In this blog we will discuss the symptoms, causes and treatment of Odontophobia.
An intense fear of teeth or dental surgery is called as Odontophobia.
It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.
Someone suffering from this type of specific phobia will be fearful of visiting a dentist or seeing his own teeth.
The sufferer experiences extreme anxiety when they see teeth or are told to have a dental surgery.
Just the thought of their fear stimuli can instigate anxiety and lead to panic attacks if the condition worsens.
Odontophobia is one of the most common phobias.
Children, or even adults are fearful of going to a dentist because of the tools used in a dental procedure or the pain caused.
Because the anxiety is so intense, one tries to manage it by avoiding their fear stimuli. They take all the necessary precautions to avoid going for a dental surgery or looking at teeth.
This avoidance, though seems an easy way to escape from an anxiety causing situation.
However, in reality it proves to be harmful for someone suffering from Odontophobia.
This avoidance justifies one’s fear of teeth and dental surgery because, the pleasant feelings it produces prove to the sufferer that the stimuli is to be feared of.
Thus, one can develop OCD in the long run.
According to the DSM-V, this anxiety and avoidance affects one’s social and occupational functioning.
For example, one might avoid visiting a dentist for surgery or a dental checkup because they feel terrified, even if a surgery is necessary for them.
Because of this, they might develop other health issues.
Someone will be deprived of going to school or office because of their bad health.
Odontophobia is referred to as a dental phobia. It is an irrational fear of teeth or dental surgery.
Symptoms of Odontophobia
People with Odontophobia, like in all other specific phobias experience intense anxiety when exposed to teeth/dental surgery or by just thinking about encountering them.
They’re unable to control this anxiety and thus, end up feeling more anxious. This anxiousness, in extreme cases can give rise to full-blown panic attacks.
Sufferer goes into flight or fight mode because of an adrenaline rush.
In this state, the body’s physiological responses help one make decisions when in fear causing situations.
They either decide to escape the situation (flight) or stay and combat their fear (fight).
One can also suffer from ‘white coat hypertension’. In this phenomena, one’s blood pressure rises’ to a significantly high level upon seeing a doctor.
According to the DSM-V, one must suffer from anxiety lasting for at least 6-months.
Symptoms one suffers from in Odontophobia, including anxiety are as follows:
- Extreme anxiety when exposed to teeth or a dental surgery
- Extreme anxiety when thinking of undergoing a dental surgery
- Ignoring signs of an illness/bad oral hygiene
- Claiming to be healthy in order to avoid a doctor’s visit and dental checkup
- Refusing to see a dentist for a dental checkup/procedure.
- Inability to control anxiety
- Full-blown panic attacks
- Increased heart rate
- Muscular tension
- Excessive sweating
- Screaming/crying when being taken for a dental surgery
Out of these, one should experience at least 3-5 symptoms, including anxiety, to be diagnosed with Odontophobia.
Causes of Odontophobia
Odontophobia, like all other specific phobias has no known cause.
These types of phobias can be a result of a number of factors such as biological (genetics) and or environmental (past experiences or social learning).
Genetics refers to the genes and neurotransmitters in our body. Someone with a family history of a phobia/mental disorder has a higher chance of having the same or different disorder in the future.
This is because the genes of the parents are transferred to their children, thus any alteration in the genes of ones’ parents is inherited by the child.
This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.
According to this, one with a genetic predisposition will not develop symptoms of Odontophobia until and unless there is some trigger event, instigating anxiety or fear of doctors.
A trigger event can be for example, an unpleasant childhood experience while having a dental surgery.
As a child, one might be scared of the injections or medical tests a doctor does in order to check the patient before or during a surgery.
Or, in the past, one might’ve had an incident where these tests caused some sort of physical or mental harm to the child. Thus, they fear dental surgery.
In the worst case scenario, media reports or movies also often show how some dental surgeries go wrong, which leave a lasting effect on the patients’ health.
Odontophobia can also occur along with other disorders, such as Nosophobia (fear of diseases), Dentophobia (fear of dentists), Iatrophobia (fear of doctors) or needle phobia.
Therefore, it is evident that Odontophobia can be caused by both genetics and or environmental factors.
Treatment of Odontophobia
Odontophobia, like all other specific phobias has no exclusive type of treatment that is specifically designed to treat it.
Like all the other specific phobias, Odontophobia is treated by a number of different therapies including, Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms.
• Cognitive-Behavioral Therapy (CBT)
It is one of the most frequently used treatment for patients with almost all kinds of mental disorders.
Odontophobia is defined as the irrational fear of dental surgery/teeth. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.
The patients are helped out in analyzing and justifying the way they feel about having a dental surgery/getting exposed to teeth.
Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts.
The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.
The ABCD stands for:
i. A (antecedents) a situation or triggering event.
ii. B (belief) the thought that comes to one’s mind when in that triggering situation.
iii. C (consequences) the symptoms/feelings caused by that event/thought
iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to dispute/challenge those irrational beliefs.
This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.
• Exposure Therapy
It is one of the most frequently used ways of treating patients with Odontophobia (or any other kind of specific phobia).
In this therapy, the patient is exposed to the source of his fear over a certain span of time.
To begin with the therapy, the therapist exposes the patient to the least triggering stimuli, a picture of a dental surgery’s procedure for example.
As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further.
In this part of the treatment the patient is asked to visualize/imagine a situation in which he is undergoing the surgery himself.
During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.
Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to a real dentist clinic and either undergoes the dental surgery himself or watches someone else have it.
While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises.
These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation.
This teaches them how to remain calm when exposed to the fear stimuli.
Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patients fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes.
However, these steps desensitize one to their fear of dental surgery/teeth, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.
• Mindfulness-Based Stress Reduction (MBSR)
MBSR is a meditation therapy, is used to manage stress or anxiety. It is an 8-week program which includes group sessions.
Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.
In mindfulness meditation the person is told to, for example to focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.
This distracts the person’s attention from something stressful to something which is neutral and soothing.
For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.
• Dialectical Behavior Therapy (DBT)
This is another effective therapy used to treat Odontophobia.
It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobias.
Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group).
i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.
The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.
Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.
ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.
Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then.
For example, a person is told to focus on his breath or on the smell of a certain food presented to them, making use of their olfactory sense.
iii. The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.
Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.
Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.
They are not just one of the many treatment therapies used for Odontophobia, instead they are one of the most common ways of relaxation used by many people.
Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.
Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.
Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.
The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts of dental surgeries/teeth.
• Drug Therapy
Drugs are used to reduce the physical symptoms caused by Odontophobia.
Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken.
This type of biological treatment is usually more effective if the cause of the phobia is only genetic.
However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.
Two types of drugs are used in the treatment of this phobia:
i. Anti-anxiety Drugs
Medicines like Klonopin are anti-anxiety drugs.
They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.
ii. Antidepressant Drugs
These drugs, as the name suggest don’t only treat depression but are also very effective in treating phobias.
Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm.
They need to be taken on a daily basis but not without a doctor’s advice.
Whether the cause of Odontophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).
Titles to read
- Stop Fear from Stopping You: The Art and Science of Becoming Fear-Wise
by Helen Odessky
- Badass Ways to End Anxiety & Stop Panic Attacks! A counterintuitive approach to recover and regain control of your life
by Geert Verschaeve
- Science of Yoga: Understand the Anatomy and Physiology to Perfect your Practice
by Ann Swanson
- How to Overcome Fear of the Dentist: A Patient’s Guide to Understanding Dentistry
by Bertrand Bonnick Dds Magd Ddocs Afaaid and Kaye Bonnick Mba
Frequently Asked Questions
Q1) Is dental anxiety real?
Dental anxiety also known as dental phobia is real and one of the most common phobias.
Q2) How can I reduce dental anxiety?
By consulting a health professional, one can overcome his dental anxiety.
Effective therapies used to treat anxiety include exposure therapy, CBT and or medicinal drugs.
Q3) What are the symptoms of Odontophobia?
Extreme anxiety, panic attacks, nausea and or increased heart rate are one of the many symptoms one experiences in Odontophobia.
Q4) How is Odontophobia caused?
One develops Odontophobia as a result of some genetic predisposition or an unpleasant past experience of dental surgery.
This environmental trigger, along with genetics can cause Odontophobia.
Examples of other interesting phobias