Dental Anxiety: Fear of Going to the Dentist

One of the most widely spread forms of fear in every day life is the fear of going to the dentist. A psychological understanding of this fear might be helpful in handling those patients who are subject to it. This fear may be slight or it may take the form of an excessive dread of anything being done to the teeth; but it is doubtful if it is ever completely absent in any patient. This type of fear may be termed dental anxiety and in some cases is so prominent and exaggerated that it becomes an obsessive anxiety concerning the teeth, to such an extent that any dental surgery, no matter how minor, or even dental prophylaxis treatment, may be so postponed or procrastinated that the inroads of disease may affect the entire dental apparatus.

It seems that this fear is a true form of anticipatory anxiety because it is not motivated by pain or anticipation of pain. It may occur even when nerve blocking is used or the patient anticipates it. Therefore, this anxiety has a deep psychological meaning entirely independent of any dread of dental manipulation. In some cases it becomes actually what may be termed a tooth neurosis.

In order to understand this dental anxiety, the subject of anxiety in general must first be discussed and then its particular application to dental treatment of whatever nature. Anxiety is the reaction to a specific danger-situation, either a real danger-situation from without or an internal danger-situation from within. All anxiety is related to expectation and its predominant symptom is that of dread. A real anxiety situation is a danger which is known, something which is definite and has a specific object, such as a dread of an accident; the danger which is unknown is neurotic anxiety and it is unknown because the individual in whom this anxiety occurs is unaware of the unconscious basis and motivation of the anxiety. In all anxiety, whether real or neurotic, certain protective devices are utilized in order to defend the individual from danger because,