A “phobia” is traditionally defined as “an irrational severe fear that leads to avoidance of the feared situation, object or activity” (even though the Greek word “phobia” simply means fear…). Exposure to the feared stimulus provokes an immediate anxiety response, which may take the form of a panic attack. The phobia causes a lot of distress, and impacts on other aspects your life, not just your oral health. Dental phobics will spend an awful lot of time thinking about their teeth or dentists or dental situations, or else spend a lot of time trying NOT to think of teeth or dentists or dental situations. Which is pretty hard in today’s society, which is saturated with ugly reminders such as toothpaste commercials.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) describes dental phobia as a “marked and persistent fear that is excessive or unreasonable”. It also assumes that the person recognizes that the fear is excessive or unreasonable. Conclusion? The DSM-IV criteria were obviously not decided upon by a representative group of dental phobics (read on to see why). Having said that, there is a new revised version coming out soon, so maybe the definition will have changed. You might be interested to learn that DSM-IV’s predecessor, DSM-III, defined homosexuality as a mental disorder. I’d hazard a guess that many if not most dental phobics would object to being labeled as having a mental disorder.
This is not to say that dental phobia cannot co-occur with mental health conditions – of course it can. Dental phobia appears to be more common in people who suffer from another mental health problem, notably Generalized Anxiety Disorder, panic disorder/agoraphobia, depression, and emetophobia. Research suggests that about 20% of dental phobics have a concurrent mental health problem. Then again, 25% of all British adults experience at least one diagnosable mental health problem in any one year.
The main problem with defining “dental phobia” is that there isn’t just ONE type of dental phobia, but many types – some rational, and some which seem more “irrational”. Bracha and others (2006, HI Dental Journal) have suggested that the term dental phobia is typically a misnomer, for much the same reasons I’m outlining here (you can find the abstract of their article at the bottom of this page). Whether the fear is “unreasonable”, “excessive”, or “irrational” is debatable… certainly not if you end up in the hands of the wrong dentist! Which, incidentally, is one of the reasons why people end up as dental phobics in the first place.
A distinction has been made between dental anxiety, dental fear, and dental phobia.
- DENTAL ANXIETY is a reaction to an UNKNOWN danger. Anxiety is extremely common, and most people experience some degree of dental anxiety especially if they’re about to have something done which they’ve never experienced before. Basically, it’s a fear of the unknown.
- DENTAL FEAR is a reaction to a known danger (“I know what the dentist is going to do, been there, done that – I’m scared!!”), which involves a fight-or-flight response when confronted with the threatening stimulus.
- DENTAL PHOBIA is basically the same as fear, only much stronger (“I know what happens when I go to the dentist – there’s no way I’m going back if I can help it. I’m so terrified I feel sick”). The fight-or-flight response occurs when just thinking about or being reminded of the threatening situation. Someone with a dental phobia will avoid dental care at all costs until either a physical problem or the psychological burden of the phobia becomes overwhelming.
Town Center Dental can help you get the professional oral care you need, while being sensitive to your fears of going to the dentist.
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