FEAR OF PAIN: CASE STUDY INMA

Nobody likes going to the dentist. But for some people, the problems run deeper and form a phobia. The causes of dental phobia can be many and varied. This case study is of a patient whose dental phobia was centred on a fear of pain.

The Patient Inma was in her early-30s and had been unable to visit her dentist for many years. One element in the phobia was her memory of having 1cavities when she was a young girl. She remembered the
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fillings as being very painful. This resulted in a desire not to return to the dentist, which became a

phobia as she constantly delayed and missed appointments.

Most of us would prefer not to suffer any pain. However, for people who suffer from dental phobia, the idea of the pain is often much worse than the pain itself. In fact, Inma was a contradiction in terms. While she was unable to visit the dentist because of a pain phobia, she suffered almost constant pain from teeth that eventually required urgent attention.

Similarly, many of us have childhood memories of visiting the dentist and experiencing pain. In the case of phobias, it is also important to remember that those visits were often long ago. Memories have become 3warped over time and, even if the pain was acute, modern dental practices means that patients feel much less pain nowadays than they did even as recently as ten years ago.

The scenario Because Inma was suffering from an acute dental phobia, she had not seen a dentist for several years. Therefore as well as not receiving 4suitable levels of dental treatment, she had also lost any sense of a relationship with her dentist. This meant that she had had no opportunities to articulate her fears, express her concerns or 5gain any sort of professional 6reassurance. In fact, by staying away from the dentist she had probably increased her sense of fear as there had been nothing to
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counterbalance her imagination. All she had to create a mental picture of the dentist were her

memories of painful childhood treatment.

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At the same time, the pain in her teeth from not visiting the dentist was growing. One of the fillings that she had when she was younger had become 8loose and needed replacing. She was also suffering some pain from impacted 9wisdom teeth. The long time periods between her visits to the dentist meant that she had not just
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missed out on running repairs to her teeth. She had also

missed out on the 11ongoing advice, proactive ideas and preventative care that dentists can offer. This may have helped her future visits to the dentist to go more 12smoothly and to be pain-free.

The symptoms The symptoms for Inmas dental phobia were shortness of breath and difficulty breathing. At the thought of visiting the dentist, she would experience factor in her phobia, 14heightening the sense of fear.
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tightness in her chest and anxiety. The

thought of experiencing these types of symptoms while in the dentist chair acted as an additional

In this case, the symptoms were probably a natural response by the body. After all, the patients brain is giving advance warning to the rest of the body that pain is coming. The problem is that the warning from the brain and the bodys response are disproportionate to the threat in question.

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