Past trauma brings fear to dentist's chair

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DENTAL phobia has nothing to do with going to the dentist. It is triggered by other traumatic experiences which become accidentally associated with the dental surgery, according to a study published in the British Dental Journal this week.

One in ten people has a phobia of the dentist and studies stretching back 70 years show that the level is unchanged since the days of treatment with pliers and oil of cloves. Despite huge advances in techniques and anaesthetics which have rendered dentistry an almost painless affair, the same proportion of patients today as in the Thirties suffer such intense anxiety they avoid treatment.

Dr Ruth Freeman, of Queens University Dental School, Belfast, who wrote the article, says that if dental phobia were related to previous painful experiences in the dentist's chair its incidence ought to have fallen as techniques improved. That it hasn't suggests that dental phobia in both adults and children arises when anxiety is transferred onto dentistry from experiences outside.

A five-year-old child became distressed during a visit to the dentist because the white coat worn by the dentist reminded him of the hospital where his twin brother died. His mother had told him that angels had come to the hospital to take his brother to heaven. When he saw the dentist's white coat he thought the angels had come to take him to heaven.

In a second case, a 23-year- old woman associated a childhood accident in which she fell off a swing damaging her teeth with the beatings that her alcoholic father meted out to her mother. She had a general anaesthetic to extract the damaged tooth and remembered waking with blood on her lips and in her mouth - just like the blood she had seen on her mother's mouth.

Dr Freeman said: "Dental phobia may remain at a similar level in the future because life experiences will always influence a person's feelings about going to the dentist. However, there are techniques which can help them overcome their anxiety."

Psychologists use behaviour therapy and relaxation techniques to help people who are too afraid to visit the dentist to become accustomed to the sights, sounds and other experiences associated with treatment. Those who can visit a dental practice can be given sedation, advised about pain control and how to stop treatment with a signal.