The Cause of Dentist Phobias
Why do we fear the dentist? As humans, we are born with only two natural fears, the fear of falling and the fear of loud noises. There is also evidence to suggest that we are also born with a predisposition to fearing spiders and snakes, as these fears were key to our ancestor’s survival.
Looking at it from an evolutionary standpoint, some fears have been key for our survival as a species. Fear served a purpose.
The fear of the dentist isn’t a natural fear and it isn’t key to our survival as a species. So why do so many of us experience anxiety when visiting our dentist? And why do an estimated 12% of the UK population have a dental phobia?
In this post, I aim to shed a bit more light on our shared fear of the dentist.
Dental Phobia Meaning
Dental phobias are known by many different names. The fear of the dentist may be referred to as dentophobia, dentist phobia, dental phobia, dental anxiety, dental fear or even odontophobia.
Each of these terms has the same meaning, a phobic response to receiving dental work.
The Difference between a Fear, Anxiety and a Phobia
Fear – An emotional response to a real or perceived imminent threat (something that is happening at that moment or is about to) that is in proportion to the threat.
Anxiety – An emotional response to a perceived future threat.
Phobia – A fearful or anxious response to an imminent or future threat that is excessive or out of proportion to the cause.
Those who have a fear of an object or stimulus will feel uncomfortable when they are dealing with it but ultimately are able to handle it. Those who have a phobic response will avoid the object or stimulus at all costs.
So. let’s take our fear of the dentist for example. Those with a fear of the dentist may feel uncomfortable but will be able to engage in dental treatment. Their anxiety may begin to build at a certain point before visiting the dentist, but it will be at a level that they can handle.
Those with a dental phobia will be unable to visit their dentist or engage in dental treatment. Their anxiety response will be so high that they will do anything to avoid feeling that way.
Dental Phobias and the Nervous System
When we experience fear, anxiety or are faced with a phobic response we activate what is know as our fight or flight response (although it is more accurate to call it the fight, flight or freeze response).
It is a natural human response that is responsible for our survival as a species. Without it, we may have never survived long enough to grow and evolve over the millions of years since the dawn of humans.
To understand this response, we look to our nervous system, more specifically our autonomic nervous system.
The autonomic nervous system does things automatically and therefore unconsciously, i.e. not directed by our conscious awareness. It is responsible for tasks such as breathing, heartbeat regulation, digestive processing, control of bodily functions, etc.
The Automatic Nervous System
The automatic nervous system breaks down again into two separate systems. These are the sympathetic nervous system and the parasympathetic nervous system.
Our body is constantly controlled by these two nervous systems and they each serve a purpose.
The sympathetic nervous system is responsible for our fight, flight or freeze response. When we feel fearful or anxious (of the dentist for example), it is the sympathetic nervous system that is in charge.
The parasympathetic nervous system is responsible for how our body feels when we feel calm and is commonly referred to as rest and digest. This is why so many people turn to food when they are fearful or anxious. When the body has to digest food it signals to the brain that we cannot possibly be in danger and therefore activates the parasympathetic nervous system.
The Brain and Fear
The brain works on associations. These associations make for quick, streamlined unconscious processing. It is also important to note that the brain cannot tell the difference between something that is real and something that has been imaged. Hence why we get anxiety.
So when an individual with a dental phobia thinks about visiting the dentist, their brain activates the sympathetic nervous system. With hypnotherapy, we look at changing the association so that the parasympathetic nervous system remains in control.
What is a Phobia and how does it develop?
Fears/phobias in their most basic sense are simply associations between a trigger (object, stimulus) and the activation of the sympathetic nervous system. They are a learned response and develop for a variety of reasons.
Modelling or Imitation – Children learn by modelling those that are closest to them.
Direct Experience – A negative experience is far more useful to the brain that a positive experience. Your brain is not designed to make you happy, it is designed to help you survive. In terms of survival, a negative experience is more important. Imagine having a difficult tooth extraction. It might be quite traumatic and it may be painful. Your brain remembers this and stores it away to protect you in the future whilst ignoring all the positive experiences you have had in the past. The next time you go to the dentist you begin to feel anxious as a result of that past experience.
Transference – A negative association with the dentist doesn’t need to come from going to the dentist. For example, a patient who has developed claustrophobia may become anxious when sat in the dentist’s chair.
The Mouth is an Erogenous Zone
When thinking about why we fear the dentist, it is important to address where the work takes place. The mouth is a highly erogenous zone. It is also a part of our face, an area where all of our senses are housed in some way or another. Our head and therefore our face could be seen as the core of where we are.
If we think about the feet, the feet are about the furthest part away from you whilst still being you and house only the kinaesthetic sense. The mouth, on the other hand, handles kinaesthetic, taste and is very close to our senses of smell, sight and sound.
When a patient is having dental work, all of the senses are stimulated and it can feel incredibly intrusive work.
Old Perceptions of Dental Work
Historically, dental work was quite traumatic. Fearing the dentist was therefore not uncommon. However, in the modern age, dentistry has evolved as an incredibly safe practice. Advances in science and technology have allowed for safer procedures, specialist equipment to minimise pain and injury risk, and a greater understanding of oral hygiene have all lead dentistry to be a safe practice.
The issue then becomes how it is perceived. Although dentistry has evolved the perception of the work remains the same. This perception continues to generate anxiety and is one that is seemingly difficult to move past. There is also evidence to suggest that if a patient perceives dental work to be painful then it will be regardless of how safe it is now. Beliefs play an incredibly powerful roll in how we perceive the world.
Other Phobias that are Barriers to Dental Work
Alongside a general fear of the dentist from one of the reasons above, there are other objects and stimuli associated with the dentist that can cause a phobic response. These phobias can be from modelling, direct experience or transference and can all be barriers to good oral hygiene.
- Needle Phobias (Aichmophobia)
- Blood Phobias (Haemophobia)
- Fear of Dental Equipment (Example: drills)
- Fear of being helpless (Agoraphobia)
Any one of these phobias can make dental work difficult as a result.
Overcoming Dental Fears
Although fear of the dentist is common, it does not mean that it cannot be overcome. Our approach to overcoming dental phobias is through the use of hypnotherapy.
Hypnotherapy and dentistry have gone hand in hand ever since the 19th century. However, whilst hypnosis was once only on the periphery of dentistry, it is now making a natural move into partnership. Hypnosis application within dentistry is now commonly referred to as hypnodontics.
Advantages of Hypnosis Application in Dentistry
Hypnodontics brings about benefits not only for the patient but also for the dental practitioner.
Benefits for Patients
- Eliminate dental fears and anxiety
- Eliminate other phobic responses that act as barriers to dental work (needles, blood, etc)
- Help in pain management and the reduction of general anaesthetics
- Eliminate habits that are detrimental to good oral hygiene (smoking, nail biting, thumb sucking)
- Increased confidence in the dentist and the maintenance of a positive relationship
- Boosting general checkup attendance leading to a decrease in the likelihood of more advanced dental work
Benefits for Dentists
- Happier and calmer patients leading to less stressful procedures
- Patients attending for general checkups leading to less invasive advanced dental work
- Reduction in anaesthetic use for the dental practice cutting costs
- An increase in satisfaction and potential referrals from patients
- Stress reduction for dental practitioners leading to a happier working environment