Dental phobia is a more serious condition than anxiety. It leaves people panic-stricken and terrified. People with dental phobia have an awareness that the fear is totally irrational, but are unable to do much about it. They exhibit classic avoidance behavior; that is, they will do everything possible to avoid going to the dentist. People with dental phobia usually go to the dentist only when forced to do so by extreme pain. Pathologic anxiety or phobia may require psychiatric consultation in some cases.
The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable. If your dentist doesn't take your fear seriously, find another dentist.
Treatments for dental fear often include a combination of behavioral and pharmacological techniques. Specialized dental fear clinics use both psychologists and dentists to help people learn to manage and decrease their fear of dental treatment. The goal of these clinics is to provide individuals with the fear management skills necessary for them to receive regular dental care with a minimum of fear or anxiety. While specialized clinics exist to help individuals manage and overcome their fear of dentistry, they are rare. Many dental providers outside of such clinics use similar behavioral and cognitive strategies to help patients reduce their fear.
The good news is that more and more dentists understand their patients’ fears. With a combination of kindness and gentleness they can do a lot to make dental treatment stress free.
Karen Coates, a dental adviser at the British Dental Health Foundation, says the organisation’s dental helpline receives many calls about fear and phobia. "People who are scared of the dentist often call us for help because they’re at the end of their tether. Their teeth don’t look nice any more or they’re in a lot of pain with toothache, and they want to make the first step to seeing a dentist and getting their teeth sorted out.
Many people who suffer from dental fear may be successfully treated with a combination of "look, see, do" and gentle dentistry. People fear what they don't understand and they also, logically, dislike pain. If someone has had one or more painful past experiences in a dental office then their fear is completely rational and they should be treated supportively. Non-graphic photographs taken pre-operatively, intra-operatively and post-operatively can explain the needed dentistry. Pharmacologic management may include an anxiety-reducing medication taken in a pill, intravenously and/or using Nitrous Oxide (laughing) gas. Most importantly is the need to provide an injection of anesthetic extremely gently. Certain parts of the mouth are much more sensitive than other parts; therefore it is possible to provide local anesthesia (a "novocaine" shot) in the less sensitive area first and then moving the injection within the zone of just-anesthetized tissue to the more sensitive area of the mouth. This is one example of how a dentist can dramatically reduce the sensation of pain from a "shot." Another idea is to allow the novocaine time (5 – 15 minutes) to anesthetize the area before beginning dental treatment.