Dentistry: Dental phobia |24 July 2021
In the following interview, DrBibhakar Ranjan talks to us about dental phobia, some of the main reasons behind this condition in adults and children, how the patients are managed, as well as his advice to people who have dental phobia.
Dr Ranjan has been working as the principal dentist at ‘Dr Murthy’s Family Medical & Dental Klink’ at Anse Aux Pins for more than two years. He has diverse experience in general dentistry for more than eight years.
Seychelles NATION: Tell us about dental phobia.
Dr Ranjan: I often hear multiple times in a day from my patients that they are scared of the dentist or dental clinic and sometimes they laugh about it or apologise for saying that to me, thinking as if saying that to me will hurt my feelings. I never feel bad about it, though I always empathise with their anxiety issues.
Dental anxiety is a term that is commonly used to describe anxiety, stress or fear to be in a dental clinic. Often this anxiety to be in front of the dentist or to be in a dental clinic results in delayed dental treatment.
This particular anxiety is often associated with certain triggers like dental drills, white doctor’s apron, injection needles, masks, or the general dental setting.
When this dental anxiety becomes severe and the patient completely avoids going to the dental clinic, it can be classified as dental phobia.
Seychelles NATION: What are some of the signs that a person has dental anxiety ‒ phobia?
Dr Ranjan: In my many years of practice in dentistry, I have noticed there's a huge number of patients who have dental anxiety. Surprisingly in many countries, most of the patients who have dental anxiety are young children, but in Seychelles I have noticed even adult male and female patients are equally affected by dental anxiety.
Most of these patients show signs of:
- Heavy breathing
- Complains of chest congestion
- Facial and palm sweating
- Increased heartrate
- Crying or panic before the dental treatment
- Regularly canceling or missing dental appointments
- Fainting on a dental chair or in the dental clinic.
Seychelles NATION: What are the main reasons behind dental anxiety in children and adults?
Dr Ranjan: I have spokento many patients in Seychelles and other countries who have dental anxiety issues to understand the root cause of their problem. Most of them often tell of their ''past traumatic experience'' at the dental hospital or at the school dental clinic. These traumatic memories often leave young minds scarred for the rest of their lives, and they avoid going to the dental clinic.
There is also the young patient who has never visited a dentist in their lifetime but is still scared of the dentist after listening to their siblings and peer's experiences with the dentist.
There are also many patients who have a “fear of loss of control” when they are stuck on a dental chair with their mouths wide open.
With Covid-19, I have also come across a new line of a patients who have anxiety of contracting Covid-19 if they visit the dental clinic. In the past, those who had ''obsessive-compulsive disorder'' about cleanliness were also scared to sit on dental chairs.
Patients with claustrophobia or other mental conditions also often find themselves in a stressful situation sitting in a small dental operatory.
Seychelles NATION: Which age group is more prone to dental anxiety‒ phobia in Seychelles?
Dr Ranjan: In my everyday practice, I get to see a very less number of child patients, but almost every child patient (age group 5-15) that I come across, shows some sign of dental anxiety.
Surprisingly, many adult (age group 20-55) patients, male and female, were having extreme dental anxiety issues because of their past dental experiences,so they kept avoiding the dentist, and this only worsened their dental health. Many researchers around the world call it a “vicious cycle of dental anxiety.”
Seychelles NATION: How do you manage patients with dental anxiety ‒ phobia?
Dr Ranjan: As I mentioned earlier, there are many trigger points behind dental anxiety or phobia. An open discussion between the patient and the dentist will definitely help the dentist to manage such patients.
Many a time we need to rope in another psychological specialist to deal with any deep-rooted issues regarding anxiety.
Otherwise, whenever I come across any dental anxiety patient in my practice,I often apply some techniques such as:
- Deep inhalation and exhalation technique
- Short guided meditation
- Sound therapy (listening to any soothing music)
- Positive and negative reinforcement in the case of young children
- ‘’Tell, show, do‘’ is a psychological technique for young children
- Friends and family’s words of advice and motivation in adult patients
In minor anxiety cases, most of the patients can be managed by making them understand the importance of their oral health and how much their reluctance to accept treatment is affecting their oral health.
I also notice that patients really open up about their anxiety and phobia to dentists who show some sign of empathy towards them and really willing to help them in improving their oral health in a staged manner.
Sometimes in severe anxiety cases, the patient has an option of conscious sedation or general anesthesia to make them calm and cooperative so that the dentist can perform their treatment without any problem. Conscious sedation or general anesthesia can be administered by an anesthetist in an operation theater setting.
Seychelles NATION: How does dental anxiety affect our nation's dental health?
Dr Ranjan: Many developed countries around the world focus on early detection and prevention of oral diseases. This helps in reducing the overall health expenditure of the government and also to those individuals who have to pay from their own pockets.
Those patients who have dental anxiety often avoid going to the dentist for many, many years. This results in worsened dental conditions and often requires complex dental treatment. It not only affects the patient’s oral health, but also increases the burden on their pocket.
Many a time, patients with anxiety issues visit the dental clinic only when they have extreme pain, swelling or difficulty in eating, which often makes the job of dental professionals difficult in terms of saving the tooth.
Seychelles NATION: Do you have any suggestions for those with dental anxiety – phobia?
Dr Ranjan: By avoiding your fear or by not dealing with the root cause of the phobia, most of the patients are often devoid of dental care for many, many years. This often leaves them with irreparable damages or conditions which are very difficult to be treated.
I would suggest that all of these patients go for regular dental checkups, teeth cleaning and diagnostic x-rays are a must and helpful to the dentist to find any dental problems early so that it will be a simpler and less invasive treatment.
Most dental diseases are because of bad lifestyle choices and often these lifestyle choices lead to diabetes, hypertension and chronic pulmonary disease. So I would suggest that every patient goes for screening as early as possible to detect any oral or systemic disease.
For more information, contact Dr Ranjan:
- Telephone: 2 590 728
- Email: firstname.lastname@example.org
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