Psychopathology, feelings of confinement and helplessness in the dental chair, and relationship to the dentist in patients with disproportionate dental anxiety (DDA)

Abstract

Nineteen individuals with inordinate fear of dental treatment are presented and discussed with respect to their psychopathology and those aspects of their fear involving feelings of confinement and helplessness in the dental chair, and a negative relationship with the dentist. This material is part of a comprehensive investigation previously reported by the authors into the components and factors contributing to this kind of fear, and the personality and emotional reactions of the individuals suffering from it. The data presented are based on single structured interviews of each patient. Analysis of the patient population suggests division into four major categories: those in whom fear of dental treatment was associated with feelings of inferiority in bodily appearance or function (the largest category); those in whom the fear was associated with neurotic disturbances in which disturbance in body image is not apparent; those in whom the fear was a reflection of a schizophrenic or schizoid process; and those in whom no overt psychopathology was found. The patients in the first category were those who tended most to be afraid of dental treatment due to feelings of confinement or helplessness in the dental chair, or due to a negative relationship with the dentist.

The prevalence of dental anxiety across previous distressing experiences

“…Individuals who have experienced this are two and a half times more likely to experience HDA than those who have not independent of other experiences. This feeling of helplessness is strongly related to the sense of confinement reported by others (Seeman & Molin, 1976). The inability to communicate easily while treatment is being conducted exacerbates these feelings.…”

Prevalence of dental anxiety and its relation to age and gender in coastal Andhra (Visakhapatnam) population, India

“…[7] In the investigations of DA since 1960s, the occurrence of DA has been attributed to many factors: Personality characteristics; traumatic or painful dental experiences in childhood; learned attitudes toward dental services that elicit fear from dentally anxious family members or peers (vicarious learning/modeling) perception of body image: Blood-injury fears: Coping styles (vigilant, avoidant and emotion-focused): And pain reactivity. [891011] It has been found that Dentist's communicative styles as well as perceived technical competence were predictive of levels of DA during treatment. [12]…”

What are people afraid of during dental treatment? Anxiety‐provoking capacity of 67 stimuli characteristic of the dental setting

“…Quite a large number of studies have been conducted to identify the potential anxiety-provoking stimuli present in the dental setting. These stimuli include receiving an injection (15,16), having dental X-rays taken (17), the sight of the needle (18)(19)(20)(21)(22)(23), various aspects of the drill, such as sight, sound, smell and sensation (8,(23)(24)(25), negative behaviour of the dentist (14,(26)(27)(28)(29), pain sensations (4,23,(30)(31)(32), and several other potentially fear-evoking aspects present in the dental practice (e.g. the smell, the dental personnel, and the chair; [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”