Odontophobia refers either to the fear of dentists (sometimes also called dentophobia), or the fear of dental treatment. It can also mean a fear of teeth! For the purposes of this short article, odontophobia is the fear of dentists or the fear of dental treatment.
People very commonly have some degree of anxiety relating to dentists and dental treatment, although this is not usual as severe as to be considered a phobia. For example, a number of studies in the USA have shown that, although as many as 75% of the population may exhibit a degree of anxiety relating to dentists, it is sufficiently severe to be called a phobia in less than 10%. Even so, that’s a lot of people! A study carried out in Australia (Armfield JM et al, (2006), Aust Dent J. 51 (1): 78-85) suggested that women report fear of dentists more commonly than men.
Other pages in this section on phobias on this website discuss the 5 reasons for the development of a phobia: severe past trauma; a series of minor traumas accumulating over a period of time; severe stress; fear of fear; learned from other people. Fear of dentists can develop for the same 5 reasons, but most commonly occurs because of the first of the reasons listed above: severe past negative, traumatic or painful experience. There is also some evidence to suggest that the personal manner of the dentists is also a contributory factor to the degree of development of odontophobia – with dentists considered to be more impersonal or less caring apparently creating a greater anxiety than dentists considered to be more caring or warm!
Fear of dentists can also develop from an accumulation of less serious negative experiences, or from hearing about the negative experiences of other people. As discussed on the ‘Causes of phobias’ page, a person experiencing a high level of stress may exhibit a phobia about something unrelated to the cause of the stress. This is true of fear of dentists, too – it is easy to avoid dentists!
As with other phobias, the symptoms fall into three groups: psychological; somatic (physical); avoidance.
People who suffer from a fear of dentists experience the same psychological symptoms as sufferers of other phobias: fear; strong desire to get away from the stimulus; inability to concentrate; feelings of distraction or dissociation.
The physical symptoms are the same as for other phobias: rapid heart rate; nausea; breathlessness; diarrhoea; faintness; dizziness; tremor; dry mouth; feelings of muscle weakness.
Avoidance is a very common feature of fear of dentists. People with odontophobia will not go to a dentist until they are driven to do so by a problem – usually the pain of a toothache caused by decay or an abscess. Some patients experience what is known as the cycle of avoidance: they avoid dental care due to fear until they have an urgent need (pain!); the need leads to treatment (rather than a simple regular examination; the minor trauma of treatment then reinforces their phobia, leading to further avoidance.
Medical treatment for fear of dentists usually consists of the use of benzodiazepine tranquillizers to reduce the anxiety and reduce the heart rate, or sedation in severe cases.
Behavioural techniques (cognitive behavioural therapy), guided imagery and relaxation techniques are all used in the treatment of dental phobia.
Desensitisation by progressive ‘in vivo’ exposure. Find a helpful dentist who will let you sit in the chair! (Inevitably, looking after your teeth properly so that your regular visits to the dentist require no treatment will reduce the fear because of the regularity you experience the phobic situation without adverse consequences.)
Hypnosis and self-hypnosis. My recommendation with all phobias is that they are more successfully treated by a trained therapist with the use of self hypnosis as support, than by use of self hypnosis as the sole therapy. Within that constraint, the forms of therapy outlined on the ‘treatments of phobias’ page on this site (link below) can all be used successfully: positive phobia replacement; positive visualisation; Hypno desensitisation; flooding; regression.