Male dental anxiety

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male dental anxiety
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A Queensland dentist is shining a spotlight on the issue of male dental anxiety in the hope men will be more proactive when it comes to the long-term protection of their teeth. By Tracey Porter

Queensland dentist Dr Cherie Yam understands that when a male patient seeks assistance with an oral health issue, there’s a good chance he has had to dig deep just to get through the door. Dr Yam believes that not only do men put off going to the dentist more often than women, but they are also more likely only to turn up when their problem is acute.

Dr Yam, founder and principal dentist of Dentists In Yamanto, says that while the scientific evidence generally indicates that dental fear is far more prevalent in women than men, anecdotal evidence suggests otherwise.

“Over the years there have been many studies on gender-related health disparities, in particular, oral health. Men have been found to attend for acute problems only, whereas women are more likely to attend for disease prevention.

“My insight into this general disparity is very much what I have observed throughout my career and people I am connected to who have made me realise that this is very much across the board in healthcare.”

A 2010 survey ‘The extent and nature of dental fear and phobia in Australia’ sought to better understand phobia prevalence estimates as well as the nature of dental anxiety in patients. 

The survey found that the prevalence of high dental fear ranged from 7.8 to 18.8 per cent across four different measures of dental fear and phobia.

A single-item dental anxiety and fear measure asked participants whether they would feel “afraid or distressed when going to the dentist”. Responses were ranked from 1 (not at all) to 5 (extremely distressed), and the findings showed more than one in four (25.3 per cent) of Australian females were at least moderately afraid or distressed about going to the dentist, compared to only one in 10 (11.7 per cent) of males.

As we know with the nature of dental disease, progression and treatment options can quickly escalate and often that line in the sand is the presence of some kind of pain. A lot of the time this is linked to some form of previous trauma often in childhood which has stayed with the patient for decades.

Dr Cherie Yam, founder, Dentists In Yamanto

A second study, ‘Male Gender and High Trait Anxiety Are 2 Major Factors Associated With Severe Dental Fear and Avoidance’ found that although women represent a large majority of the total population of patients with dental fear, a greater proportion of men than women were classified as being severely difficult to treat.

“Generally, compared with women, men pay fewer visits to the dentist to receive dental care and have fewer opportunities to visit clinics. Therefore, more men than women may be classified as being severely difficult to treat because few male patients visit dental clinics for more easily treated conditions,” the report noted.

Dr Yam says while traumatic dental experiences of men can cause initial avoidance, as time passes, male patients are aware they might have left it too long and will often “put up with the pain until they have to go in. This cycle of on-off pain can give patients, in particular men, the idea that, ‘It will just pass if I wait long enough’.”

For men who are dental phobic, it can be even longer between visits. 

In addition to working as a general dentist across the state, Dr Yam has also spent time volunteering her dental skills in India, Nepal and the Philippines. She says during this time she’s seen a range of debilitating cases of dental phobia in men. Symptoms range from what she calls “extreme gaggers” who cannot handle a mirror in the mouth to “needle phobics” who faint at the sight of a needle.

“The most telling and simple evidence is when you have a patient who says, ‘I’ve been in pain for eight months’. As we know with the nature of dental disease, progression and treatment options can quickly escalate and often that line in the sand is the presence of some kind of pain. A lot of the time this is linked to some form of previous trauma often in childhood which has stayed with the patient for decades.”

One reason for this heightened anxiety in males is the different ways different genders cope with anxiety disorders.

Scanners have been very useful to replace conventional impression taking. Patients can find impressions very overwhelming and sometimes violent (for removing impression material), so we’ve seen positive results with patients who are gaggers or generally anxious about this procedure.

Dr Cherie Yam, founder, Dentists In Yamanto

Psychologist Rachel Tomlinson, of Toward Wellbeing, says while women tend to ruminate on things and more typically express their feelings and fears, men can feel ashamed of their fear and keep it in, or exhibit a secondary emotional response such as anger when scared. 

Tomlinson says emotional regulation can help patients of both genders manage discomfort or pain experienced during dental procedures. In addition, it can also help dental phobic male patients maintain focus and be more present during appointments, allowing them to better follow instructions, making treatments more effective and “possibly” briefer.

Dr Yam says there are many ways dentists and practice managers can encourage their male patients—dental phobic or not—to visit the dentist more often.

The best way is to ensure they keep an open line of communication. Taking the time at the beginning of the consult to talk about their day before delving into their dental issues can work wonders, she says.

Sound is often the trigger for many dental phobics, so noise cancelling headphones plugged into a ceiling TV can work wonders for those enduring long restorative appointments while a blanket can make the patient feel protected in a vulnerable situation, Dr Yam suggests.

“Scanners have been very useful to replace conventional impression taking. Patients can find impressions very overwhelming and sometimes violent (for removing impression material), so we’ve seen positive results with patients who are gaggers or generally anxious about this procedure.”

While anxiolytics can be prescribed, Dr Yam says she will always investigate other options first, especially for more routine appointments. For needle phobics, it often pays to leave the topical anaesthetic on for a bit longer before injecting, she advises.

“Most importantly of all—go slow. If there is rush and panic from the dentist, there will be concern from the patient.”  

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