Hardly anyone likes to go to the dentist. Some get sweaty hands at the thought of the drill or the anesthetic injection. However, if the fear of going to the dentist goes much further, it becomes dangerous. "With a dental phobia, those affected do not even appear in practice, and often over many years," says Peter Jöhren. The specialist dentist for oral surgery directs the dental clinic Bochum.
According to the Institute of German Dentists, about twelve percent of Germans are very afraid of the dentist. This emerges from a study published in 2012. Those affected have a so-called phobic disorder, they panic when they even think about visiting the dentist. "This can manifest itself, for example, in the form of sweats, palpitations, dizziness and circulatory problems," explains Thomas Wolf, Senior Physician at the Department of Restorative Dentistry, Preventive and Pediatric Dentistry at the University of Bern.
The cause often lies in childhood
Affected people sometimes tremble all over the body, have an increased heart rate, the blood pressure can skyrocket. As different as the symptoms are, so different are the possible causes. "Often it is the pain experienced before, during and after a dental treatment that leads to avoidance in patients," explains Jöhren.
The doctor sees the origin of the disease in many patients at the first dental visits. "If childhood treatments were bad, future dentists will have a hard time regaining confidence," says Oral Surgeon Jöhren. The social environment also plays a role. If relatives or friends are afraid of the dental treatment, this feeling can be transferred to oneself.
So what do you do? Just not going is dangerous: Inflamed teeth, which remain untreated for a long time, can have fatal consequences - not to mention the pain. "Serious acute and chronic diseases are possible," says Dietmar Oesterreich, Vice President of the Federal Dental Association (BZÄK). So bacteria can penetrate beyond the affected tooth deep into the jawbone. Through the bloodstream it can lead to a sometimes life-threatening inflammation in the body. In addition, chronic dental inflammatory diseases according to Austria increase the risk of diabetes, heart attack and stroke.
In addition to health, phobia also affects the socialization of those affected. Destroyed teeth are unkempt and often reduce self-confidence. Because inflamed teeth and gums are often accompanied by more or less strong halitosis, social contacts are often limited.
Under general anesthesia on the treatment chair
So it does not work without phobia. "This is not the job of dentists, but of trained psychotherapists," says Wolf. In case of acute pain that makes a dental therapy urgent, the dentist may treat his patient under sedation or general anesthesia if necessary.
"General anesthesia should only be carried out with acutely necessary treatment," says Oesterreich. Because the phobia is not overcome - and not the problem, what is possibly behind it. In addition, a general anesthetic carries risks. This requires a patient to be informed.
Root treatment during the forest walk
Instead of under general anesthesia, patients can also be put into a state of relaxation by hypnosis. The patient's thoughts are specifically directed to positive experiences - a beach holiday with the sound of the sea, a walk in the woods with a smell of flowers. There are appropriately trained dentists who offer such hypnosis for treatments.
Ultimately, only a psychotherapist can find the right way out of the phobia with the patient. Those affected can, for example, complete a so-called anti-anxiety training. Patients are gently guided by a therapist to the situation at the dentist. "At the first meeting, it is important to use information and empathy to rebuild the trust often lost in the patient to the dentist," explains Jöhren.
Pain free with the favorite music in the ear
The doctor should sensitively inquire about the wishes of the patient and write them down so that they do not get forgotten during the treatment. "It helps some patients, for example, if they listen to their favorite music while listening to the headphones or simply relaxing music in the background," says senior physician Wolf from the Department of Dental, Preventive and Pediatric Dentistry.
Today, due to modern procedures usually a painless dental treatment is possible. "In order for psychotherapy to be successful in the long term, it is crucial that the patient does not have any bad experiences with the dental treatments," emphasizes Jöhren. Even the slightest breach of agreements between therapist, dentist and patient can lead to renewed defensive behavior, warns Jöhren: "The promise of pain-free treatment must not be broken."