In general, all children are scared of the process of dental treatment, but some easily control their fear, whereas others don’t. Dentophobia, or fear of dentists, is found not only among children but also among adults.

It is mainly formed during childhood and, as a rule, remains throughout life if no measures are taken. If a child is not only afraid to treat their teeth, but also to go to the dentist, talk about the dental clinic or dental treatment, then in this case we’re talking most certainly talking about dentophobia.

 

Fear Intensity Levels

According to the intensity of the child’s emotions, there can be 4 types of fear distinguished.

1. Light Fear. When a child carefully examines everyone, asks the dentist about his every action, begins to make excuses that nothing hurts anymore. In this case, even though the child feels tension, he/she sits down on his/her own and doesn’t make any abrupt movements.
2. Moderate Fear. During this, the child does not agree to sit in the dental chair, cries; his breathing becomes rapid.
3. Strong Fear. In this case, the child completely rejects this process, may resort to aggressive actions; push, hit, bite the doctor.
4. A very strong Fear. A very strong fear. With this level of fear, it is nearly impossible to seat the child in the dental chair, because even the entrance to the dentist’s office is accompanied by loud screams and crying. There may be coughing, vomiting, and urination.

It is necessary to be aware of these levels, as it will be necessary to assess on the spot what level the child’s fear corresponds to.  In the case of the first two levels, it will be possible to treat the teeth with a special approach. However, when it comes to the next two levels, it will be more appropriate to postpone treatment until the child is psychologically ready. It should be noted that the difference between a phobia and a regular fear is that the fear can be controlled to some extent, while the phobia cannot.

Causes

Speaking of the reasons, we can note:

• Fear of feeling pain. It is connected with the instinct of self-preservation. Toothache is acute, and with the possible presence of this pain, the child’s self-preservation instinct activates.
• Fear of uncertainty. Often the child has no idea where he/she’s going and what’s going to happen there, and this uncertainty can cause anxiety.
• Feeling of distrust. In this case, the child is unsure that he/she can be understood by anyone. He is not sure that he will be able to talk to someone and be heard. In this situation, the level of anxiety increases, as the child doubts his safety.
• Previous negative experience. A bad experience can cause a child to have situations like a post-traumatic stress disorder, because it leaves certain traumatic consequences.
• Other people’s negative experience, which has been heard by the kid. Often the parents claim that their kid has never had a negative experience connected with a dental clinic, but after questioning the situation, they recall that their relatives had discussions about their negative experience in the presence of the child. This can also cause a child to experience situations similar to a post-traumatic stress disorder. Considering a child’s vivid imagination and incomplete knowledge of causal connection at this age, a child may imagine completely different situations from the stories above and come to the wrong conclusions.
• Incorrect preparation for a dentist’s visit.

Parents often admit that they didn’t tell the child where they’re going, and when the child finds out, this leads them to stress. In many cases, parents say that the child was informed about the visit to the dentist, but later it turns out that the child was frightened rather than reassured. When the child began to express disagreement at home, his parents manipulated and got angry at him. It should be noted that in this case, an increase in anxiety is inevitable.

• Parent’s anxiety.Certain parental behavior can be a reason for concern for the child. When a parent doesn’t know how the child will behave, or remembers their visits to the dentist in childhood, he involuntarily begins to behave differently; the child immediately notices this.
• Incorrect dentist approach.

Although pediatric dentists receive special training, sometimes considering various factors, the specialist may make certain mistakes, such as scolding the child, scaring the child by a joke, not sharing the child’s worries, blaming the parent in the presence of the child, etc. All the reasons mentioned above have a stronger impact when they are accompanied by such features of the child as stubbornness and disobedience.

 

Ways of Overcoming

1. Parental readiness.

Parents also need to be emotionally prepared for a dentist visit. The psychological state of the child often depends on the psychological state of the parent. If a parent behaves strangely, constantly tells the child not to be afraid, or doesn’t talk at all, this negatively affects the child. If the parent is also anxious, with the help of certain breathing exercises, he/she can regulate his situation and behave as usual.

2. Make all dental procedures positive in the eyes of the child.

This can be done by rewarding the child, so that the child agrees to these procedures. In no case should this be done through panic or telling scary stories.
It’s also a good idea to use different films, cartoons, where children and adults go to the dentist and successfully cure their teeth. Watching various social stories on this topic will also have a positive effect on the child. By visualizing this process, the child will no longer have a feeling of insecurity, and therefore the level of anxiety reduces. After the successful completion of the dental procedure, it is recommended to reward the child in many ways, so that the process is associated with positive feelings. For example, you can go to the store after the dentist and buy something.

3. Tell the truth with the right words.

When a child is repeatedly told that he/she isn’t going to feel any pain, but he trustingly experiences pain from an anesthetic injection, he/she develops distrust or thinks that he misperceives the sensation of pain. If this pain is not painful for the parents, but painful for him/her, then something is wrong with him/her, therefore, self-confidence is lost. These phenomena can be avoided if the following expressions are used in a conversation with a child: <<We are going to cure your teeth and they will be healthy, the doctor is going to help in this process>>, <<At the beginning of treatment, you will feel a slight pain in your mouth, but it will not last long >> you can compare this pain to the pain that the child has ever experienced so that he/she can correctly imagine the intensity of the pain. Don’t focus on the pain, but rather focus on the positive outcome and the reward promised at the end. It is strictly forbidden to use such expressions as: “Pull out a tooth”, “Remove a tooth”, “Inject” and so on. Expressions and words with a similar accent, due to the vivid imagination of children, frighten them even more.

4. Proper preparation for a visit to the dental clinic.

Be sure to warn the child about this in advance. He/She must know about it two or three days prior, so that he can control his anxiety and balance it if he has these skills. Detailed discussions about the upcoming visit with the child help a lot in reducing anxiety. Similar to building a picture of the future, you need to describe step by step how you are going to have breakfast that day, which road you will take, how you will enter the dental clinic, what color the walls will be, what scents, if you have a photo of a doctor, you can show it to the child. Step by step, demonstrate how the child will sit on the chair, open his/her mouth, see the light, fix the tooth, and then show how you are going to leave the dental clinic with your teeth already cured and go after the promised reward.

5. Role-playing game

Role play has a positive effect on reducing children’s anxiety. If you organize a game, in which dentists and patients will partake, this will leave a desensitizing effect and make this procedure more predictable for the child.

6. Introductory visit to the dental clinic.

Before registering for a specific procedure, it is necessary to visit and familiarize yourself with the dentist and the dental clinic. There are cases when, due to the distrust, the child allows the doctor to intervene only from the fifth visit. It is necessary to adapt to the pace and rhythm of the child and in no case do it by force. Of course, we are not talking about cases of whim, because in this case the promised reward and the fact that only a doctor can help the child cure their teeth help.

7. The right choice of the specialist.

If you have noticed that the specialist is rude, non-tolerant, does not have a positive attitude towards the child, then you can thank him, and without hesitation look for another specialist avoiding putting the psychological health of the child at risk.

8. Consultation with a psychologist/psychotherapist.

In case of severe fears and phobias, it is necessary to turn to mental health specialists, since only due to special intervention there is a way out of situations of this intensity and make the child’s visit to the dentist psychologically safer.

It is important to remember that we were all once children and had similar fears. And the feeling that someone understood us would give a pleasant sense of peace. Times have changed, but the spiritual world of a child hasn’t changed that much: therefore, by empathizing and listening, we will only have positive results for cases of visits to a dental clinic and not only.