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Anxiety, Fear and Phobia in Children

  • In the past, going to the dentist was a painful experience, and one which people dreaded with good reason. Not only were procedures sometimes painful, but the sound of the drill often upset people as well.
  • All that is history. Dental equipment is now far more sophisticated.
    The sound of the drill is now no more than a soft whine, and pain relief is readily available. There are now drill-free treatments that may eventually make the dental drill redundant.
  • Although dental procedures are now usually painless, there can still be some discomfort associated with going to the dentist. It can, for example, be uncomfortable to keep your mouth wide open, but dental procedures are now mainly painless.
  • In spite of these improvements, many people still experience anxiety, fear and even phobia about going to the dentist. This can lead to neglect of dental problems and cause even more severe pain.
  1. What is anxiety?
  2. What are the symptoms of anxiety?
  3. Can anxiety about, or fear of going to the dentist, become a problem?
  4. What is meant by ‘phobia’?
  5. Do children have a natural or inborn fear of the dentist?
  6. How should I prepare my child for visits to the dentist?
  7. What can my family dentist do to ensure that my child doesn’t become a nervous patient?
  8. How can a Paedodontist help a nervous child?

 
1. What is anxiety?

  • Anxiety is a sense of worry, dread or fear about something, which is about to happen. This is a very common feeling.
    Most of the time we cope pretty well with anxiety, but it can intensify into fear.

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2. What are the symptoms of anxiety?

  • Some of the most common and familiar symptoms of anxiety are:
    • “Butterflies in the tummy”.
    • Sweating.
    • Nausea,
    • Diarrhoea.
    • Breathlessness.
    • As mild anxiety becomes fear, these symptoms may increase in intensity.

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3. Can anxiety about, or fear of going to the dentist, become a problem?

  • If anxiety and fear keeps the child away from the dentist, there are increased risks of the teeth being lost.
  • It is important to see the dentist twice a year. If dental problems are neglected they will become worse; they never just go away. Regular dental check-ups will prevent the need for major treatment later on.

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4. What is meant by ‘phobia’?

  • Phobia is a profound dread or terror of a specific situation or thing. It is way out of proportion to any real danger or threat.
    • Some people have a phobia about injection needles, or about going to the dentist, and they may become panic stricken or immobilised with fear at the prospect.
    • Although this fear is unreasonable and irrational, it is nevertheless very real to the person experiencing it.
    • It requires patience and understanding to help with this problem. Being impatient and telling people to “pull themselves together” is unhelpful.
    • Because the fear is irrational, reasoning or explaining the situation, won’t help very much.
    • Young children are fortunately not likely to have phobias.

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5. Do children have a natural or inborn fear of the dentist?

  • No, they certainly don’t. Young children will visit the dentist quite happily and without fear. Unfortunately, this can change if a child has an unpleasant or painful experience at the dentist.
    It is therefore important to keep your child’s teeth brushed, clean and healthy from an early age. Prevention is always better than cure.

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6. How should I prepare my child for visits to the dentist?

  • Visits to the dentist should start at about the age of three, preferably before there are any problems.
    Explain to the child that the visit to the dentist can be fun, and do your best to make it so.
    • Do this in a re-assuring fashion, and present a positive picture of the dentist to the child.
    • If you have your own anxieties about going to the dentist, try not to transmit these to your child.
  • It is helpful if the child doesn’t associate the first visits to the dentist with pain or discomfort.
    This will be harder to achieve if the child already has a toothache.

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7. What can my family dentist do to ensure that my child doesn’t become a nervous patient?

  • The dentist can welcome the child and explain quietly and patiently what he is going to do.
    • Posters illustrating dental care and dental procedures have been specially designed for young children. They are brightly coloured and rely on pictures rather than words.
    • Careful handling of children, and re-assuring words are also important.
    • It is advisable for the parent to be present to comfort and encourage the child.
    • Many dentists give small rewards and incentives to children.
    • Stickers or buttons saying something like “I was a brave girl (or boy) at the dentist” can be worn with pride by a small child.
    • Making a collection of these small rewards can give a child something to look forward to at the next dental appointment.
    • This is all much more difficult if the child has painful dental problems that have to be solved.
    • Your dentist will advise on how to avoid these painful dental problems. This is can be achieved with a low-sugar diet, brushing twice a day and flossing at night.

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8. How can a Paedodontist help a nervous child?

  • Paediatric Dentistry is a specialist branch of dentistry for children.
    • The Paedodontist treats children only, and is highly skilled in the practice of dentistry and the psychology of children.
    • The aim is to make the visit to the dentist a pleasant outing for the child.
    • Many dentists have difficulty coping with nervous children, who can be referred to a Paedodontist.
      Nervousness, restlessness and other behavioural difficulties can make good dental treatment difficult or even impossible.
      Very nervous children should always be referred to a paedodontist, who is specially trained to deal with these problems.

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