Extreme fear of the dentist linked to childhood trauma

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Few people enjoy someone else poking around their mouth. A recent study from the New York University College of Dentistry indicates that as many as three out of four adults dread going to the dentist. But for many people, even a routine cleaning can become a major issue if you contend with a diagnosis actually called dental fear. Acute instances of dental fear elicit intense psychological and physical reactions such as anxiety, sweating, heart palpitations, dizziness, nausea, and even dissociation.

It’s not only adults who deal with this problem, however. According to researchers at the Norwegian University of Science and Technology, as much as 20 percent of children and adolescents may meet the diagnostic criteria. Their findings, published in the journal BMC Oral Health, suggest that the phobia isn’t necessarily tied directly to the dentist’s chair. Instead, it may frequently be linked to childhood traumas like bullying, parental divorce, and abuse.

HUNTing for an answer

The authors reached their conclusions after analyzing data from the Trøndelag Health Study. Also known as HUNT, the project is one of the largest and longest ongoing health studies ever conducted. HUNT began in 1984, and is focused on amassing information from questionnaires,clinical assessments, and samples collected from residents in central Norway’s Trøndelag county over multiple generations.

For this study’s purposes, a team led by Center for Oral Health Services and Research, Mid-Norway, psychologist Lena Myran focused on survey responses from over 5,800 adolescents aged 13 to 17-years-old. The team compared the accounts of trauma to documentation of dental fear, and saw a marked connection between the two issues.

According to Myran, dental fear is easily understandable from a psychological perspective. But it’s also clear that dentistry’s inherent physicality exacerbates the issue. Myran said this is particularly difficult for people who experienced a great deal of childhood insecurity. 

“The patients lie on their backs in a vulnerable position while an authority figure works inside the mouth,” Myran explained in a statement. “It’s no wonder that dental treatment can be difficult.”

Unsurprising links

An adolescent’s chance of developing dental fear is also more likely if they have a more stressful past. Myran offered a history of bullying as an example.

“Bullying means being systematically rejected and ridiculed. If you have experienced bullying, you may have a hypersensitivity to other people’s intentions,” she said. “There may be periods during dental treatment where it is silent, and you do not quite know what the dentist is thinking.”

Myran added another takeaway that she says was as striking as it was unfortunately unsurprising: dental fear is far more common among girls than boys.

“We know that dental fear is more common among girls and that more girls than boys have experienced sexual abuse. There are also more girls than boys who develop anxiety and depression in adolescence,” she said. 

Even so, Myran said it was “still surprising” to note such a clear difference between the sexes.

Clear communication

The recent study does include a few noteworthylimitations.. Since the authors only examined possible connections between childhood trauma and dental fear, it doesn’t take other possible influences into account. For example, a disconcertingly painful procedure, may also influence the chances of developing the diagnosis. 

“It is also important to note that this is a cross-sectional study that does not provide a basis for saying what is cause or effect. We can only see if there is a connection,” said Myran.

Thankfully, there are strategies to address and mitigate dental fear. Myran and collaborators believe one of the best methods is to emphasize clear communication between a dentist and their patients. Even a brief mention of the issue from a patient can help alert professionals to take a more sensitive approach during treatments and examinations.

“Patients know that the dentist is not a psychologist, so it does not have to be a long conversation,” said Myran. “But by taking the patient’s experiences and fears into account, dental professionals can contribute to better dental health and safer patient experiences.”

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Andrew Paul is a staff writer for Popular Science.