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Dental Anxiety, Phobia Often Starts At Childhood. Here's How To Manage A 'Deep Fear' Of The Dentist

Close up of dentist holding angled mirror and hook while examining a patient. (Getty Images)
Close up of dentist holding angled mirror and hook while examining a patient. (Getty Images)

Sarah DeOpsomer’s fear of the dentist started in her childhood.

DeOpsomer, who lives in Bozeman, Montana, says the dentist didn’t give her numbing agents like novocaine when she was a child in England.

“The recollection of that pain has never left me,” she says.

Christine Washowich of Petaluma, California, says when she first sat in a dentist’s chair at 5 years old, she panicked when the dentist made her mother leave the room before he pulled a baby tooth.

“No numbing,” she says, “I can still hear the tooth being pulled.”

Dozens of listeners wrote in to Here & Now saying their anxiety started as a child. Many also responded to say their distress is triggered by the sounds and smells of drilling and metal against teeth, invasion of a tool going in their mouths, shame from getting a poor report back on their dental hygiene, the cost of going to the dentist without insurance and even attending dental school.

Lisa Heaton, a clinical psychologist in Seattle and a member of Dental Fear Central, studies dental dread. For 13 years, she worked in a specialized dental fear clinic at the University of Washington School of Dentistry to treat people who were fearful and even phobic of going to the dentist.

Dental Anxiety Vs. Dental Phobia

Dental fear is a common issue that many people struggle with, she says. Only about 10% of U.S. adults have dental phobia, she says, but some studies suggest as many as 75% have some amount of anxiety about going to the dentist.

Dental anxiety ensues when you experience symptoms of anxiety — your heart races or your hands tremble before or during your dentist appointment — but you make it to the chair, like Mary Ann Mason of Seattle.

More than two decades ago, Mason had gum surgery. Since then, she says just thinking about it makes her heart race.

“Sometimes when I’m in the dentist chair, I’ll even start crying uncontrollably,” she says.

On the other hand, people with dental phobia are “so fearful of the dentist that the only time they can bring themselves to go is when they’re in really significant pain,” Heaton says. “And that pain sort of overrides the fear.”

Because of the pain, dental phobia typically prevents people from eating foods they enjoy or partaking in activities they normally would engage in out of embarrassment of their teeth.

In the days leading up to an appointment, Justin O’Dell of Versailles, Kentucky, experiences nausea, insomnia and a constant feeling of dread. O’Dell says if he thinks he can handle the consequences, he’ll put off the appointment for years.

The oral health consequences of skipping appointments can become dire. First, Heaton says, dentists don’t get the opportunity to catch tooth decay before it worsens. Cavities, if not caught in time, can become larger and more painful without regular cleanings and can potentially lead to a root canal procedure, she says.

It’s not just cavities: Gum disease, if not treated, can cause tooth loss. Dentists also regularly screen for signs of oral cancer, which can be caught at an early stage with regular dentist appointments, she says.

How To Prevent Childhood Fears From Carrying Into Adulthood

Fear stemming from childhood is very common, Heaton says, so much so that studies show about 75% of adults with dental fears say it was caused by a negative childhood experience.

“If your earliest experiences with something are all negative and painful and scary, that’s something that can very often stay with you into adulthood,” she says.

Janine Duffy from Arlington, Massachusetts, had a harrowing experience with her braces as a kid. Teeth removal and cleanings — really any procedure at the dentist — “put a deep, deep fear in me,” she explains.

The American Academy of Pediatric Dentistry recommends that parents bring their kids to the dentist by the first year of age or when the first tooth appears, Heaton says. It may sound early — your child might only have one single tooth — but it’s important for two reasons: to ensure the teeth are coming in properly and without decay, she says, and to expose your child to the dentist early.

“Bring the kids to the dentist when it’s easy and it’s fun and they’re just taking a ride in the chair and they get a toy afterward,” she says.

Communication Is Key

Janni Hansen of White River Junction in Vermont blames her dental fears on being a redhead.

“It is well documented that redheads have a low tolerance for pain, especially in the mouth,” she says. “I, like most redheads, need more medication to block the pain. Sometimes I do cancel an appointment days ahead because I am too anxious.”

People with red hair have a gene variant called melanocortin 1 receptor, Heaton says. While there aren’t a lot of studies on the topic, she says one study that looked at individuals with this gene variant found redheads were much more likely to report dental fear and avoidance — most likely out of concern for numbing and pain.

Heaton encourages people to be transparent about their pain tolerance with their dentist and inquire about different types of anesthesia.

“It makes everything much easier for everybody involved, especially the patient, but also for the dentist when the patient is nice and numb and comfortable,” Heaton says.

There are also different types of sedation to help relax you in the dentist’s chair, like nitrous oxide, otherwise known as laughing gas. Benzodiazepine like Valium or Xanax is an option, or IV sedation, a deeper form of sedation usually reserved for long procedures.

Many Here & Now listeners wrote in to say their dentist didn’t have patience or compassion for their dread. Like any health care provider, some can be better at connecting with patients and more understanding than others, Heaton says.

The good news, she says, is dental schools have adapted over the last few decades. Now, dental students are trained by experts who understand dental fear and teach students the tools they need for putting a fretful patient at ease.

To help cope with the fear, Heaton says if you don’t currently have a dentist, ask trusted friends and family who they go to. That’s the best way to find the right match, she says.

She also encourages people who have dental anxiety to initiate a conversation with the dentist ahead of an appointment, whether over the phone or in person, to discuss concerns. The dentist can walk through options to make the appointment more comfortable.

When sitting in the dentist’s chair — you made it! — dwell on the positive outcomes of your decision to prioritize oral care. Reframing your mindset during the appointment or setting up a small reward once you’re done may help get you in and out with ease, she says.

“You can have a candy bar,” she says. “Just brush your teeth afterward.”

Marcelle Hutchins produced and edited this interview for broadcast with Jill RyanSerena McMahon adapted it for the web.

This article was originally published on WBUR.org.

Copyright 2021 NPR. To see more, visit https://www.npr.org.