Fear and anxiety about dental treatment and dentists are significant characteristics that lead to avoidance of dental care. The fear of visiting the dentist for preventive care and dental procedures is known as dental anxiety. According to research, dental anxiety is the fifth most common cause of anxiety. Dental anxiety can arise due to multiple factors, such as past traumatic experiences, learning from family members, lack of awareness, the vulnerable position of lying back in a dental chair, and frightening portrayals of dentists. 

A dental setting can also bring on anxiety, such as the sight of needles and air-turbine drills, the sound of drilling and screaming, the smell of eugenol and cut dentine, and the sensations of high-frequency vibrations.

Some common fears giving rise to dental anxiety are:

• fear of pain
• blood-injury 
• lack of trust or fear of betrayal
• fear of being ridiculed 
• fear of detached treatment by a dentist or a sense of depersonalization
• fear of mercury poisoning 
• fear of radiation exposure
• fear of choking and/or gagging
• lack of control during dental treatment

How to Manage Dental Anxiety or Phobia

Dental anxiety can be managed. Let your dentist know about your fears and open a discussion about your triggers of stress. Two-way communication is vital. The management of anxiety requires a good patient-dentist relationship. There are many ways to help people manage dental fear or phobia. It can help the dentist work with you to tailor a management plan for you.

Some techniques that can help you come out of your dental anxiety include:

• A deep breathing relaxation technique
• Distraction- visual and auditory distractions, such as TV, computer games, and 2-D and 3-D video glasses.
• guided imagery is a directed, deliberate daydream technique that uses all senses to create focused relaxation
• Biofeedback: It is a mind-body technique that provides patients in gaining self-regulation of the physiological process being monitoring
• Progressive muscle relaxation
• Establishing a break signal with your dentist during treatment
• Hypnosis
• A psychologist can also help you overcome your dental anxiety. Short, targeted psychological therapies like cognitive behavioral therapy are successful.

An individual with severe dental anxiety or phobia may sometimes require medical management with relative analgesia (happy gas), anxiety-relieving medication, conscious sedation (twilight sedation), or general anesthesia.

Relative Analgesia (happy gas)

Nitrous oxide, or happy or laughing gas, can help people with dental anxiety relax during dental treatment. During the procedure, you will be allowed to inhale a mixture of oxygen and nitrous oxide. Within a few minutes, you will feel relaxed, and the effect will wear off quickly.

It is possible to speak with the dentist and hear what they say, but after the procedure, you may not remember everything the dentist has told you.

Anxiety relieving medication (oral anxiolytic tablets)

To help anxious patients relax, dentists and doctors sometimes prescribe anxiolytic (anxiety-relieving) drugs (such as temazepam). You should only take these medications after speaking with your dentist or doctor. 

However, you may need someone to accompany you or drive you home after the procedure as you cannot safely drive a car under the influence of sedative medication.

Conscious sedation

This sedation involves administering sedatives through a drip placed into an arm or hand vein. A trained dentist will carry out the procedure in the presence of an anesthesiologist. During the sedation, you are relaxed and may drift off into a light sleep. However, you can respond to verbal prompts. You may feel nauseous and tired after the procedure and so should not drive yourself back home after IV sedation. 

General anesthesia

The dentist and an anesthetist administer treatment under a general anesthetic in a hospital setting. General anesthesia involves a patient being asleep for the duration of the procedure. Patients under general anesthesia may experience nausea and a longer recovery time.

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About the Author:

Suprithi Choudhary, M.Pharm (Pharmacology) Medical Content writer

Suprithi is a Pharma Professional working as a medical content writer and previously worked as a Research Scientist and Senior Research Analyst

Education

• C.M Academy
• Attended the Panjab University- Chandigarh, Pharma post-graduate in Pharmacology

Special thanks to Dr Deepak Kulkarni, a dental surgeon with over 23 years of experience who proofread this blog. He graduated from the H.K.E's Dental College, Gulbarga, and has certifications in ACHS International Accreditation Education Plan; Advanced Rotary Endodontic - Restorative Continuum; and Leadership, Team Building and Customer Service Leadership from the Oscar Murphy International.