Characteristics of early unpleasant dental experiences

Negative events and their potential risk of precipitating pathological forms of dental anxiety

“…A large array of studies on dental anxiety suggests that the experience of pain is one of the most powerful conditioning experience in terms of the development of dental phobia (see, for example, Davey, 1989;Liddell & Gosse, 1998;Locker et al, 1996;Skaret et al, 1998;Vassend, 1993). Among the wide variety of dental experiences potentially predisposing to pathological forms of dental anxiety investigated in the present study, including pain, the retrospective report of helplessness during treatment was found to be most Table 3 Final results of the stepwise logistic regression analysis in the analysis of 'high dental anxiety' (1 = yes, 0 = no) and 'fulfilling criteria for dental phobia' (1 = yes, 0 = no).…”

“…Some examples of the first category involve (a) invasive dental treatments, for instance, root canal treatments or injections (see, for example, Abrahamsson et al, 2002;Berggren & Meynert, 1984;Davey, 1989;Liddell & Gosse, 1998;Locker, Shapiro, & Liddell, 1996;Moore et al, 1991;Stouthard, Rijkse, & Van den Berg, 1992;Vassend, 1993); (b) pain (see, for example, Abrahamsson et al, 2002;Berggren & Meynert, 1984;Davey, 1989;De Jongh et al, 1995;De Jongh, van der Burg, van Overmeir, Aartman, & van Zuuren, 2002;Skaret, Raadal, Berg, & Kvale, 1998;Versloot, Veerkamp, & Hoogstraten, 2008); (c) distress caused by dentist behavior (see, for example, Abrahamsson et al, 2002;Stouthard et al, 1992); (d) distressing emotional responses to dental treatment (for example, feelings of helplessness or loss of control; see De Jongh et al, 2002Moore, Brodsgaard, & Rosenberg, 2004); and (e) distressing stories told by important others (Abrahamsson, Berggren, & Carlsson, 2000;Moore et al, 1991). Examples of traumatic stressors reported by subjects with pathological forms of dental anxiety are (a) sexual abuse (see, for example, Leeners et al, 2007;Walker, Milgrom, Weinstein, Getz, & Richardson, 1996;Willumsen, 2004); (b) war trauma (Friedlander, Mills, & Wittlin, 1987); (c) severe traffic accidents (Smyth, 1999); (d) a tragic death of a loved one (Berggren, 1992); (d) a distressing medical experience (Lautch, 1971); and (e) physical assault (De Jongh et al, 2006;Walker et al, 1996).…”

The contribution of embarrassment to phobic dental anxiety: a qualitative research study

“…Many of these subjects probably exhibited learned distrust of dentist behaviors, which was confused with symptoms of social phobia. Liddell and Gosse [13] referred to the Danish studies described above and noted the distinction between conditioned social distrust at the dentist versus fears of negative dentist evaluation in a sample of graduate students with dental anxiety. Present results also confirm a clinical distinction between distrust of dentists versus embarrassment, shame or guilt as chief complaint and primary problem.…”

“…Since symptomatology and clinical significance are important in differential diagnosis of anxiety disorders, it seems that the influences of embarrassment, shame or guilt on dental anxiety have been relatively neglected in the literature. Inspite of the fact that the dentist-patient clinical situation is a social situation and that several studies have also pointed to negative dentist behavior as highly anxiety provoking [4,7,8,11,13-16], descriptions of possibilities for the existence of social anxiety, defined as intense fear of negative evaluation [17,18] or humiliation [19] in social situations, have been few for patients suffering with dental anxiety [7,8,13]. …”

Salivary cortisol level and uncooperative behavior in pediatric dental practice

“…Several authors have reported that stress in patients leads to the manifestation of non-cooperation pediatric dentistry behavior that hinder or prevent the completion of dental procedures 27 . Some authors suggest that fearful children have often a painful history of treatments and/or unpleasant events in their first visits to the dentist [26][27][28] . The children in this study had not experienced dental curative treatments, but they had been exposed several times to preventive procedures.…”