Re: Iatrosedation

Dental fear refers to the fear of dentistry and of receiving dental care. A severe form of this fear (specific phobia) is variously called dental phobia, odontophobia, dentophobia, dentist phobia, or dental anxiety. However, it has been suggested that the term "dental phobia" is often a misnomer, as many people with this condition do not feel their fears to be excessive or unreasonable and resemble individuals with post-traumatic stress disorder, caused by previous traumatic dental experiences.
Incidence

It is estimated that as many as 75% of US adults experience some degree of dental fear, from mild to severe.] Approximately 5 to 10 percent of U.S. adults are considered to experience dental phobia; that is, they are so fearful of receiving dental treatment that they avoid dental care at all costs.Many dentally fearful people will only seek dental care when they have a dental emergency, such as a toothache or dental abscess. People who are very fearful of dental care often experience a “cycle of avoidance,” in which they avoid dental care due to fear until they experience a dental emergency requiring invasive treatment, which can reinforce their fear of dentistry.

Women tend to report more dental fear than men,and younger people tend to report being more dentally fearful than older individuals. People tend to report being more fearful of more invasive procedures, such as oral surgery, than they are of less invasive treatment, such as professional dental cleanings, or prophylaxis.
Causes
Direct experiences

Direct experience is the most common way people develop dental fears. Most people report that their dental fear began after a traumatic, difficult, and/or painful dental experience.However, painful or traumatic dental experiences alone do not explain why people develop dental phobia. The perceived manner of the dentist is an important variable. Dentists who were considered "impersonal", "uncaring", "uninterested" or "cold" were found to result in high dental fear in students, even in the absence of painful experiences, whereas some students who had had painful experiences failed to develop dental fear if they perceived their dentist as caring and warm.
Indirect experiences

* Vicarious learning: Dental fear may develop as people hear about others’ traumatic experiences or negative views of dentistry (vicarious learning)

* Mass media: The negative portrayal of dentistry in mass media and cartoons may also contribute to the development of dental fear.

* Stimulus Generalization: Dental fear may develop as a result of a previous traumatic experience in a non-dental context. For example, bad experiences with doctors or hospital environments may lead people to fear white coats and antiseptic smells, which is one reason why dentists nowadays often choose to wear less "threatening" apparel. People who have been sexually, physically or emotionally abused may also find the dental situation threatening.The dental situation may be especially difficult for people who have experienced forced sexual intercourse which included oral penetration.

* Helplessness and Perceived Lack of Control: If a person believes that they have no means of influencing a negative event, they will experience helplessness (see Learned helplessness). Research has shown that a perception of lack of control leads to fear. The opposite belief, that one does have control, can lead to lessened fear. For example, the belief that the dentist will stop when the patient gives a stop signal lessens fear. Helplessness and lack of control may also result from direct experiences, for example an incident where a dentist wouldn’t stop even when the person was in obvious pain.

Diagnosis

Phobia of dental care is sometimes diagnosed using a fear measurement instrument like Corah’s Dental Anxiety Scale or the Modified Dental Anxiety Scale.