Anxiety is a big issue in todays’ society and everyone seems to have some type of it. There are different types of mental disorders related to anxiety, some among them are generalized anxiety disorder, obsessive compulsive disorder, and post- traumatic disorder. These are disorders that can be labeled. They are labeled from a list of physical and mental key traits that are recognizable. People who do not deal with a anxiety disorder, also deal with situations that cause anxiety that are induced. For instance, if someone is shy they can have social anxiety. Related to that category there are people who have dental anxiety. Having the thought of coming into the dental office and having some type of work done gets people anxious. It can be from a multitude of reasons. Some can be just stepping into the dental office, the sight of the front desk, the distinct smell of the dental office, and the sounds of the drill can place this anxiety and or fear in people. There is a reason behind having anxiety in the dental office and what is being done to minimize it.
Some people love going to get their teeth cleaned, others not so much. It is important to maintain good oral health, but why does it have to be an intimidating chore to go to the dental office.“Dental anxiety is characterized by a physical and or emotional response to a perceived threat.” Childhood experiences, environment, gender, and demographic are the factors that contribute to dental anxiety. It does not have to be physically known but can be the idea of an uncomfortable situation that causes feelings of uneasiness, and apprehension. The patients anxious thoughts could be the anesthetic shot, the patients’ TMJ (jaw pain) while keeping it open for a long time, and the idea of a long and expensive treatment plan. “ Dental anxiety is different than a fear and or phobia”(White, 2017, p.30). Fear is emotional and can take a physical approach to whatever we feel is threatening us in some way. “Psychological disorder is a syndrome ( a symptom collection) marked by a “clinically significant disturbance in an individual’s condition, emotion regulation, or behavior”(Myers, 2016, p. 528). This disturbance in the individual can take a toll on their life.
Like the fear of the dentist office results in the patient not coming in for routine checkups and usually not maintaining care at home. This results in further damage to one’s health. The person may think its no big deal but then when they come into a dentist office with a tooth ache then to find out the diagnosis would be a root canal or to pull the tooth, this isn’t ideal. “Anxiety disorders are marked by distressing and persistent anxiety and often dysfunctional anxiety- reducing behaviors” (Myers,2016, p.528). Generalized anxiety disorder is when a person is tense and uneasy without reason or with a reason. This can happen from time to time or everyday. Some people never leave their house due to having a anxiety attack. Panic disorders are when a person experiences panic attacks, which are sudden episodes of intense dread and fears. Panic attacks are minutes long episodes that give the thought that something bad is going to occur. These panic attacks can come at any time, so its very uncontrollable. When a person has a phobia, they can be extremely afraid of a specific object, activity, or situation. Specific phobias focus on animals, insects, heights, blood, closed spaces. “ Irregular heartbeat, chest pains, shortness of breath, choking, trembling, or dizziness”(Myers,2016, p.537). A phobia makes it where a patient wouldn’t want to come into the dental office because they experience all of this. The symptoms that we can look out for when trying to see if a patient is having any of these disorders would be that they continually worry, jittery, on edge, and are always tired form lack of sleep. “Furrowed brows, twitching eyelids, trembling, perspirations, fidgeting from autonomic nervous system arousal”(Myers,2016, p.537). It is stated that women are prone to have more anxiety than men, and it also decreases with age. It’s hard for people to figure out if they do have an anxiety disorder or just normal nervousness. This ties in with patients who have anxiety attacks before going into the dental office and while in the chair. “Those with higher anxiety receive less regular dental care”(White, 2017, p.31). Fear of the dentist or a doctor and the white lab coat makes this a sensory visual that can cause them to feel this way. “Stimulus generalization occurs when a person experiences a fearful event and later develops a fear of similar events.” Reinforcement helps maintain phobias. People get the feeling of relief when they cancel their appointment or never think about going to the dental office. Thus resulting in continuous missed appointments and adding to their disorder. Ultimately, never breaking the chain and their tooth health and or pain getting worse.
The health and science related to the brain is that our experiences change our brain pathways. Traumatic fear in the dental office when we were a child can cause a stop, leaving tracks on the brain. Our brain then creates fear circuits in the amygdala, these fears creates pathways and inroads for more experiences related to that particular fear. Antidepressant drugs help with fears related to different disorders. In the dental office dentists offer nitrous oxide also known as laughing gas. This helps relax the patient before the shot of anesthetic is given or while the procedure is happening. It is a little bit loud from the air so that can also contribute to the blockage of the sound of the drill and suctions. If a patient is having extreme anxiety and nitrous oxide is not a strong opinion for them, they can also take valium before the procedure. This drug paired along with the nitrous oxide gas helps people maintain calm, but they should not drive or go to work. To classify disorders and label people is to "predict a disorders future course, suggest appropriate treatment, prompt research into a disorder’s causes” (Myers, 2016, p.530).
There was a study done in the Netherlands and it included a total of 1,119 Dutch citizens. The experiment was based upon two different factors: invasive treatment by high stimuli and the non-invasive with low stimuli measured. 960 people were participating and out of this population, 437 scored at least one stimulus as the highest anxiety. 27 of the population were not used in the outcome because of unfinished research. “ Of the 960 remaining participants (response rate: 85.8%), 558 were female (58.1%) and 401 were male (48.8%); the gender of one participant remained unknown. The age of the respondents varied between 16 and 81 yr [mean=39.1, standard deviation (SD) = 15.3]” (Oosterink, De Jongh, & Aartman, 2008, p.45). Women more than men are more prone to anxiety in the dental chair and even in some research outside of dentistry it is stated as well. Younger people were seen to have more anxiety rather than older people. This could be due to the fact that older people have been though more experiences. For example, older people have been to the doctor and the dentist more. They have more life experience comparing to younger people. It would be biased to say they have had more work done because each person has a different case and oral health history. A younger person could not take care of their teeth compared to an older person and have more work done hypothetically speaking. This also intertwines with the other variables of availability of dental insurance and dental offices. “ Similarly, people with non-Dutch background rated a large majority of the stimuli as more anxiety provoking than their Dutch counterparts. These differences may be explained by the fact that people from foreign countries and non-western civilizations tend to utilize regular dental care less of” (Oosterink,et al., 2008, p.49). Part of the fear could be with people not being able to take advantage of the health care system and its benefits. In terms of financial means and the ability to understand the doctor/dentist and how he explains the procedure.
Leading to the procedures that were tested the most stimulating induced fear one would have to be dental surgery. Second place to that is “having some gum burned away”, which rarely happens in the dental office. Other procedures going down the list would be related to extractions, root canals, drilling in the teeth, anesthetic injections, and more. Also, containing examples of ours senses: smell, sight, touch, and sound. A lot of the stimulus that was rated by the Dental Anxiety Scale are similar in wording so it is hard to measure the severity of the data. “The same negative influence holds true for the wording of some of the items. While our ambition to be comprehensive may have resulted in apparently redundant wording of some items or show some overlap with that of other items, the wording of other items may in itself have caused a send of apprehension. An example is the description of an electrosurgical procedure in periodontal treatment (‘having some gum burned away’)” (Oosterink et al.,2008, p.50).
“Dental hygienists are in a unique position to assess patient comfort and to educate patients on dental anxiety and coping mechanisms”(White, 2017, p. 33). Dental professionals and them being aware of what their patients are dealing with may help to establish a trusting relationship. Patients then feel encouraged to come back to that specific office for routine care. Some people love going to get their teeth cleaned, others not so much. The sight of the dentist, the sight of the needle, the sound of the drill, and all the smells around does not make for a calming environment for some patients. It is important to maintain good oral health, but why does it have to be an intimidating chore to go to the dental office. Dental Anxiety is based upon childhood experiences, environment, gender, and the demographic.In conclusion, the dental office can be a scary place. Dental offices and personal are making patients experiences better than ever. Continuing to think and learn of different ways to improve the stressful situation which is coming for your 6 month checkup.