The anxiety patient

Horror at the thought of pain

The actual causes of a dental phobia can be totally diverse. Most of the affected persons have made very bad experiences with a dental treatment. Of course they don�t want these bad and painful experiences in the dentist�s chair to be repeated. Basically the dentist who is often insensitive and does not respond to his patient and his dental treatment also add to the development of dental phobia to a great extent.

But also injections, drilling noise, medical malpractices and the sterile smell inside the dental practice as well as the face mask and the rubber gloves and the pain during the treatment are crucial for this. Therefore the normal protective mechanisms and of course defensive reactions frequently occur. Also, furthermore certainly none of us wants negative experiences to be repeated.

Basically the mind should prevail over feelings. In the case of people without dental phobia this applies. But in the case of patients with pathological dental phobia this doesn�t work. In this case the pain, or also the psychological strain, have to first of all become unbearable before the last resort, going to the dentist, is adopted. As this is almost considered an emergency the dental treatment will also be conducted according to this. Therefore the circle is closed and has created another space for a negative experience and confirmed the phobia.

But not only children and grown-ups who have made negative experiences when going to the dentist suffer from dental phobia. People who have not yet made any experiences at the dentist also suffer from this phobia. In this case fears were stirred by means of gruesome reports and the rejection of the unknown was dreaded.

Overcoming fears

Before taking psychotherapeutic measures into consideration all other methods should be exhausted.

The phobia patient should procede as follows:

• In order to avoid the visit at the dentist from being unpleasant and a new scary experience the patient should only go to the dentist if he does not have any afflictions. This positive experience can reduce the fears.
  
  
• Fear, anxieties and horror from the treatment should be disclosed to the dentist.
  
  
• The patient feels less powerless and at the dentist�s mercy if he asks for short breaks before his panicky fears.
  
  
• It is appropriate to consult a dentist who offers alternative treatments. Above all in this case acupuncture, hypnosis or also electric stimulation.
  
  
• Muscle relaxation, autogenic training, meditation or also yoga are possibilities a phobia patient can acquire in order to deal better with their dental fears.
  
  
• Parents can consult specially trained pediatric dentists for the treatment of overanxious children.

What can a phobia patient expect from a dentist?

• The phobia patient should undergo a treatment as fast as possible. The appointment has to be made in such manner that no time pressure occurs.
  
  
• Many people suffer from this phobia. The patient has to receive the message that he is not alone, that his condition is not considered abnormal and that he doesn�t have to be ashamed because of it.
  
  
• Special emphasis is placed on giving comprehensive information on all measures of treatment. Schedule the required time and most especially limit surprises on the dentist�s chair to a minimum.
  
  
• Playing music is considered very calming and relaxing by many patients.
  
  
• In order to conduct the dental treatment as pain-free as possible local anaesthesia should be employed even for minor procedures. The injection site of the shot should always be anaesthesized superficially.
  
  
• Post-treatment care with suitable painkillers always has to be ensured.

What can be done if all else fails?

In many cases the most gentle methods don�t work for pathological phobia patients. The Dentist and the patient have reached the end of the line and are at a dead end.

In this case the only resolution is possibly psychotherapeutic attendance. The behaviour therapy is applied as a very effective measure in this case. Hereby the fear is overcome by exposing thoughts and fears.

Of course many patients don�t want to succumb to their phobia even more and therefore wish to conduct the dental treatment under general anaesthesia. As a dental treatment under general anaesthesia always implies a sanitary risk it should only and exclusively be employed in special exeptional cases.

An example is an extensive, complete dental reconstruction. As the acutal fears of a dental treatment are not reduced by means of a general anaesthesia it is of no use from the psychotherapeutic point of view.