised that was the wrong thing to do. I now have a totally different outlook, I’m still very nervous, but my dentist is willing to work with me and goes at the speed that I can cope with. My dentist talks to me and I feel so in control, it’s a totally different experience from what I had before.

You can find a dentist like this too, but you must be honest with them, don’t try and hide the fear you feel.

The impact of dental phobia on daily life

Dental phobia can have wide-ranging effects on your life. Not only can your dental health suffer, but dental phobia may lead to anxiety and depression. Laughing out loud may be out of the question – too hard to hide one’s teeth…

Depending on how noticeable the damage is, you may avoid meeting people, even close friends. Or you may turn down jobs which involve contact with the public.

There may even be times when you’re in so much pain that you can’t even leave the house. Many dental phobics will put up with terrible pain to avoid having to face their greatest fear.

Or you may feel a loss of self-esteem over not being able to do something as “simple” as going to a dentist. Intense feelings of guilt over not having looked after one’s teeth properly are very common as well. You may also avoid doctors for fear that they might want to have a look at their tongue or throat and suggest that a visit to a dentist would not go amiss.

There is a light at the end of the tunnel…

Light at the end of the tunnel

It is possible to overcome dental phobia or at least make progress that would have seemed utterly impossible before. The path to success will be different for different people, but there are many options to help. If you do your research, find the right person and the right practice for you, then it is possible.

There are many people out there who used to have a debilitating dental phobia. But in the end, they managed to build trust and confidence and overcome this burden. At this time, that may seem very difficult to imagine. But remember, if others can do it – you can do it too!


If you or someone close to you is affected by dental phobia, fear, or anxiety, visit our Dental Phobia Support Forum!

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Sources of Information and Footnotes

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  9. Humphris G, King K (2011). The prevalence of dental anxiety across previous distressing experiences. Journal of Anxiety Disorders 25(2):232-6.[]
  10. Fredriksen TV, Søftestad S, Kranstad V, Willumsen T (2020). Preparing for attack and recovering from battle: Understanding child sexual abuse survivors’ experiences of dental treatment. Community Dentistry and Oral Epidemiology 48(4): 317-327.[]
  11. Leeners B, Stiller R, Block E, Görres G, Imthurn B, Rath W (2007). Consequences of childhood sexual abuse experiences on dental care. Journal of Psychosomatic Research 62(5):581-8.[]
  12. Uziel N, Bronner G, Elran E, Eli I (2012). Sexual correlates of gagging and dental anxiety. Community Dental Health 29(3):243-7.[]
  13. Bernstein DA, Kleinknecht RA, Alexander LD (1979). Antecedents of dental fear. Journal of Public Health Dentistry, 39, 113-124.[]
  14. Moore R, Brodsgaard I, Rosenberg N (2004). The contribution of embarrassment to phobic dental anxiety: a qualitative research study. BMC Psychiatry, 4:10.[]
  15. Townend E, Dimigen G, Fung D (2000). A clinical study of child dental anxiety. Behaviour Research and Therapy, Vol. 38, Issue 1, pp 31-46.[]
  16. Randall, CL, Shaffer, JR, McNeil, DW et al. (2017). Toward a genetic understanding of dental fear: evidence of heritability. Community Dent Oral Epidemiol 45:66-73.[]
  17. The Health and Social Care Information Centre (2010). Adult dental health survey 2009.London: Department of Health.[][]