Young people who have experienced bullying, divorce, violence or abuse are significantly more likely to be anxious in the dentist’s chair. And this angst may cause some people to avoid going to the dentist, while others feel an intense urge to flee once they are there.
This is according to a study – “Associations of adverse childhood experiences with dental fear, and the mediating role of dental fear on caries experience: the Young-HUNT4 Survey” by Lena Myran, Yi-Qian Sun, Göran Dahllöf, Tiril Willumsen, Anne Rønneberg, Audun Havnen, Therese Kvist, Abhijit Sen, and Hedda Høvik – that was published in BMC Oral Health.
It is estimated that between 8% to 20% of children and adolescents are so afraid of dental treatment that they meet the criteria for being diagnosed with dental fear. The researchers, thereby, wanted to know why so.
Lying on your back can make you feel vulnerable
The study, with responses from more than 5,800 adolescents aged 13-17 years, showed that adolescents who have experienced stressful experiences during childhood, such as violence, divorce, abuse or bullying are significantly more likely to have dental fear than adolescents who do not have such experiences.
The researchers found that the more stressful experiences the young people had, the great was the likelihood that they would have dental fear. The study also shows that the association was stronger in girls than in boys.
“For many people who have experienced a lot of insecurity in childhood, dental treatment can be demanding. The patients lie on their backs in a vulnerable position while an authority figure works inside the mouth. It’s no wonder that dental treatment can be difficult,” said co-researcher Myran.
Myran noted that their study may not have provided a basis for saying what is cause or effect, but “we can only see if there is a connection” as they found a clear link between dental fear and various types of painful childhood experiences, including bullying.
“Bullying means being systematically rejected and ridiculed. If you have experienced bullying, you may have a hypersensitivity to other people’s intentions. There may be periods during dental treatment where it is silent, and you do not quite know what the dentist is thinking. This may be similar to situations where these individuals have felt insecure. For people who have been bullied, saying what you think and feel may have felt dangerous,” said Myran.
Myran was surprised that the correlation between painful childhood experiences and dental fear was stronger in girls than in boys.
“We know that dental fear is more common among girls and that more girls than boys have experienced sexual abuse. There are also more girls than boys who develop anxiety and depression in adolescence, but the fact that we found such a clear difference in our material was still surprising,” Myran said.
She believes the findings should have consequences for how the dental health service treats young people.
“When dental professionals meet frightened patients, they can ask about the cause. Patients often find it safe for the dentist to ask. Patients know that the dentist is not a psychologist, so it does not have to be a long conversation. But by taking the patient’s experiences and fears into account, dental professionals can contribute to better dental health and safer patient experiences,” said Myran.
For the researchers, it is important “to talk to your dentist or dental hygienist about how you feel. Just telling your dentist that you are afraid can help an incredible amount. Even a short sentence about your fears will lead many dentists to be more sensitive. The dentist is a good friend who should help, and you don’t have to ask in any specific way, but just say that you are afraid,” Myran ended.
