Fear of visiting a dentist is pretty common amongst us and can result in delaying or avoiding dental treatment.
Avoiding the dentist can result in the worsening of dental diseases, a greater need for emergency care, or more complicated procedure. (1)
Dental anxiety is common and can affect people of any age. When dental anxiety is severe and results in irrational fear and complete avoidance of going to the dentist, it can be classified as dental phobia.
For people who avoid dentists, sedation dentistry may take away some of their anxiety. Sedation can be used for everything from invasive procedures to simple tooth cleaning.
There are strategies to help you cope with dental anxiety. Let’s continue on this article to find out more about these coping mechanisms.
What is dental anxiety?
It can be associated with specific triggers such as needles, drills, or the dental setting in general.
Some mental health conditions including generalized anxiety disorders, depression, post traumatic stress disorder, bipolar disorder or schizophrenia, or a previous history of head and neck trauma can increase the risk of a person experiencing dental anxiety. (3)
Signs and symptoms of dental anxiety
People with dental anxiety may experience:
- Racing heartbeat or palpitations
- Low blood pressure and possible fainting (syncope)
- Visible distress, crying, or signs of panic
- Withdrawal, or using humor or aggression to mask anxiety
Causes of dental anxiety
Dental anxiety can be caused by:
- A traumatic dental experience or other health experiences
- Previous trauma to the head and neck
- Other traumatic experiences, including abuse
- Generalized anxiety, depression, or posttraumatic stress disorder (4)
- The view that the mouth is a personal area and accessing the mouth is an invasion of personal space
- Fear of loss of control
- Trust issues
- Anxiety associated with other conditions
What is sedation dentistry?
Sedation dentistry uses medications to help patients relax during dental procedures. Patients are usually awake except for those who are under general anesthesia.
Sedation dentistry may also be appropriate for people who:
- Have a low pain threshold.
- Can’t sit still in the dentist’s chair.
- Have very sensitive teeth.
- Have a bad gag reflex.
- Need a large amount of dental work completed.
How to manage dental anxiety?
There are many ways to help people manage dental anxiety. Open discussions around the individual triggers of stress can help the dentist work with you to tailor a treatment plan for you.
Referral to a psychologist can be helpful too. Short-targeted therapies, including cognitive behavior, can be very successful.
There is a wide array of medications and techniques- used alone or in combination- that can reduce or eliminate pain and control anxiety during most procedures. (5)
Some coping methods that can assist some individuals include:
- Deep breathing
- Distraction (such as listening to music)
- Guided imagery
- Progressive muscle relaxation
Severe dental anxiety or phobia may require management with the following:
1. Relative analgesia/ Nitrous oxide
It is also known as inhaled minimal sedation or ‘laughing gas.’ It is a combination of nitrous oxide and oxygen, which you breathe through a mask placed over your nose.
It takes effect within a few minutes and wears off quickly, but it can help people relax during dental treatment. (6)
This is the only form of sedation where you may be able to drive yourself home after the procedure
2. Anxiety relieving medications
A dentist might prescribe oral anxiolytic tablets to help anxious patients relax. Short-acting, small, single dose is usually taken 1 hour before the dental appointment.
The pill will make you drowsy, although you will still be awake. This type of anesthesia is most commonly associated with sedation dentistry.
You will need somebody to accompany you to and from the dental visit as you cannot safely drive a car while under the influence of anxiolytic medication.
3. Conscious sedation
This type of sedation involves receiving medication through a drip placed into a vein of the arm or hand. This method allows the dentist to adjust the level of sedation.
Under IV sedation, patients are relaxed and may drift off into a light sleep, but they can respond to verbal prompts. Patients should not drive themselves home after IV sedation.
4. General anesthesia
General anesthesia involves patients being ‘fully asleep.’ While you are under GA, you cannot easily be awakened until the effects of the anesthesia wear off or are reversed with medication
It works best when used in conjunction with other strategies so that some treatments can be done without GA.
Some possible side effects include nausea and longer recovery time than other forms of sedation.
Take away message
All of us have experienced some degree of anxiety before a visit to the dentist. Some of us are so scared and anxious about going to the dentist that they prefer not to have any treatment at all.
There are several medications available that can help create more relaxed, comfortable dental visits.
You and your dentist can discuss several factors when deciding which drugs to use for your treatment: the type of procedure, your overall health, history of allergies and your anxiety levels are considered when determining which approach is best for your particular case.