Insights Into Dental Anxiety

***UPDATED: November 30, 2015*** A recent study has confirmed that cognitive behavioral therapy can help with a range of psychological problems, including the reduction of dental anxiety. The study was published in the British Dental Journal and included the analysis of 130 patients who attended a psychologist-led CBT clinic. Participants were assessed prior to the clinic, identifying levels of dental anxiety, general anxiety, depression, suicidal thoughts, alcohol use and oral health-related quality of life. After receiving cognitive behavioral therapy, nearly 80% went on to receive dental treatments without the need for sedation. The average number of CBT appointments required before a patient received dental treatment without sedation was five, according to a recent Science Daily article. Professor Tim Newton, lead author of the study, said “People with dental phobia are most commonly given sedation to allow them to become relaxed enough for a short period of time to have their dental treatment performed. However this does not help them to overcome their fear in the long term. The primary goal of our CBT service is to enable patients to receive dental treatment without the need for sedation.”

Visiting the dentist is not usually on the top of anyone’s list of fun things to do, but for some, going for a simple cleaning and exam is considered far more difficult than for others. Suffering from dental anxiety (DA) is a very real condition, and it can cause extreme fear for those afflicted. According to research conducted by  Dr. Victor Carlsson of Sahlgrenska Academy at the University of Gothenburg in Sweden, the condition is more common than you might think. As a part of his doctoral thesis, Carlsson found that about 20% of the common population can be regarded as dentally anxious, with about 5% having severe DA. He also found that DA is more common among women and the numbers seem to decline among the middle-aged and elderly. But there is a light at the end of the tunnel, as his research also found that cognitive behavioral therapy might also provide some relief.

According to a recent article from Dentistry Today, adults who suffer from severe DA are often dissatisfied with their appearance, especially in regards to their mouth, teeth and face. It comes as no real surprise that this dissatisfaction may be caused by poorer oral health, depression and anxiety and is also associated with poorer quality of life.

“People with severe DA are often trapped in a vicious cycle that begins with avoidance of dental care,” claimed Carlsson. “The next stage is poorer oral health, often followed by a sense of shame and withdrawal from social intercourse.”

As part of his research, Carlsson found other studies that have shown that approximately 93% of individuals with DA reported at least one psychosocial consequence such as poorer relationships in their social and working life, while 84% reported psychological reactions, such as anger, shame and depression. Many DA sufferers regularly avoid dental care and subsequently have been found to have high levels of decayed surfaces and teeth, missing teeth and periodontal disease.

Another interesting correlation between DA and attention deficit hyperactivity disorder (ADHD) was also found. In fact, patients who reported that they suffered from ADHD and fear of dental care were among those with the most severe DA and reported very low self-rated oral health.

“Since ADHD is associated with anxiety in general, it is not so surprising that it is also associated with DA,” Carlsson added. “Difficulties with organization and restlessness may also increase the difficulties in managing the dental treatment situation.”

While Carlsson admitted that more studies are needed, his work found that the use of cognitive behavioral therapy (CBT) is effective in treating severe DA. Patients receiving therapy at a specialized DA clinic have reported decreases in the frequency of tension headaches and stomach problems along with a reduction in the abuse of alcohol. Carlsson believes that patience is key when working with patients who suffer from DA, especially if it accompanies a diagnosis of ADHD. These individuals have a poor prognosis in regards to oral health, and working through this debilitating fear is crucial to receive maximum results.

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