Odontophobia: the extreme fear of the dentist and its treatment.

Some people feel great discomfort at the thought of going to the dentist. This can damage their health.

You have had discomfort in your mouth for a long time, your gums bleed, you have been postponing your annual oral cleaning for more than three years and you are accumulating tartar, you think you may be starting to develop periodontitis, and you know there is only one way to solve all this, there is no other way... but just by imagining it, you panic, insurmountable fear, you try to convince yourself that it is not really necessary to go and you are willing to endure this situation rather than go to a dentist's office.

In this article we are going to talk about a phobia that is much more common than you might think: odontophobia, the irrational fear of going to the dentist.a problem that can trigger several serious health complications.

What is odontophobia? Differentiating between anxiety and phobia

As we have commented previously, odontophobia is the irrational and persistent fear of going to the dentist. To be considered a phobia, this fear must last for at least six months.

We should point out that it is not the same thing to talk about the anxiety that we can all feel before going to the dentist (something very common in society, not only in children) and another thing to talk about a phobia of the dentist (odontophobia). Whether we like it or not, sometimes going to the dentist is uncomfortable because of the invasive intervention that is usually done, since the mouth is a very sensitive area. It is normal and adaptive that in some way our organism detects that there is a "danger", and as a consequence anxiety is activated to "flee" or to "fight". However, odontophobia is something much more serious for the person who suffers from it, since it negatively affects the quality of his or her life. negatively affects their quality of life..

A differentiating element between having a simple state of anxiety and having odontophobia will be the extent to which the person actively avoids going to the dentist even though it is really necessary to go. A very appropriate analogy to understand this is to compare it to airplane phobia. Many people feel anxiety before flying, but it does not go any further and they get on the plane without the need for alternative measures. People with a phobia of flying will avoid boarding an airplane as much as possible, and whenever possible they will take alternative transportation, even if this is objectively detrimental to them (financially, in terms of time, etc.).

In the case of the person with odontophobia, he/she will, as far as possible will avoid going to the dentist at all costsWhile the person with anxiety will face it without giving it much importance, in spite of the discomfort or pain that he/she may feel.

Symptoms of extreme fear of the dentist

People with odontophobia are generally afraid of invasive procedures (pricking, surgery, tooth extraction, anesthesia, drilling...). They experience great anxietywhich can lead to increased sensitivity to pain. Some authors relate odontophobia or dental phobia to SID (Blood-Injection-Damage) phobia.

They are afraid of suffering pain, and in some cases they are afraid of having a panic attack at the time of the intervention. As a consequence of fear, patients often tense their muscles, including those of the face.including those of the face. Sometimes there may be a hypersensitivity to the choking reflex, especially in men. Choking occurs when trying to introduce objects into the person's mouth or pressing on the throat, making medical intervention difficult or impossible.

In the most severe cases of odontophobia with hypersensitivity to the choking reflex the stimuli that generate choking are amplified: thinking about the dentist, the smell of dental utensils, brushing teeth, wearing high collars, etcetera.

Causes

In general, the causes of any specific phobia, such as odontophobia, can be explained by three important factors (Barlow, 2002): Biological vulnerability, generalized psychological vulnerability and specific psychological vulnerability. We are going to focus especially on specific psychological vulnerability, since it is usually the one that plays the most important role in odontophobia.

This would be related to a direct negative learning experience, based on direct conditioning.. More specifically, it would be the typical scene of a child going through a negative experience at the dentist and thereafter conditioning the dentist with the pain or phobic stimulus, and generalizing to other stimuli (e.g., white coat, the smell of the dentist, seeing the materials...).

Logically, the severity and frequency of these negative experiences (feeling that every time we go to the dentist we have a very unpleasant or moderately negative experience) and an infrequent exposure to the situation after the negative experience (increasing the frequency with which we go to the dentist due to the aversion and fear it generates in us: avoidance) are the most important variables for the development of this specific phobia.

Fortunately, nowadays dentists' interventions are less invasive and less painful. than a few years ago, as a result of technological innovation and the use of finer and painless tools.

How can it be overcome? Treatment

The Live Exposure is one of the most effective treatments for dental phobia or odontophobia. If the person has an uncontrollable fear, it may be useful to start with imaginary exposure exercises or watching videos about dentists, to continue with live exposure when the patient feels more prepared.

During the live exposure it is important that the patient feels that he/she has the possibility to control the feared stimulus through signals previously agreed with the dentist (e.g., deciding when he/she wants to be pricked, stopping the drill). It is important that there is a high degree of predictability, i.e., that the patient is in control of the situation and knows what is going to happen at all times.

Obviously, it is better that the client chooses a dentist he trusts. and have special empathy towards the difficult situation that the person is going through, because surely his intervention will require patience and special care. The dentist must explain the procedures to be followed, what the next step will be, and apply the appropriate anesthesia for each case.

In cases of odontophobia it is also it is also useful to train the patient in controlled breathing or applied relaxation.(especially when the somatic reactions of intense fear produce muscular tension or throat tightness).