Fear is an individual’s emotional response to a perceived threat or danger. The response is composed of three related components: (1) An unpleasant cognitive state such as feeling something terrible is going to happen. (2) Physiological changes such as increased heart rate, sweating, hyperventilation, increased muscle tone. (3) Overt behavioural movements such as shaking, pacing, jitteriness, and attempts to escape or avoid the perceived threat.
Dental fear can come from different sources. It can result from direct negative experience in the dental environment in the patient’s past. It can result from negative experiences of a friend or family member. It can result from negative media coverage of dentistry. Most fear behaviours are not socially acceptable; however dental fears are socially acceptable. This social acceptability makes it easier for individuals to rationalise their fear behaviour. It makes it easier to develop and maintain the fear. It also makes the job of the clinician more difficult in any attempt to overcome the fear so that treatment may be facilitated.
Anxiety is an emotional experience similar to fear, but the source of threat to the individual is not immediately present. Anxiety is a reaction to non-immediate situations. We might often experience anxiety the night before an important match or examination.
A phobia is a special form of intense fear of clearly discernable, circumscribed objects or situations. Exposure to the phobic stimulus provokes an immediate anxiety response. If avoidance results or causes significant distress or interferes with one’s social or role functioning, the reaction qualifies as a phobia.
Reactions to dentistry can come in all degrees of intensity and rationality, some people have mild apprehension which causes little problem, while others may avoid attending for dental care until their pain is very severe. For good dental health access to and continuity of dental care is vital.
In surveys in the US and Europe up to 75% of the population are anxious in the dental situation. 15-20% report being fearful, while 2-6% reported avoiding dental care. The outcome of dental fear and phobia is a delay in seeking timely dental care. With this delay, which may be for several years, the treatment required is often more extensive. It also makes the dental visit more difficult for the patient.
