Are you Afraid of the Dentist?

By: Munir Gomaa, D.M.D.

What’s not to fear?


Author: Munir Gomaa

Four years of dental school, a license to practice dentistry in hand…and the thought of going to the dentist still gives me the chills..
I get it. Dentists are mysterious creatures who reveal only 50% of their face at a time, poke you with sharp instruments and drill through your teeth like it’s butter. When taken out of context, they actually make for a perfect villain.

It thus comes as no surprise that 5-8% of Americans are so consumed by fear of the dentist that they avoid going altogether, only to experience an abundance of oral health problems that work to fuel this fear. Around 1 in 5 Americans possess a degree of dental anxiety that prevents them from seeking out dental care unless it becomes absolutely necessary, generally due to intolerable pain or lack of proper functioning. And by the time they do seek care, it’s often too late to save the teeth in question.

Dental fear and anxiety has been, and continues to be, a widespread problem among all populations. It has inevitably contributed to a “vicious cycle dynamic”, in which fear of dental treatment, lessened use of dental services, and consequent oral diseases continuously reinforce one another.


Munir Gomaa Figure 1

A collection of variables are commonly responsible for establishing a lasting fear of the dentist. Some of these variables are discussed in this article. According to several studies, the onset of dental fear and anxiety usually occurs in childhood. Oftentimes the reason is directly related to traumatic dental experiences in the past. Sometimes this fear is deeply rooted in entirely non-dental experiences, such as childhood sexual abuse (rather disturbing findings implicating this relationship can be found here), post-traumatic stress disorder, general anxiety disorders, or even substance abuse. However, just as often, personal trauma has little or nothing to do with it.

A rather frustrating fact of life demonstrated by several studies is that parents can easily transmit their fears and anxiety to their children. Children actually learn from their parents to become fearful of spiders, social situations, or the dreaded dentist, and the mechanism of this transmission is subtle yet powerful. One study demonstrated that parents’ degree of vulnerability to certain general, non-dental related perceptions, namely uncontrollability, unpredictability, and dangerousness, reliably predicted their child’s level of dental fear. Another study found evidence that there is a genetic component to dental fear in addition to environmental influences. This study demonstrates that fear of pain is a genetically heritable trait, and that this fear is significantly associated with dental fear.


With the presented knowledge in hand, I’m prescribing a less intuitive approach to battling dental phobia. Since vulnerable perceptions of adults can be so easily and unintentionally inherited, both socially and biologically, by their children, it’s important for dentists to focus on alleviating fear and anxiety present in their adult patients. When treating the fearful adult patient, most dentists assume that fear is so fortified that it’s useless to try and address it. Instead, they focus on temporary solutions, such as distraction techniques or compromising the treatment plan, to allow for resolution of immediate dental needs. The fear lingers and is nurtured until the next visit.

It’s also important for dentists to inform their adult patients of this very apparent risk, as they can play a large role in preventing transmission by concealing their fears or reservations from their children, or even their younger siblings or relatives, as they work on eliminating or minimizing these qualities in themselves. It’s crucial to take cautious advantage of the openness and moldability of a child’s brain by encouraging a positive attitude towards the dentist and oral hygiene, preventing a plethora of dental problems down the road.

By Munir Gomaa

Insightful read for dental practitioners–keep your patients happy

Posted by Munir Gomaa

I ran across this article and thought it’d be useful for new dental practitioners out there. Included are creative methods, some more obvious than others, that might help give dentists an edge in building healthy, lasting relationships with their patients.

My personal favorite is perhaps the most obvious one–likely why it’s the first to be listed–and that is remembering who they are! Not just their names, but their stories–to the extent which they’ve felt comfortable sharing with you during past appointments, of course. Remembering their interests, fears, and families among other qualities will help build positive, comfortable and trusting relationships, ultimately helping you deliver the best quality care you can while maintaining a warm, friendly environment.  Seems rather intuitive, but it can surely become a difficult task when you’re seeing over a thousand patients! Documenting highlights of your conversations with patients along with your post-op note is always a good idea.

Click here for another recent post on “Stress in the Dental Profession and…Horses” by Munir Gomaa

Stress in the dental profession and…horses

By: Munir Gomaa

It’s certainly no secret, especially to dentists and their families, that the dental profession is an inevitably stressful career. The multifaceted role that a dentist plays–as a clinician, an entrepreneur, a manager, a lab technician (perhaps dental students like me assume this role more than actual dentists), a therapist, and in several ways, an artist–establishes a natural tendency towards perfectionism. After all, financial success for the dental business owner does depend on the dentist’s ability to succeed in all of these facets. Proper fulfillment of these roles demands paying continuous and precise attention to detail during diagnosis and treatment, satisfying patient’s and staff’s evolving needs, and, perhaps most importantly, nurturing the dentist’s own mental health.

Juggling all of these responsibilities in a productive and time-efficient manner takes an incredible toll on the mental health of dentists. It’s no surprise that dentists rank #2, after medical doctors, in careers with the highest suicide rates.

An interesting article I ran across uses empirical data to prescribe a most natural kind of medication to alleviate stress–for dentists, physicians and, quite frankly, anyone with a stressful career or lifestyle–called horses.



Apparently, this mysterious creature’s heart emits an electromagnetic field five times larger than the human heart (which translates to a field extending 40-50 feet from the horse’s body!) According to research, a horse’s electromagnetic field directly influences the nearby human’s own heart rhythm by increasing its coherence–and a heart with increased coherence is directly associated with tranquility, happiness and well-being.

In fact, the physiological and psychological benefits of being around horses don’t stop there; research shows decreased heart rate and blood pressure, reduced feelings of stress, anxiety and anger, increased levels of endorphins, heightened feelings of empowerment, patience and self-efficacy, and the list goes on. Several of these effects work together to alleviate depression, which recent research has associated with a higher risk of cardiovascular disease.

Dr. Bethany Piziks, a dentist and certified life-coach, incorporates this surprisingly effective method in coaching her clients. She uses a method called “Equine Gestalt Coaching Method (EGCM)”, in which two life coaches, a horse and a human, work to help dentists alleviate stress, depression and work through longstanding personal-dilemmas to promote self-development. The outcomes achieved by her client’s are pretty incredible. Highly recommend this article to any and all stressed individuals!

Sources: Stress in the dental profession and why a horse could save your life”Top 11 professions with highest suicide ratesDepression and Cardiovascular Problems

By Munir Gomaa