Psychosocial aspects of dental and general fears in dental phobic patients

Abstract

Phobic reactions can often be a significant health problem for fearful dental patients. This is true in particular for individuals with long-time avoidance and elevated general psychological distress. The aim of this study was to investigate the expression of dental fear among 67 dental phobic individuals with a low versus high degree of general fear. Reported etiologic background factors, avoidance time, general psychological distress and psychosocial manifestations and consequences of dental phobia were studied. No significant difference in dental anxiety level between individuals with low versus high general fear was found, and both groups reported high frequencies of negative dental experiences. The low-fear group reported a longer (though not statistically significant) average avoidance time than the high-fear group. However, patients with a high level of general fear showed a significantly higher degree of psychological distress, and also reported stronger negative social consequences from their dental anxiety. These results indicate that the character of dental fear might be different between different groups of fearful patients, which makes the condition psychologically handicapping. Such aspects should be assessed in the diagnostic analysis of patients with severe dental anxiety. In particular, assessments of signs of general psychological distress are warranted.

The oral health of individuals with dental phobia: a multivariate analysis of the Adult Dental Health Survey, 2009

“…19 This will have an impact on QoL, 16,19,20 affecting their physiological, psychological, social and emotional wellbeing. 14,21,22 People with dental phobia showed higher scores for OHIP and OIDP even when levels of dental disease were controlled for.…”

Negative events and their potential risk of precipitating pathological forms of dental anxiety

“…Some examples of the first category involve (a) invasive dental treatments, for instance, root canal treatments or injections (see, for example, Abrahamsson et al, 2002;Berggren & Meynert, 1984;Davey, 1989;Liddell & Gosse, 1998;Locker, Shapiro, & Liddell, 1996;Moore et al, 1991;Stouthard, Rijkse, & Van den Berg, 1992;Vassend, 1993); (b) pain (see, for example, Abrahamsson et al, 2002;Berggren & Meynert, 1984;Davey, 1989;De Jongh et al, 1995;De Jongh, van der Burg, van Overmeir, Aartman, & van Zuuren, 2002;Skaret, Raadal, Berg, & Kvale, 1998;Versloot, Veerkamp, & Hoogstraten, 2008); (c) distress caused by dentist behavior (see, for example, Abrahamsson et al, 2002;Stouthard et al, 1992); (d) distressing emotional responses to dental treatment (for example, feelings of helplessness or loss of control; see De Jongh et al, 2002Moore, Brodsgaard, & Rosenberg, 2004); and (e) distressing stories told by important others (Abrahamsson, Berggren, & Carlsson, 2000;Moore et al, 1991). Examples of traumatic stressors reported by subjects with pathological forms of dental anxiety are (a) sexual abuse (see, for example, Leeners et al, 2007;Walker, Milgrom, Weinstein, Getz, & Richardson, 1996;Willumsen, 2004); (b) war trauma (Friedlander, Mills, & Wittlin, 1987); (c) severe traffic accidents (Smyth, 1999); (d) a tragic death of a loved one (Berggren, 1992); (d) a distressing medical experience (Lautch, 1971); and (e) physical assault (De Jongh et al, 2006;Walker et al, 1996).…”

Psychophysiological reactions in dental phobic patients with direct vs. indirect fear acquisition

“…Ost & Hugdahl, 1985;Davey, 1989;Locker, Shapiro, & Liddell, 1996;Poulton, Waldie, Craske, Menzies, & McGee, 2000). Dentally anxious individuals are however not a homogenous group regarding etiology and manifestations of their fear of dental treatment (Locker, Liddell, & Shapiro, 1999;Willershausen, Azrak, & Wilms, 1999;Abrahamsson, Berggren, & Carlsson, 2000). Rachman (1977) proposed three pathways to fear: conditioning, vicarious learning and exposure to negative information.…”