Dental and periodontal health, oral health-related quality of life and life satisfaction in patients with severe dental phobia

As a "simple phobia", dental phobia is often dismissed as a harmless anxiety disorder and relegated to the domain of dentists, who can treat the dental diseases but not the anxiety disorder. The subjective burden of patients with dental phobia is indicated by numerous studies showing reduced oral health-related quality of life (OHRQL). We aimed to assess the biopsychosocial consequences from objective oral manifestations to the previously unknown effects on life satisfaction. In our cross-sectional study, 61 dental phobic patients and 69 age-matched non-anxious patients were recruited before treatment under endotracheal anesthesia. In addition to a higher caries burden, dental phobic patients had a higher prevalence of periodontal diseases. Their OHRQL was reduced, with shame and affective impairment due to dental problems being most prominent. They were significantly dissatisfied with almost all aspects of daily life. In particular, their dissatisfaction with themselves, their sexuality, their friendships, and their financial situation were associated with oral health-related shame. The shame-inducing fear of being stigmatized because of visible dental problems appears to contribute to discomfort and withdrawal from social and intimate contacts. The consequences of untreated dental phobia highlight the importance of early psychotherapy and a trusting, non-shaming therapeutic relationship in dental treatment.