A fifth of adults in Sweden report dental anxiety

In Sweden, approximately one in five adults suffers from dental anxiety or phobia. The number has decreased over time, but still an important part of the population have major problems, according to a recent doctoral thesis from the University of Gothenburg.

The thesis includes a nationwide interview study involving 3,500 adult individuals, randomly selected from the general population of Sweden. Nineteen percent of the participants reported some degree of dental anxiety, fear or phobia.

The results showed that 4.7% of the respondents described their dental anxiety as severe, 4.5% as moderate and 9.8% as low. The remaining 80.9% reported no dental anxiety. The proportion with no dental anxiety was more than twice as high as in a similar study from the 1960s, when 38.5% of respondents reported no dental anxiety.

"There's been a marked change: people aren't as anxious of dentistry anymore," says Lisa Svensson, who has a doctorate in Odontological Science, department of Behavioral and Community Dentistry , Institute of Odontology, at Sahlgrenska Academy, University of Gothenburg, and is a dentist in Sweden's Public Dental Service, Region Västra Götaland.

Public health problems

Svensson stresses that preventive dentistry for children and adolescents has been a crucial factor. It has created good habits, improved dental health, and thus reduced the need for extensive dental procedures early in life. Better communication and a more equal relationship between dentist and patient are as well important factors to this improvement.

On the other hand, dental phobia is so common that it is a public health problem, Svensson emphasizes. Her doctoral studies focused particularly on individuals with severe dental anxiety. Of these, 85% said their daily life was affected by mouth or tooth problems, and 78% reported dental pain and graded their pain at a high intensity.

"The most highly anxious people often have negative experience of dental care, with a lot of pain involved. But the feeling of vulnerability can also be due to previous experience of trauma as assault involving the face and mouth, or sexual abuse," Svensson says.

Marked comorbidity

"There's a high degree of comorbidity in this group," she states. "People with severe dental anxiety are often prone to anxiety, depression, other specific phobias or some other mental disorder."

Dentists and other dental staff meet and treat patients with severe dental anxiety every day. Even people with severe phobia of dental care attend dental care regularly, despite their fear.

"Among the highly dentally anxious study participants, pain and not being in control were the most common causes of dental anxiety. For a dentist, these factors are relatively easy to control, and if we do, we're engaging in both preventive dentistry and treatment of severe dental anxiety," Svensson says.