Dental Fear, Anxiety, Phobia

INTRODUCTION
Introducing the topic of dental fear, anxiety, and phobia in pediatric dentistry involves
understanding the unique challenges and considerations when working with children in a dental
setting. Dental anxiety refers to a feeling of unease or nervousness that individuals may
experience before or during dental procedures. In pediatric dentistry, this anxiety can be
particularly pronounced due to children’s developmental stage, lack of familiarity with dental
procedures, and fear of the unknown.
Dental fear can range from mild apprehension to severe phobia, where the fear is so intense
that it interferes with the child’s ability to receive necessary dental care. Pediatric dentists often
encounter varying degrees of fear and anxiety in their young patients, which can pose
challenges to delivering effective treatment.
Several factors contribute to dental fear and anxiety in children, including previous negative
experiences, fear of pain, sensory sensitivities, and the influence of parental anxiety.
Additionally, the unfamiliar environment, sights, sounds, and smells of the dental clinic can
further exacerbate a child’s anxiety.
Subjective fear and maternal anxiety are associated with children’s reactions at their first dental
visit. Maternal anxiety is a prominent factor in children’s reactions. Negative attitude towards
physicians and previous pain experiences also contribute to children’s reactions. Children of
lower socioeconomic status may exhibit more negative behavior. It is recommended to avoid
extensive treatment during the first visit, except for emergencies or non-invasive procedures.
Building trust with the child during the initial visit is crucial. Parents should familiarize their child
with dentistry to ease fears. Counseling parents on moderate attitudes and behavior can lead to
well-adjusted children.
Educating children on dental treatment can lead to a positive dental experience. Dentists can
control the environment of the dental office to create a welcoming and comforting atmosphere.
Understanding the nuances of dental fear, anxiety, and phobia in pediatric dentistry is essential
for dental professionals to provide compassionate and effective care tailored to the unique
needs of young patients. By creating a supportive and nurturing environment, pediatric dentists
can help children overcome their fears and develop positive attitudes towards dental health.
1
DEFENITIONS OF DENTAL FEAR, ANXIETY, PHOBIA and CRY
Dental Fear:
- Defined as a feeling of apprehension or uneasiness before a dental visit or procedure
- Can be triggered by past negative experiences or fear of pain
Dental Anxiety:
- Refers to a more intense feeling of worry or fear related to dental treatment
- May cause physical symptoms such as sweating, increased heart rate, or trembling
Dental Phobia:
- Dental phobia is an extreme and irrational fear of visiting the dentist
- Can lead to avoidance of dental care, which can have negative consequences for oral health
Dental Cry:
- Different types of cries, such as obstinate, frightened, hurt, and compensatory cries, can be observed in
children during dental visits
- The dentist’s role is to provide a supportive and structured environment to help children cope with
their emotions.
2
TYPES OF DENTAL FEAR
Objective fear:
- Based on child’s own experiences
- Produced by direct physical stimulation
- Responses to stimuli that are felt, seen, heard, smelt, or tasted
Subjective fear:
- Developed based on somebody else’s experience
- Without actually undergoing dental treatment
- Retained in child’s mind from parents’ unpleasant experiences
TYPES OF DENTAL FEAR BASED ON DIFFERENT AGE GROUPS:
3
Factors in Etiology and Perpetuation of Fear in Dentistry:
I. Factors involving the child:
- Genetic, familial, cultural, interpersonal, and psychic factors influence growth and development
- Emotional maturation along with physical growth
- Behaviour affected by genetic makeup and new experiences
II. Factors involving the parents:
- Maternal anxiety and attitude towards dentistry can influence child’s fear
- Family influence and parent-child relationship play a role in perpetuating fear
III. Factors under the control of dentist:
- Environment of dental office, personality of dentist, scheduling of appointments, and dentist’s skill and
speed can impact fear
- Use of fear promoting words, flattery, praise, and reward can affect child’s fear
- Presence of parents in operatory and fear of medical appointments can also contribute to fear
Overall, a combination of child, parent, and dentist factors can contribute to the etiology and
perpetuation of fear in dentistry. It is important for dentists to be aware of these factors in order to
effectively address and manage fear in their patients.
1. DETERMINANTS OF DENTAL FEAR
4
The following factors generally determine dental fear:
 Dental behaviour management problem
 Mother-Child relation
 Temperament
 Pain and anxiety
 Predictability and controllability
 Gender and age.
 Communication
 Age of onset
 Culture, ethnicity and socioeconomic status.
 Physical disability
 Genetics
 Determinants related to dentist.
 Psychosocial and emotional determinants.
TYPES OF DENTAL ANXIETY

5
THE PREVALENCE OF FEAR AND ANXIETY
6
The prevalence of fear and anxiety related to dentistry varies between countries, ranging from 5
to 20 percent among children. In India, there is limited epidemiological data on dental anxiety
and fear.
In 1997, a study by Rao et al. found that 51 percent of students aged 17 to 22 had some fear of
dentistry, with females and dental students being more fearful than males and medical
students.
Another study by Pramila M and Murthy AK in 2010 reported a 23.4 percent prevalence of high
dental fear among 12 to 15-year-old school children.
Ekta AM and Ajithkrishnan CG’s research in 2011 revealed that approximately 41 percent of
patients waiting for dental treatment in outpatient departments (OPD) were dentally anxious.
Females and individuals living in villages exhibited higher dental anxiety than males and city
dwellers.
Marya CM et al.’s study in 2012 indicated that the prevalence of dental anxiety was 50.2
percent, which was higher than the prevalence of dental phobia (4.38 percent). Most of the
anxious patients fell within the age group of 20 to 30 years.

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INTRODUCTION

- Can be triggered by past negative experiences or fear of pain

- Dental phobia is an extreme and irrational fear of visiting the dentist

- Based on child’s own experiences

- Produced by direct physical stimulation

- Responses to stimuli that are felt, seen, heard, smelt, or tasted

- Developed based on somebody else’s experience

- Without actually undergoing dental treatment

- Retained in child’s mind from parents’ unpleasant experiences

TYPES OF DENTAL FEAR BASED ON DIFFERENT AGE GROUPS:

I. Factors involving the child:

- Emotional maturation along with physical growth

- Behaviour affected by genetic makeup and new experiences

II. Factors involving the parents:

- Family influence and parent-child relationship play a role in perpetuating fear

III. Factors under the control of dentist:

1. DETERMINANTS OF DENTAL FEAR

TYPES OF DENTAL ANXIETY

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