When we think of fears, we often associate them with heights, spiders and axe-wielding clowns. Some people experience severe anxiety when faced with large crowds or tight spaces.

Truly, there are all types of fears, both rational and irrational. A problem only arises when those fears interfere with healthy life functions. It’s OK to be afraid of spiders, but when that arachnophobia becomes so great you won’t enter a building that has a single web on its eaves, then the fear becomes problematic.

One extremely common fear that can carry heavy consequences is dentophobia – fear of the dentist. I personally suffer from this phobia.

Sure, hardly anyone enjoys visiting the dentist, and most don’t look forward to dental appointments. However, those with dental phobia, also known as odontophobia, can become so terrified at the mere thought of a dentist that they will do anything to avoid even a checkup.

They might even put off routine visits for years or decades, which can lead to pain, gum disease, cavities and even broken teeth. By the time they are in such emergent need they can’t help but visit the dentist, their visit is far more traumatic than any regular checkup could ever be.

Does any of that sound familiar? It’s no surprise. According to Colgate and the Columbia University College of Dental Medicine, 30 to 40 million Americans avoid the dentist because of anxiety and fear.

Likewise, the British Dental Health Foundation claims 36 percent of those who don’t see a dentist regularly cites fear as the primary reason. That’s a huge chunk of the population at a greater risk of gum disease and tooth loss. Among that group, however, are another 3-5 percent of the general population whose high levels of fear can be debilitating to the point that they suffer severe oral health problems, according to Comprehensive Clinical Psychology.  

Like many fears, dental phobia can be based on negative experiences. I had two abscessed teeth when I was just barely 3 years old, I and can still see what to a toddler was a gigantic needle heading into my mouth. That vision is associated with pain, and it’s never really diminished.

Dental trauma is actually less likely to be a cause of dental fear and phobia, however. Instead, visiting the dentist evokes fears of being trapped, getting an injection, seeing blood or even intrusions into personal space. 

Often, dental phobia results from negative depictions of dental appointments in literature or media. How often have we all heard a complex or difficult task compared to a root canal?

While those with dental phobia might have generalized concerns about visiting the dentist, more often they have specific worries, such as fear of pain or fear of an injection. For the most part, however, dental fears fall into the following categories:

1. Fear of the Dentist

Some people suffer from iatrophobia – fear of doctors, and the dentist certainly would fall into that category.

But dentophobia can also be specific to a fear of the dentist. Just like root canals have become associated with pain and suffering, the dentist is often cast as cold, unfeeling or even sadistic – as if he or she enjoys causing patients pain.

Dental patients who have had a bad experience with a particular dentist can be prone to this fear. Whether they believe it or not, many dentists have mastered customer empathy, and they really do want to keep the experience as painless to the patient as possible.

2. Fear of Pain

While new ways of managing dental pain are growing more common, painless dentistry has not been the traditional norm. Some procedures still involve some pain, and some people are particularly prone to mouth pain. In fact, the fear of dentist-related pain is more common in adults aged 24 and older – probably because their earlier visits to the dentist were before advances in “pain-free” dentistry.

While the fear of pain can be worse than the pain itself, that fact does little to ease the fears of those suffering from true dentophobia.

3. Fear of Numbness

People who have ever experienced choking or difficulty breathing might grow afraid of having their mouths numbed. They might fear they will be unable to breathe or swallow, or having their mouths numbed might simply cause them to relive their past traumatic experiences – even if it had nothing to do with the dentist.

4. Fear of Sounds and Smells

Many people are uber-sensitive to certain sounds or smells. The sound of the dentist’s drill is one memory of past dental experiences that can have a lasting impact on a patient’s psyche. The thought of the drill might cause so much anxiety they avoid visits to the dentist, or they might become so panicked at the sound of it – even in the next room – that they skip future appointments.

5. Fear of Needles

Plenty of people are terrified of needles – especially when they are inserted into the mouth. That needle can look enormous heading into a patient’s mouth. Beyond fear of needles themselves, others fear the side effects of anesthesia, which can include dizziness, nausea or simply fear of the “fat lip” associated with local anesthetics.

6. Fear of Lost Control

Many people develop phobias associated with a loss of control, including fears of riding on an airplane or undergoing surgery. A similar phobia can impact dental visits.

Once patients are in the dental chair, they have to sit still while objects they can’t even see very well are stuck into their open mouths. They might not know what to expect, and this feeling of helplessness can trigger a phobia. The dentist’s chair can also create anxiety associated with claustrophobia or agoraphobia, or it can aggravate obsessive compulsive disorder.

7. Fear Associated with Embarrassment

Plenty of people feel shame or embarrassment to have a stranger looking inside their mouths. After all, the mouth is an extremely personal space, and they might be self-conscious about their own smiles.

Unfortunately, this is one fear that exacerbates itself. They feel embarrassed, so they avoid the dentist, which causes oral health problems, which leads to more embarrassment, etc.

The truth is their dental problems are unlikely to be any worse than plenty of other patients. If they only knew how many of the most beautiful A-list celebrities have had major dental work, including dental implants, bridges and veneers!

8. Fear from Previous Trauma

While it’s surprisingly not the most common cause of dentophobia, previous trauma is also a cause of fear. Anyone who has had pain or discomfort during a dental procedure is bound to be anxious during their next visit.

But sometimes, these memories can scar a person for life. Trust me, I can still see that needle heading into my 3-year-old mouth like it was yesterday; and I can still feel the fear of realizing the dentist was going to yank out my little baby molars. Ouch! I can’t even imagine the anxiety for someone who had a far more painful experience.

In addition to new technologies that contribute to more “pain-free” dentistry, many dentists now provide a variety of ways to ease patients’ fears and anxieties. They might offer pre-treatment conditioning to help patients overcome their phobias.

During these office visits that occur before their actual exams and procedures, patients are invited to visit the dentist’s office, talk with assistants and hygienists and even briefly sit in the dental chair. By walking the patient through the steps they can expect during their upcoming procedure, dentists alleviate the fear of the unknown, which can bolster confidence levels.

Other practices to alleviate dental anxiety and fear include:

  • Distractions – Calming music, televisions and even aquariums are placed in the dentist’s office waiting room and procedure areas to distract patients from what is going on in their mouth.
  • Oral Medication – If patients are afraid to even visit the dentist and indicate feelings of panic, the dentist might prescribe pharmaceuticals, including mild sedative agents, in order to boost relaxation. These medications can be prescribed for the patient to take the night before the dental appointment or on the day of treatment.
  • Relative Analgesia – Nitrous oxide, better known as “laughing gas,” has long been used by dentists to sedate anxious patients. Relative analgesia is administered by fitting a mask to patients’ faces, and they inhale a mixture of oxygen and nitrous oxide. The patients remain fully conscious but become relaxed and less sensitive to pain. While alert enough to answer the dentists’ questions, they often won’t remember much after the visit ends.
  • Fail-safe Signal – The minds of dental patients who fear losing control can sometimes be eased if the dentist establishes a fail-safe signal with them. For example, they can establish a signal to use if the patient feels pain, at which point the dentist would stop what he or she is currently doing. The signal is often as simple as raising a hand, and it can allow patients to feel more control over their situation.
  • Dental innovations – Technological advances in the field of dentistry can alleviate the pain and injections many patients fear. For example, the DentalVibe Injection Comfort System can be used in place of the traditional Novocain injection, so dentists don’t have to “hurt” patients in order to avoid causing even greater pain. The instrument uses a state-of-the-art VibraPulse technology to send soothing vibrations into oral tissue during an injection.

“As dentists, we are often so focused on our technical skills that we lose sight of one of the most important aspects of the practice of dentistry — the patient’s perspective,” wrote New York College of Dentistry’s Steven Goldberg, who actually invented the DentalVibe. “As patients become more aware of advances in pain-free dentistry, widespread odontophobia will begin to decline. Treating patients with the utmost concern for their fear, anxiety, and comfort will prove to be a win-win situation for both the patient and the dentist.”

Have you experienced fear of visiting the dentist? What steps did you take to overcome it?