Dental phobia

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Classification according to ICD-10
F40.2 Specific (isolated) phobias
ICD-10 online (WHO version 2019)

The dental phobia , also called dental phobia , dentophobia, oral phobia or odontophobia, is a specific phobia . The exaggerated fear almost always leads to years of avoiding dental treatments and is of the non-pathological dental anxiety distinguished.

causes

A frequent but not the only cause of dental phobia are negative experiences. The fears learned can be directed against certain aspects of dental treatment, for example fear of injections .

Prevalence

There are no large-scale studies on the frequency of this disorder, which is also significant in terms of social medicine . It is estimated that around five to ten percent of the population of western countries will be affected. On the relationship between “specific phobia” and “simple fear”, a study in 2002 reported on 70 consecutive patients at the Center for Odontophobia at the University of Bergen in Norway, of whom 33 (47%) met the diagnostic criteria for odontophobia, 24 (33%) ) only had severe fears, while the rest received multiple diagnoses according to DSM-IV .

Prevention and therapy

Phobia as a treatment difficulty means that an appropriate, fear-reducing atmosphere is important to the practice. For the diagnosis of anxiety, there are standardized questionnaires that are used in practices that focus on this treatment. There the patients are treated according to a scientific therapy plan.

In the case of very high anxiety levels, an interdisciplinary therapy approach by the dentist and psychotherapist is recommended , since the therapy of first choice is cognitive behavioral therapy with exposure. The trauma therapy method of Eye Movement Desensitization and Reprocessing (EMDR) is the therapeutic approach of the second choice. For acute therapy in emergency situations, when the therapy of first choice is not available, the use of an oral benzodiazepine (e.g. midazolam) is recommended dental treatment is possible as a first-choice therapeutic agent. As an alternative to the oral benzodiazepines, nitrous oxide can be used (therapy of the second choice). An indication for the use of general anesthesia is only given in limited exceptional cases (therapeutic agent of the third choice). Treatment under general anesthesia cannot cure a phobia. The German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK) or the Institute for Psychosomatic Dentistry conduct special training for dentists in the treatment of phobic patients .

Assumption of costs

The phobia of dental treatment is recognized as a mental illness (ICD-10 GM 2006 F40.2), therefore the health insurance companies cover the costs for psychotherapy with a contract psychotherapist or contract doctor with appropriate additional training. A dentist may only provide psychotherapeutic services at the expense of the health insurance companies if he is also licensed to practice medicine as an appropriately trained doctor.

literature

  • S3 guideline (long version) Dental treatment anxiety in adults , AWMF registration number: 083-020 As of: October 2019, valid until: October 2024
  • Hans-Christian Kossak , Gisela Zehner: Hypnosis at the children's dentist. Behavioral Leadership and Communication. With 14 tables (with online video). Springer, Berlin 2011, ISBN 978-3-642-17737-8 .
  • Dominik Groß, Karin Groß: Dealing with fearful dental patients from an ethical point of view. In: ZWR - Das Deutsche Zahnärzteblatt , 121/6, 2012, pp. 202–209.

Web links

Individual evidence

  1. ↑ Scientific statement of the DGZMK (PDF; 235 kB)
  2. ↑ G. Kvale, M. Raadal, M. Vika, BH Johnsen, E. Skaret, H. Vatnelid, I. Oiama: Treatment of dental anxiety disorders. Outcome related to DSM-IV diagnoses. In: European journal of oral sciences , Volume 110, Number 2, April 2002, pp. 69-74, ISSN  0909-8836 . PMID 12013565 .