Fear of dentists and needles needs sympathetic ear

By Philippa Roxby
Health reporter, BBC News

Image caption,
A needlephobe's ultimate nightmare...

Nobody enjoys going to the dentist. But for some people their feelings of anxiety can turn into fear and even a fully-blown phobia.

Dentophobia is an extremely common affliction. Around 12% of us suffer from extreme dental anxiety and the British Dental Association says that 25% of the British population suffer from some sort of anxiety before visiting the dentist.

Phobias of needles and blood can also prevent people from going to see their GP, from being treated in hospital and from having certain medical procedures.

Whether the dentist's drill or doctor's needle is to blame for these anxieties, avoiding them puts your long-term health at risk.

The term "phobia" is derived from the Greek word phobos meaning 'flight', 'panic-fear' and 'terror'.

A phobia is more than just an anxiety. It is an excessive fear of a particular type of object or situation which sufferers then try to avoid at all costs. This kind of fear is often exaggerated and disabling.

The Royal College of Psychiatrists' website says: "Your life can become more and more dominated by the precautions you have to take to avoid the things that scare you. You will usually know that there is no real danger, you may feel silly about your fear, but still find that you can't control it."

Rational reaction

Dr Jennifer Pinder, a dentist in London, has been treating dental phobic patients for over 30 years. She says it's vital to find out exactly what someone's phobia is and then deal with it in a sensitive and sympathetic way.

She has dealt with people who have a fear of the drill, fear of gagging and fear of needles and pain, among other things.

Only when their teeth look really awful, begin to disintegrate or their breath has got seriously bad do phobics finally realise that a visit to the dentist is unavoidable, she says.

"People keep saying it's irrational, but phobias are actually a rational reaction to pain and fear," Dr Pinder says.

Image caption,
Relax, you won't feel a thing...

"People are often embarrassed and ashamed about it. I hear the words 'shame' and 'guilt' all the time."

She helps patients overcome their embarrassment by making time for them to talk about their fears, encouraging them to email her with a description of their feelings before their appointment.

Then it's a case of managing their anxiety and offering a range of pain-free treatments.

Dr Pinder uses a new implement called The Wand, which covers the needle and controls the speed at which the flow of anaesthetic is given to the patient. She finds it helpful for needle phobes and pain phobes.

She also welcomes a new device which cancels out the anxiety-provoking drill noise - but not the dentist's voice - and believes it will help more people overcome their fear.

At present, her patients often bring along a personal music player to take their minds off the treatment. She also offers hypnotherapy and counselling.

Although phobias are a worldwide phenomenon, poor dental health is a noticeable problem in the UK. Compared to countries like the US, Dr Pinder says, "education on oral hygiene is not as good and flossing levels are much lower".

Phobics who avoid dentists tend to live with constant pain from infections and gum disease and there are often social effects from the phobia too.

"Dentophobes stop going out, stop seeing friends and even start to keep away from their partners if they have poor oral hygiene," says Dr Pinder.

Blood and needles

Dr Paul Blenkiron, consultant psychiatrist in York, has helped people with needle phobias to "face their fear in a gradual way", often using cognitive behaviour therapy (CBT).

This approach is all about changing the patient's thinking and behaviour.

"Firstly I get the patient to practise handling needles, then press a needle against their arm and finally, when anxiety has reduced, I carry out an injection," he explains.

It's almost impossible to quantify how many people in the UK have phobias. The list of phobias is never-ending - from ablutophobia (fear of washing) to zoophobia (fear of animals). While for some they are fears, for others they are real clinical problems.

Blood and injury phobia, for example, can be very serious if it results in people refusing to have life-saving operations or avoiding hospitals altogether. People with blood phobias are also particularly prone to fainting.

Emma, who has a phobia of blood, told Anxiety UK about her experience of being hemaphobic: "I have passed out many times in the past, often out in public due to the smallest cuts that most people wouldn't even notice. And by passing out I have caused more damage to myself resulting in stitches and trips to casualty."

Emma's fainting occurs because of a sudden decrease in blood pressure at the sight of blood. This can become a self-perpetuating problem if blood phobics become afraid of fainting as well the sight of blood.

Paul Salkovskis, professor of clinical psychology and applied science at Bath University, says that, "all phobias are cureable, but they don't all require the same treatments".

Those who faint, he says, should try to tighten up their muscles and increase their blood pressure to prevent them fainting.

And he said: "Those who don't faint still have to confront their fear, work out exactly what the specific fear is and then deal with it."

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