People may talk openly about their fear of heights or spiders. Those who are afraid of dogs may delight in telling you about the bite they got from the neighbor's pooch while walking home in third grade.
One phobia that may have a significant negative impact on a person's health is fear of going to the dentist.
In fact, a large Dutch study found that dental phobia was the most common phobia. (After that comes a phobia of heights and spiders.) While it may be possible to avoid high places and spiders, it really is best not to avoid the dentist, especially when you have a toothache.
Some surveys report that almost one in four people are afraid of getting a dental exam. In most cases, dental anxiety is unpleasant, but does not interfere with health.
People whose dental fear is severe, however, may so dread the thought of going to the dentist that they cancel appointments, delay seeking care, and sometimes wind up needing more invasive and painful procedures as a result.
Women are more likely than men to report experiencing dental fear and phobia. (The same is true with other types of anxiety disorders.) About half of adults who suffer from dental phobia can trace their fears back to unpleasant childhood experiences. Just the sight of a dentist's chair, the sound of a dental drill or the smell of certain chemicals can trigger memories.
There are drugs that may help reduce anxiety. They work best when used with various mental, educational and behavioral strategies — especially those that help you gain a sense of control in a situation where you may feel helpless.
Try some of the following techniques during your next dental visit. They're easy to learn, get better with practice and can be used together.
Dentists have gotten very good at making you comfortable before they start working on your teeth. Even procedures like root canal are not actually so bad. It no longer holds up as a metaphor for torment! What used to take several visits often now takes one — the tools are more refined and the treatments are more efficient.
There is no shame in being very afraid, however. Come armed with a few techniques that you can use. If one doesn't work, have a backup to try next.
Also, find a dentist who is patient with your fear. He or she can help you bear the few moments of discomfort before the anesthetic takes hold. Your teeth will thank you with every bite.
Dionne RA, et al., eds. Management of Pain and Anxiety in the Dental Office. (W.B. Saunders Company, 2002).
Loggia ML, et al. "Effects of psychological state on pain perception in the dental environment." Journal of the Canadian Dental Association. 2008; 74(7): 651–56.
Oosterink FM, et al. "Prevalence of dental fear and phobia relative to other fear and phobia subtypes. European Journal of Oral Science. 2009; 117(2): 135–43.
Peltier B. "Psychological Treatment of Fearful and Phobic Special Needs Patients." Special Care Dentist. 2009; 29(1): 51–57.
Simpson R, et al., eds. Hypnosis in Dentistry: A Handbook for Clinical Use (Charles C. Thomas, 1985).
Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.