Has part of you thought about why you dread dental appointments so much that you’ve cancelled or just never booked? Is this just nerves? Or is it something clinical? The short answer: it depends on the severity.
Dental Anxiety vs. Dental Phobia
Dental anxiety is a general feeling of unease, worry, or apprehension about visiting the dentist. It’s uncomfortable, but most people with dental anxiety can still get themselves into the dental chair for a teeth cleaning or checkup — even if they’re white-knuckling it the whole time. This level of nervousness is extremely common and does not qualify as a mental illness on its own.
Dental phobia, sometimes called dentophobia or odontophobia (but not related to anti-dentism), is a different issue entirely. This is an intense, irrational fear that can be crippling and leads to complete avoidance. People with dental phobia will endure toothaches, gum infections, and serious tooth decay rather than step foot in a dental office. They may experience panic attacks, nausea, difficulty breathing, or insomnia just thinking about an appointment.
The American Psychiatric Association recognizes dental phobia as a specific phobia disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So yes, at its most extreme, fear of the dentist absolutely falls under the umbrella of a diagnosable mental health condition. An estimated 15% of people worldwide report clinically significant dental anxiety, with women more frequently affected than men.
Where Does Normal Nervousness End?
In our other post about How Common Is Dental Anxiety, we show that everyone sits on a spectrum. A little anxiety before a dental procedure is perfectly normal, most people aren’t exactly thrilled about having their mouth examined and their plaque scraped away. That’s not a disorder. That’s being human.
It crosses into clinical territory when the fear becomes disproportionate to the actual threat, persists for six months or more, and significantly disrupts your life. If you’re losing sleep, avoiding all dental treatment, or letting oral health problems escalate because you simply cannot bring yourself to go, that’s worth paying attention to.
The Vicious Cycle of Avoidance
Here’s where things get tricky. Dental anxiety and avoidance feed each other in a loop that’s hard to break. You skip your dental checkup because you’re anxious. Your oral hygiene suffers. Cavities form. Gum disease develops. Now the dental work you need is more extensive — and scarier — than the routine cleaning you originally avoided. The anxiety grows, and the cycle continues.
In Canada, this pattern plays out on a large scale. A national survey found that over 400,000 Canadian adults skipped dental visits in a single year specifically because of fear or anxiety. Over their lifetimes, more than 1.5 million Canadians have missed, cancelled, or avoided a dental appointment for the same reason. Among those with the highest levels of fear, nearly half had avoided care at some point.
Breaking this cycle is critical, not just for your oral health but for your overall well-being. Research consistently links poor dental health to broader health issues including heart disease, diabetes complications, and respiratory infections.
Other Mental Health Conditions Can Make It Worse
Dental anxiety doesn’t always exist in isolation. People with generalized anxiety disorder, PTSD, depression, or panic disorder are significantly more likely to experience heightened fear around dental visits. If you already struggle with anxiety in other areas of your life, it makes sense that the dental chair would be another trigger.
This is why a holistic approach matters and we can look at How Do You Overcome Dental Anxiety?
Getting Help Is Easier Than You Think
Whether your fear is mild or severe, you don’t have to go through it alone. Working on it takes time, but at the dental office, modern sedation options like sleep dentistry can make even the most anxious patients comfortable during treatment. Talking to a dentist who has a professionally trained team that caters to the dental anxiety spectrum can help you immensely.
References
- Chanpong, B., Haas, D.A., & Locker, D. (2005). Need and demand for sedation or general anesthesia in dentistry: A national survey of the Canadian population. Anesthesia Progress, 52(1), 3–11. PMC2526218
- Silveira, E.R. et al. (2021). Estimated prevalence of dental fear in adults: A systematic review and meta-analysis. Journal of Dentistry, 108, 103649. medRxiv preprint
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Specific Phobia Disorder criteria. Cleveland Clinic overview
- Carlsson, V. et al. (2022). Treatment of dental anxiety and phobia — Diagnostic criteria and conceptual model of behavioural treatment. Int. J. Environ. Res. Public Health, 19(1), 198. PMC8700242
