• Anxiety
• What is a phobia?
• Dental anxiety
• Nature or nurture?
• Coping strategies

Dental phobia can cause significant distress, but by learning to use these coping strategies, it may become ‘mind over matter’

Anxiety

Anxiety is a normal part of everyday life. However, when you feel it becoming something beyond your control, or out of proportion to the circumstances that caused the feeling, it can be described as an anxiety disorder and may need treatment, either through relaxation methods, alternative therapies or conventional medicine. Anxiety can trigger the stress response (otherwise known as the ‘fight or flight’ response) and is associated with physical and emotional symptoms such as hyperventilation, increased heart rate, palpitations, dizziness, nausea, increased sweating, and feeling tense, agitated, frightened and nervous.

What is a phobia?

While some degree of anxiety is perfectly normal, in some cases, extreme anxiety can become a phobia. A phobia typically involves a strong fear and avoidance of one particular type of object or situation. Direct exposure to the feared object or situation may cause a panic reaction. The fear and avoidance are strong enough to interfere with your normal routines, work or relationships and can cause high levels of stress.

Dental anxiety

Dental anxiety is rated as one of the most common phobias, along with others such as fear of heights, fear of flying, fear of people, animal phobia and elevator phobia. Dental phobias can begin as a fear of painful procedures (such as injections and fillings) that take place in the dentist’s surgery. Later it can develop to include anything related to the dentist. The danger is that one may avoid necessary medical treatment and suffer unnecessary stress.

Nature or nurture?

So, where does dental anxiety/phobia come from? Are we born with the tendency or do we see something that triggers a sequence of events for us? Does it start in childhood? Research shows three clear categories. Firstly, specific phobias are often childhood fears that were never outgrown. Secondly, they can result from conditioning, that is, they can develop after a traumatic event such as an accident, illness or visit to the dentist. Thirdly, they can develop as childhood modelling, that is, repeated observation of a parent with a phobia.
The good news is that a phobia is usually a benign disorder, particularly if it begins as a common childhood fear. Even though it may continue for years, it rarely gets worse and often fades as time goes on. The most popular methods of treatment for specific phobias are imagery desensitisation and real life exposure. However, using relaxation techniques and learning to take control of your own thoughts is a necessary and valuable place to start.

Coping strategies

The way in which you perceive a situation has a direct effect on your body’s reaction to that situation. If you perceive a situation or object as dangerous or threatening, or beyond your capacity to cope, you will trigger a stress response. This in turn triggers a release of adrenalin and cortisol, and the sympathetic nervous system increases your heart rate, breathing and blood pressure, causing feelings of panic. While this is happening, it is very difficult to think calmly or rationally. On top of the panic reaction are the irrational negative beliefs that cause you to lose confidence.

One way to combat this is recognising your own ‘self talk’. The next time you need to go to the dentist, simply ask yourself: “what am I saying to myself ... what thoughts are whizzing around my head”? On examination, it is likely that you will have been using negative language and engaging in negative thoughts. So you are already working yourself into a state and you are nowhere near the dentist. No matter what the dentist is going to do, you have already decided that it is going to be a terrible situation.

In short, you are responsible for how you feel (excluding any physical illness). It is very easy to blame the way you feel on someone or something else (in this case the dentist) rather than to accept responsibility for your reactions. The ability to accept responsibility for your own reactions and thoughts is an important step in taking control of your life.

Exercise: positive self talk

The next time you need to go to the dentist, or even if you are simply thinking about going to the dentist, try the following exercise. On a blank piece of paper, write down one typical negative thought that you might have when you think about the dentist. On the other side of the paper write a positive counterstatement. In other words, think of a positive statement about the dentist that you can believe in. Repeat this to yourself every time you begin worrying or thinking about the dentist. Repeat this exercise another three times so that you have four positive counterstatements in total to choose from each time you feel the anxiety building.

A few useful tips on writing counterstatements are:

• Keep them in the first person, e.g. “I...”
• Keep them in the present tense
• Be realistic: you must actually believe in them
• Keep them short and positive
• For example, a typical negative thought might be:

“I’ll never be able to stand the pain of a filling” or “what if I faint when I hear the drill?” A counterstatement might be: “I can talk to the dentist and I can ask her to stop at any time.”

Whether your anxiety is about dentists or aeroplanes your thoughts are the controlling factor. When faced with a potentially stressful situation, are you more likely to expect the worst? Or can you see yourself making the best of any difficult situation simply by asking yourself: “what are the facts?” … “Is this likely to happen?” and telling yourself: “I am in control”.

No matter what the situation, a simple positive command to your brain can turn a potentially stressful situation into one in which you are calm and in control.

As you make your next dentist appointment, take a deep breath, exhale slowly and tell yourself: “I can do this one step at a time”.